Table 3d.

TSHS

Retention Strategy	Description	Start	End	Strengths	Weaknesses
Community Outreach Specialist A	A “case manager” for difficult/hard-to-reach participants, especially 24-month participants. The outreach workers focuses directly on the retention of difficult participants through home visits and the ability to build relationships with these participants.	9/2014	Ongoing	Adequate time to devote towards the retention of hard-to-reach participants. Ability to conduct multiple home visits at different times of day. Ability to focus solely on these participants unlike the regular TSHS staff.	As the study progresses, there is a larger accumulation of hard to reach participants, so it is difficult to assign all of these participants to a single case worker.
Home Visits (Retention Visits) A	Retention Visits are conducted both by part-time outreach workers and TSHS staff. A retention list consisting of hard-to-reach participants with multiple missed visits or no phone numbers, is created by the coordinators. A retention visit consists of knocking on a participant’s door and trying to obtain a new number or scheduling an appointment if the caregiver is home. If no one is home, a postcard is left at the door with a phone number for them to reach the OHAPH staff.	Study Initiation (more extensive visits were conducted when the outreach workers were hired)	Ongoing	Provides a way to reach individuals with disconnected phone numbers who do not respond to postcards or other means of communication.	Home visits are resource intensive, requiring significant time from staff members. Time of day that retention visits are scheduled is limited to staff availability; sites where keys are required for building access must be obtained from the management offices.
Compensation, FV Application & MI environmental supports B	Participants receive a $40 gift card when baseline, 12 and 24 month visits are completed ($120 in total) All children enrolled in the study receive FV applications quarterly for 2 years (9 times in total). Individuals in the intervention group receive environmental supports to assist with achieving goals set during the MI visit.	Study Initiation	Ongoing	Provides oral health promotion to a population at high risk for ECC. Provides incentives for attending visits.	Participants have different motives for continuing in the study. These incentives will not always work as motivators for retention.
Raffle B	During each study visit attended, participants are given a raffle ticket. The raffle is drawn on a monthly basis, and the winner receives a $50 gift card.	7/2011	Ongoing	Easy to implement and requires little resources.	The raffle has a different effect on the participants depending on how it is presented by the staff. The staff sometimes get discouraged by the raffle if their participants do not win.
Post Cards B	The Coordinators identify participants who have missed several visits or have a disconnected/wrong phone number and a postcard is sent to them. Postcards tailored to the participants’ specific status in the study have been developed in both languages.	Study Initiation	Ongoing	Provides participants the means to contact staff on their own when they are difficult to reach. Returned postcards are also a good way to identify participants that may have moved.
Dental Health Advocate/participant assignments B	The participant stays with the same Dental Health Advocate (DHA) throughout the entire study. The DHA delivers the MI intervention quarterly.	Study Initiation	Ongoing	Participants form a relationship with their DHA. Therefore, DHAs sometimes have more success contacting the participants.	Staffing turnovers have caused some participants to be switched to a different DHA.
Birthday Cards C	Participant birthdays are tracked, and TSHS sends a birthday card each year.	4/2012	Ongoing	Easy to implement; requires few resources	The effect of the birthday cards is difficult to measure.
Unity Days C	Unity Days is an annual celebration at each development, sponsored by the Boston Housing Authority. The TSHS staff members set up a table with arts and crafts for the children and provide attendees with toothbrushes. During 2013 and 2014 events, in order to encourage more people to come over to the table, TSHS held a $20 raffle.	Study Initiation	Ongoing	Build visibility and trust within communities. BHA/development sponsored, organized, and implemented resulting in minimal effort and minimal burden on site. Allows staff to re-connect with study participants.	This event was helpful for recruitment but less effective for retention, as there is no guarantee that participants will be at the Unity Days. Finding sufficient staff to attend Unity Days can be difficult. Attending events is an opportunity cost; during the time spent at the Unity Day, staff could be conducting participant visits.