The impact of deployment experience and prior healthcare utilization on enrollment in a large military cohort study

BACKGROUND: Longitudinal cohort studies are highly valued in epidemiologic research for their ability to establish exposure-disease associations through known temporal sequences. A major challenge in cohort studies is recruiting individuals representative of the targeted sample population to ensure the generalizability of the study’s findings. METHODS: We evaluated nearly 350,000 invited subjects (from 2004-2008) of the Millennium Cohort Study, a prospective cohort study of the health of US military personnel, for factors prior to invitation associated with study enrollment. Multivariable logistic regression was utilized, adjusting for demographic and other confounders, to determine the associations between both deployment experience and prior healthcare utilization with enrollment into the study. RESULTS: Study enrollment was significantly greater among those who deployed prior to and/or during the enrollment cycles or had at least one outpatient visit in the 12 months prior to invitation. Mental disorders and hospitalization for more than two days within the past year were associated with reduced odds of enrollment. CONCLUSIONS: These findings suggest differential enrollment by deployment experience and health status, and may help guide recruitment efforts in future studies.