Do incentives, reminders or reduced burden improve healthcare professional response rates in postal questionnaires?

two randomised controlled trials

Liz Glidewell*, Ruth Thomas, Graeme MacLennan, Debbie Bonetti, Marie Johnston, Martin P. Eccles, Richard Edlin, Nigel B. Pitts, Jan Clarkson, Nick Steen, Jeremy M. Grimshaw

*Corresponding author for this work

Research output: Contribution to journalArticle

24 Citations (Scopus)
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Abstract

Background: Healthcare professional response rates to postal questionnaires are declining and this may threaten the validity and generalisability of their findings.

Methods to improve response rates do incur costs (resources) and increase the cost of research projects. The aim of these randomised controlled trials (RCTs) was to assess whether 1) incentives, 2) type of reminder and/or 3) reduced response burden improve response rates; and to assess the cost implications of such additional effective interventions. Methods: Two RCTs were conducted. In RCT A general dental practitioners (dentists) in Scotland were randomised to receive either an incentive; an abridged questionnaire or a full length questionnaire. In RCT B non-responders to a postal questionnaire sent to general medical practitioners (GPs) in the UK were firstly randomised to receive a second full length questionnaire as a reminder or a postcard reminder. Continued non-responders from RCT B were then randomised within their first randomisation to receive a third full length or an abridged questionnaire reminder. The cost-effectiveness of interventions that effectively increased response rates was assessed as a secondary outcome.

Results: There was no evidence that an incentive (52% versus 43%, Risk Difference (RD) -8.8 (95%CI -22.5, 4.8); or abridged questionnaire (46% versus 43%, RD -2.9 (95%CI -16.5, 10.7); statistically significantly improved dentist response rates compared to a full length questionnaire in RCT A. In RCT B there was no evidence that a full questionnaire reminder statistically significantly improved response rates compared to a postcard reminder (10.4% versus 7.3%, RD 3 (95% CI -0.1, 6.8). At a second reminder stage, GPs sent the abridged questionnaire responded more often (14.8% versus 7.2%, RD -7.7 (95% CI -12.8, -2.6). GPs who received a postcard reminder followed by an abridged questionnaire were most likely to respond (19.8% versus 6.3%, RD 8.1%, and 9.1% for full/postcard/full, three full or full/full/abridged questionnaire respectively). An abridged questionnaire containing fewer questions following a postcard reminder was the only cost-effective strategy for increasing the response rate (15.99 pound per response).

Conclusions: When expecting or facing a low response rate to postal questionnaires, researchers should carefully identify the most efficient way to boost their response rate. In these studies, an abridged questionnaire containing fewer questions following a postcard reminder was the only cost-effective strategy. An increase in response rates may be explained by a combination of the number and type of contacts. Increasing the sampling frame may be more cost-effective than interventions to prompt non-responders. However, this may not strengthen the validity and generalisability of the survey findings and affect the representativeness of the sample.

Original languageEnglish
Article number250
Number of pages9
JournalBMC Health Services Research
Volume12
DOIs
Publication statusPublished - 14 Aug 2012

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Motivation
Randomized Controlled Trials
Delivery of Health Care
Costs and Cost Analysis
General Practitioners
Surveys and Questionnaires
Dentists
Scotland
Random Allocation
Cost-Benefit Analysis
Postcards
Tooth
Research Personnel

Keywords

  • clinical-practice
  • applying psychological theories

Cite this

Do incentives, reminders or reduced burden improve healthcare professional response rates in postal questionnaires? two randomised controlled trials. / Glidewell, Liz; Thomas, Ruth; MacLennan, Graeme; Bonetti, Debbie; Johnston, Marie; Eccles, Martin P.; Edlin, Richard; Pitts, Nigel B.; Clarkson, Jan; Steen, Nick; Grimshaw, Jeremy M.

In: BMC Health Services Research, Vol. 12, 250, 14.08.2012.

