With a large-scale project such as the one we conducted, paying attention to participant retention was critical to ensuring the success of our project and that we would have adequate numbers to answer the research questions put forth in the original proposal to NIH. However, even if you do not have to report to a funding agency, retention is important to your efforts because it is the gauge against which you will measure the worth of the program to your participants. Simply put, if your participants are dropping out, it is an indication that they are not finding any benefit from the training. They may be looking for something as simple as an interesting way to spend a few hours each week. They may also be trying to learn the details of how to use the technology so that they can be proficient on their own. The trick for retention is finding the right balance. When the balance is correct, participants will be more likely to keep coming back and to recommend to others that they give it a try. The wrong balance, making things overly technical or difficult, or having a poor instructor, will make it more likely that participants will stop coming and will also discourage others from ever starting. Still, whatever balance you strike (and that will depend on the makeup of each training cohort), there are some strategies to encourage retention in any situation.
To encourage retention, we employed a number of different approaches. Many of these involved being supportive and responsive to the needs of our participants. Within the scope of the project, we tried to engage participants in as many aspects of the training as possible. For example, when we had to search for materials on the Internet, we asked them for topics. When covering entertainment sites such as Hulu and YouTube, we asked participants to name a singer that they enjoyed listening to. Often this would be someone who was popular 30-50 years ago. Participants were amazed at the range of singers and television shows that could be found online, including ones from their generation. Getting participants excited about what they were learning meant they stayed engaged in the training program.
A larger approach is simply getting to know each participant and understanding what he or she wants from the class. Most participants will sit through an occasional session that does not interest them or material that they find confusing or irrelevant if the trainers demonstrate an understanding that this is the case for them and attempt to offer something indicating this. For example, you may approach a participant at the end of a class and let them know that the next session is something that they had said they were not interested in, but that you encourage them to come because you have tried to include a couple of skills or pieces of information that they may find useful. Similarly, you might attempt to tailor some of the sessions in a way that you still cover the material you wished to cover, but in a way that incorporates some specific interests.
Within the larger scope of our project, we were also able to tailor the training in some cases. For example, although we introduced the topic of social networking sites in class, few of our participants were interested in joining these sites. Thus, we had the ones who were interested in joining one or more social networking sites attend an office hours where we would show them how to join. As more participants were interested in learning how to effectively use email, we spent more time than originally planned with this aspect of the training, compared to time spent on social networking sites.
Even though being responsive and attentive to our participants helped to reduce attrition and maintain retention, there were times when nothing we could do could help with these issues. As is typical with older adults in CCRCs, there are usually health issues that led many of them to move into these communities. We found that as our 8-week training sessions progressed, as well as the year-long follow-up after the training, a percentage of our participants experienced significant health issues that resulted in their not being able to continue in the training. It was very sad for us to see some of our participants' health decline, and even sadder when some of them tried to rejoin the class but their health (in particular, their memory) would not let them retain the material they had learned.
In addition to health issues, we had some participants who moved to other CCRCs, and a few who passed away. Others were not able to continue due to lack of participation (we had a specific number of classes that participants could miss and still stay in the class) or interest. Although we had 314 participants who passed our cognitive screener (for the full study), by the end of our involvement with participants 12 months past the end of the 8-week sessions, we had only 208 participants who completed the final assessment.