Qualitative Attrition Interviews
MR, death
ATTRITION
Attrition (vs LTFU) was most likely to occur for participants who did not successfully complete registration for MR. Because the qualitative attrition interviewees were randomly selected, the subsample (n=10) is theoretically similar to the overall attrition group. Although varied reasons were identified for participant attrition, interviewees predominately identified the construct of “personal circumstances.” Veterans and their partners indicated circumstances in their lives such as competing personal health concerns or death in the family as factors that pulled their attention from the MR onboarding process. This construct is exemplified by 1 participant stating, “I had some health issues and stuff come up on our plates that we weren’t able to fulfill our side of the agreement or the program.”Interviewees also indicated a lack of understanding of MR as a program. Interviewees reported confusing the weekly research surveys as the intervention or not understanding the program’s intent. One veteran stated, “I don’t feel no (sic) connection with all these questions and the title of the program.” Excess paperwork was also identified as a factor contributing to participant attrition. Interviewees perceived the mailed informational and registration packet as overwhelming, “too tedious,” or they did not prioritize completing the forms. In addition to exploring the reason for attrition, interviews also inquired about potential means to improve the study experience. The most reported recommendation was to increase human interaction. Some interviewees stated preferences for person-to-person interaction to provide program assistance in times of need and maintain study engagement. One veteran stated “I need somebody to hold my hand” when it comes to MR onboarding. Additionally, interviewees recommended digital forms to minimize the use of paper and decrease potential feelings of burden associated with completing the forms. The latter recommendation also addresses participant concerns with the forms being overwhelming.Participants often cited similar reasons for withdrawing from the study onboarding process. Passive and active withdrawals cited partners that withdrew after consenting, difficulties experienced with the mobile and web-based platforms for data collection and the intervention, and adverse health issues that were unrelated to study activities.