Abstract WP181: Factors Associated with Retention in a Study of Intracerebral Hemorrhage Survivors

Introduction: Retention is poor in secondary prevention studies among survivors of intracerebral hemorrhage (ICH), who face particularly high risk of recurrent stroke, dementia, and depression. Adverse social determinants of health may further challenge retention. We aimed to determine which social determinants of health were associated with poor study retention in ICH survivors, to guide targeted strategies for those most at risk. Methods: We analyzed data from two multi-center longitudinal cohort studies enrolling ICH survivors across the United States between 2021 and 2025. Participants were classified as retained if they completed at least one follow-up assessment at ≥3 months post-enrollment. We compared key demographic factors and social determinants between those retained and those lost to follow up using appropriate tests. We performed unadjusted logistic regression analyses to examine predictors of retention, followed by a multivariable model adjusted for a priori selected confounders (age, sex, race, education, and preferred language [English versus Spanish]). Results: Of 186 enrolled ICH survivors (mean [SD] age: 60.9 [14.0] years, 40% female, 59% White), 65.6% were retained in the study. Stroke literacy (defined as number of stroke risk factors correctly identified) was the only factor associated with better retention (Table 1). In the unadjusted model, each 1-point increase in stroke literacy was associated with 47% greater odds of retention (OR [95% CI]: 1.47 [1.09-1.98]; p = 0.012). This association persisted in the multivariable model (OR [95% CI]: 1.40 [1.01-1.97]; p = 0.047). Conclusion: Higher stroke literacy independently predicted retention in this national secondary prevention cohort of ICH survivors. Addressing stroke literacy during the hospital stay and at follow-up visits could be a promising strategy to enhance study retention and strengthen secondary prevention in ICH survivors.