What Motivates Participation and Dropout Among Low‐Income Urban Families of Color in a Prevention Intervention?*

• DOI: http://doi.org/10.1111/j.1741-3729.2001.00246.x
• Author: Louis Fogg,Deborah Gross,Wrenetha Julion
• Published date: 01 July 2001
• Date: 01 July 2001

246 Family Relations

What Motivates Participation and Dropout Among Low-Income

Urban Families of Color in a Prevention Intervention?*

Deborah Gross,** Wrenetha Julion, & Louis Fogg

Low-income urban parents of color enrolled in a parent training study were interviewed to understand what motivated theirparticipation

and what led 30% of them to subsequently drop out. Most enrolled because they wanted to be better parents. Most dropped out because

of time and schedule constraints. Retention was higher when parents’ motivations for participation matched program goals. Program

location and qualities of the recruiter were cited most often as important; financial compensation was cited least often as important.

Parent training during early childhood has been identified

as a potentially powerful intervention for promoting pos-

itive parenting skills and reducing risk factors associated

with antisocial behavior in children (Gross, Fogg, & Tucker,

1995; Kazdin, 1997; Webster-Stratton, 1998). However, parent

training studies are plagued by methodological flaws that affect

most prevention studies: low participation and attendance rates

and high attrition rates (Coie et al., 1993; Given, Keilman, Col-

lins, & Given, 1990; Motzer, Moseley, & Lewis, 1997; Siddiqui,

Flay, Phil, & Hu, 1996).

Poor participation and high attrition rates are particularly

apparent in research using low-income families of color. For ex-

ample, in a study of the effectiveness of the Effective Black

Parenting Program for inner city African-American families,

Myers et al. (1992) reported participation rates as low as 13%

and attendance rates at parent group meetings as low as 33%.

Study validity is further compromised by the fact that low par-

ticipation and retention tend to be systematically related to those

risk factors that also are associated with poor childhood out-

comes including low socioeconomic status, single parenthood,

and lower parent educational levels (Forehand, Middlebrook,

Rogers, & Steffe, 1983; Haggerty et al., 2000; Spoth, Goldberg,

& Redmond, 1999; Weinberger, Tublin, Ford, & Feldman,1990).

These biases in participation and drop-out rates make it difficult

to interpret the effectiveness of parent training for low-income

families. Further, these biases make it difficult to determine

whether the successes reported for parent training among middle-

class European-American families can be generalized to low-

income families of color (Forehand & Kotchick, 1996).

To increase enrollment among low-income populations, re-

searchers have typically implemented a range of costly incen-

tives, such as monetary rewards for attending parent groups,

monetary rewards for completing research assessments, gifts and

door prizes, free food and childcare, and transportation (Cipaldi

& Patterson, 1987; Conduct Problems Prevention Research

Group, 1999; Dumka, Garza, Roosa & Stoerzinger, 1997; Stoy

et al., 1995). However, it is not clear the degree to which these

incentives are, in fact, important to the members of the target

population (Moore, 1997; Saylor, Elksnin, Farah, & Pope, 1990).

For example, parents participating in the Fast Track prevention

*This study was supported by Grant RO1 NRO4085 from the National Institute for

Nursing Research to Drs. Gross and Fogg. We thank Christine Garvey for her assistance

with data analysis, and the parents and teachers for their participation in this study.

**Address correspondence to: Deborah Gross, Rush University College of Nursing,

600 South Paulina Avenue, Suite 1042B, Chicago, IL 60612 (dgross@rushu.rush.edu).

Key Words: attrition, low-income families, minority, parent training, participation,

prevention.

(Family Relations, 2001, 50, 246–254)

intervention were paid $15 for every 2-hour class they attended

(Orrell-Valente, Pinderhughes, Valente, Laird, & Conduct Prob-

lems Research Groups, 1999). Although enrollment rates were

high, parent attendance at these groups averaged 56.3% of ses-

sions. In a study of parent skills training for parents of middle-

school children, Irvine and others (Irvine, Biglan, Smolkowski,

Metzler, & Ary, 1999) offered a series of payments to parents

for varying levels of participation. These included $10 for al-

lowing the recruiter to come to their home, another $10 for at-

tending at least 4 of the first 6 parenting classes, $10 for attend-

ing at least 4 of the last 6 classes, and an additional $10 for

attending a total of 10 of the 12 classes. Nonetheless, 38% of

parents never attended a class, and overall attrition in the study

was 55%. Thus, monetary rewards may effectively get a partic-

ipant’s attention but that may not be sufficient to sustain their

interest over time.

It is also not clear why participants ultimately decide to drop

out of prevention trials. Researchers traditionally conduct post

hoc analyses to determine whether select demographic or re-

search variables are associated with attrition (Siddiqui et al.,

1996). However, these variables tend to provide a limited rep-

resentation of the participant who has dropped out and of their

experience with the intervention study. For example, why would

parents with less education or income drop out at higher rates

than other parents? Is it that less education and income makes

one less motivated? Are these parents more likely to be em-

ployed in jobs with little autonomy and flexibility, limiting their

ability to attend prevention programs? Might parents’ goals for

participating in prevention programs be different among parents

with less education and income than among parents who are

more affluent and educated? In sum, post hoc analyses by de-

mographic categories usually do not expand our understanding

about why individuals from certain groups choose to prematurely

terminate participation.

It is possible that the problem lies not with the character-

istics of the participant but in inadequacies in the prevention

program’s curriculum, the study procedures, the personalities of

the individuals involved in implementing the protocols, or some

other aspect of the research (Morse, Simon, Besch, & Walker,

1995; Motzer et al., 1997). Parents may drop out of prevention

programs because the incentives that are used to entice partici-

pation are not the same incentives needed to retain participation

or are not powerful enough when the participant is also faced

with a myriad of competing responsibilities such as those related

to work, school, children, and extended family. Also, it is pos-

sible that parents stop coming to prevention programs because

the program goals do not complement participant’s goals. None

of these reasons for parental attrition would be identified through

a post hoc analysis of baseline data.

The purpose of this study was to understand what motivated