Long-term study retention of adolescents undergoing metabolic and bariatric surgery: lessons learned from the Teen-Longitudinal Assessment of Bariatric Surgery cohort

Lizzy Lee, PA-C from Cincinnati Children's highlights remarkable 10-year retention rates from the Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) cohort. This multi-center study followed 242 adolescents post-bariatric surgery, achieving 86% visit completion and 88% participant engagement. Learn which factors influenced missed visits and surprisingly, how long-term health outcomes weren't tied to visit frequency. John B Rode, Sarah B Ogle, Jane C Khoury, David L Allen, Jennifer Black, Rosemary Miller, Marc P Michalsky, Todd M Jenkins, Mary L Brandt, Angie Figueroa, Mia DeTella, Justin R Ryder, Thomas H Inge Background: High participant retention is critical for data quality and generalizability in longitudinal studies. Adolescents, especially after metabolic and bariatric surgery (MBS), are at high risk for attrition. Objectives: To describe long-term retention strategies and visit completion in the Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) cohort, and identify participant and caregiver factors associated with missed visits. Setting: Five academic medical centers in the United States. Methods: Teen-LABS enrolled 242 adolescents (≤19 years) undergoing MBS between 2007 and 2012. Data were collected through 10 years postoperatively, concluding in 2022. Participant engagement and retention strategies are described herein. Visit attendance was grouped as: no missed visits, 1-2 missed visits, or >2 missed visits. Baseline participant and caregiver clinical and demographic variables were analyzed using chi-square and general linear models to identify predictors of visit attendance. Results: In-person visit attendance averaged 86% (95% confidence interval [CI]: 85%-87%), with 88% (95% CI: 87%-90%) remaining engaged at 10 years. Baseline characteristics associated with greater missed visits included sleep apnea, public insurance, psychiatric medication use, and caregiver race and employment status. Body mass index trajectory, comorbidity status, independence, and lifestyle factors over time did not differ significantly by visit attendance group. Conclusions: Retention strategies used by study staff to maintain the Teen-LABS research cohort engagement during transition into young adulthood were powerfully effective in maintaining high cohort retention since visit completion rates of 88% were achieved for the decade-long study.