Maraj A, et al. – The current study was interested in exploring the rates and predictors of disengagement for immigrant vis–à–vis non–immigrant clients in a Canadian early intervention (EI) setting. The findings suggested that disengagement rates could be similar between immigrants and non–immigrants, but their reasons for disengagement could differ. Results revealed that medication adherence was an important predictor for all, but the role of various sociodemographic factors differed by group. Therefore, sustaining all clients' engagement in EI programs required multi–pronged approaches.

Methods

• For this study, two hundred ninety-seven clients were incorporated in a time-to-event analysis with Cox Proportional Hazards regression models.
• After that, immigrant status (first- or second-generation immigrant or non-immigrant), age, gender, education, substance abuse, family contact, social and material deprivation and medication non-adherence were tested as predictors of service disengagement.

Results

• The results of this study showed that 24.2% (n = 72) of the clients disengaged from services before completing two years.
• It was found that disengagement rates did not differ between first-generation immigrants (23.3%), second-generation immigrants (22.7%) and non-immigrants (25.3%).
• Only medication non-adherence anticipated disengagement (HR = 3.81, 95% CI 2.37–6.14) for all clients.
• Age (HR = 1.17, 95% CI 1.02–1.34) and medication non-adherence (HR = 2.92, 95% CI 1.09–7.85) were significant predictors for first-generation immigrants.
• Material deprivation (HR = 1.03, 95% CI 1.00–1.05) and medication non-adherence (HR = 11.07, 95% CI 3.20–38.22) were significant for second-generation immigrants.