Defense Date


Graduation Date

Summer 1-1-2017


Immediate Access

Submission Type


Degree Name





School of Nursing

Committee Chair

Joan Such Lockhart

Committee Member

Melissa Kalarchian

Committee Member

Lenore K. Resick

Committee Member

Anita P. Courcoulas


retention, attrition, longitudinal research, bariatric surgery, retention strategies, barriers, facilitators, participation motivation, qualitative research, research participation


Problem: Longitudinal bariatric surgical research studies often lack information on retention and attrition of study participants and the strategies utilized to optimize these. The potential for attrition bias with adverse effects on validity, reliability, and generalizability increases over time. The many factors potentially affecting retention and attrition in research, have been under studied.

Purpose: The purpose was to explore factors affecting research participation of bariatric surgical patients who are subjects in the Longitudinal Assessment of Bariatric Surgery (LABS) study. The research questions explored research participants’ perceptions, motivations, and attitudes concerning participation in the study, specifically participation in annual in-person visits as well as routine annual clinical follow-up, and factors that impeded or facilitated “complete” participation.

Design and Methods: A qualitative descriptive design with a non-probability, maximal variation sampling technique were utilized. Because the purpose was to explore factors related to research participation from the perspective of bariatric surgical research subjects, the statistically nonrepresentative stratified sampling approach was employed primarily according to levels of prior bariatric surgical research participation. Data collection consisted of one-time individual interviews. The Applied Thematic Analysis process guided the content analysis.

Results: Thirty-six interviews were completed and arrived at analytic saturation. Fifteen motivational themes were identified. The 3 most frequently cited were: Sharing one’s own experiences to help others, study participation was helpful to my own goals, and desire to support research. Motivation changed over time and did not appear related to prior participation. A small majority (22) responded that they would return to annual research visits with poor weight loss. Extensive questionnaire completion was perceived as a significant barrier. A sizable subgroup (15) of participants perceived distance to the center and travel time as a barrier. Study participants perceived strategies that better enabled them to manage their time and availability and provided them with a progress report of personal measurements as beneficial. A majority viewed a financial honorarium and travel reimbursement positively (31 of 33) and supportive to their participation (19 of 31).

Conclusion: The motivations, barriers, and facilitators to research retention identified in this study provides an evidence-base from which to further develop current and new retention strategies. Further research should focus on evaluating the effectiveness of retention strategies and developing an optimal selection process for retention strategies.



Additional Citations

Gourash, W. F., Lockhart, J. S., Kalarchian, M. A., Courcoulas, A. P., & Nolfi, D. (2016). Retention and attrition in bariatric surgery research: an integrative review of the literature. Surg Obes Relat Dis, 12, 199-209.