Research output: Contribution to journalArticle

Glidewell, Liz ; Thomas, Ruth ; MacLennan, Graeme ; Bonetti, Debbie ; Johnston, Marie ; Eccles, Martin P. ; Edlin, Richard ; Pitts, Nigel B. ; Clarkson, Jan ; Steen, Nick ; Grimshaw, Jeremy M. / Do incentives, reminders or reduced burden improve healthcare professional response rates in postal questionnaires? two randomised controlled trials. In: BMC Health Services Research. 2012 ; Vol. 12.
@article{bac43d620c984cf0843bf8c51d80ffde,
title = "Do incentives, reminders or reduced burden improve healthcare professional response rates in postal questionnaires?: two randomised controlled trials",
abstract = "Background: Healthcare professional response rates to postal questionnaires are declining and this may threaten the validity and generalisability of their findings.Methods to improve response rates do incur costs (resources) and increase the cost of research projects. The aim of these randomised controlled trials (RCTs) was to assess whether 1) incentives, 2) type of reminder and/or 3) reduced response burden improve response rates; and to assess the cost implications of such additional effective interventions. Methods: Two RCTs were conducted. In RCT A general dental practitioners (dentists) in Scotland were randomised to receive either an incentive; an abridged questionnaire or a full length questionnaire. In RCT B non-responders to a postal questionnaire sent to general medical practitioners (GPs) in the UK were firstly randomised to receive a second full length questionnaire as a reminder or a postcard reminder. Continued non-responders from RCT B were then randomised within their first randomisation to receive a third full length or an abridged questionnaire reminder. The cost-effectiveness of interventions that effectively increased response rates was assessed as a secondary outcome.Results: There was no evidence that an incentive (52{\%} versus 43{\%}, Risk Difference (RD) -8.8 (95{\%}CI -22.5, 4.8); or abridged questionnaire (46{\%} versus 43{\%}, RD -2.9 (95{\%}CI -16.5, 10.7); statistically significantly improved dentist response rates compared to a full length questionnaire in RCT A. In RCT B there was no evidence that a full questionnaire reminder statistically significantly improved response rates compared to a postcard reminder (10.4{\%} versus 7.3{\%}, RD 3 (95{\%} CI -0.1, 6.8). At a second reminder stage, GPs sent the abridged questionnaire responded more often (14.8{\%} versus 7.2{\%}, RD -7.7 (95{\%} CI -12.8, -2.6). GPs who received a postcard reminder followed by an abridged questionnaire were most likely to respond (19.8{\%} versus 6.3{\%}, RD 8.1{\%}, and 9.1{\%} for full/postcard/full, three full or full/full/abridged questionnaire respectively). An abridged questionnaire containing fewer questions following a postcard reminder was the only cost-effective strategy for increasing the response rate (15.99 pound per response).Conclusions: When expecting or facing a low response rate to postal questionnaires, researchers should carefully identify the most efficient way to boost their response rate. In these studies, an abridged questionnaire containing fewer questions following a postcard reminder was the only cost-effective strategy. An increase in response rates may be explained by a combination of the number and type of contacts. Increasing the sampling frame may be more cost-effective than interventions to prompt non-responders. However, this may not strengthen the validity and generalisability of the survey findings and affect the representativeness of the sample.",
keywords = "clinical-practice, applying psychological theories",
author = "Liz Glidewell and Ruth Thomas and Graeme MacLennan and Debbie Bonetti and Marie Johnston and Eccles, {Martin P.} and Richard Edlin and Pitts, {Nigel B.} and Jan Clarkson and Nick Steen and Grimshaw, {Jeremy M.}",
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doi = "10.1186/1472-6963-12-250",
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T1 - Do incentives, reminders or reduced burden improve healthcare professional response rates in postal questionnaires?

T2 - two randomised controlled trials

AU - Glidewell, Liz

AU - Thomas, Ruth

AU - MacLennan, Graeme

AU - Bonetti, Debbie

AU - Johnston, Marie

AU - Eccles, Martin P.

AU - Edlin, Richard

AU - Pitts, Nigel B.

AU - Clarkson, Jan

AU - Steen, Nick

AU - Grimshaw, Jeremy M.

N1 - PMID: 22891875 [PubMed - indexed for MEDLINE] PMCID: PMC3508866 Free PMC Article

PY - 2012/8/14

Y1 - 2012/8/14

N2 - Background: Healthcare professional response rates to postal questionnaires are declining and this may threaten the validity and generalisability of their findings.Methods to improve response rates do incur costs (resources) and increase the cost of research projects. The aim of these randomised controlled trials (RCTs) was to assess whether 1) incentives, 2) type of reminder and/or 3) reduced response burden improve response rates; and to assess the cost implications of such additional effective interventions. Methods: Two RCTs were conducted. In RCT A general dental practitioners (dentists) in Scotland were randomised to receive either an incentive; an abridged questionnaire or a full length questionnaire. In RCT B non-responders to a postal questionnaire sent to general medical practitioners (GPs) in the UK were firstly randomised to receive a second full length questionnaire as a reminder or a postcard reminder. Continued non-responders from RCT B were then randomised within their first randomisation to receive a third full length or an abridged questionnaire reminder. The cost-effectiveness of interventions that effectively increased response rates was assessed as a secondary outcome.Results: There was no evidence that an incentive (52% versus 43%, Risk Difference (RD) -8.8 (95%CI -22.5, 4.8); or abridged questionnaire (46% versus 43%, RD -2.9 (95%CI -16.5, 10.7); statistically significantly improved dentist response rates compared to a full length questionnaire in RCT A. In RCT B there was no evidence that a full questionnaire reminder statistically significantly improved response rates compared to a postcard reminder (10.4% versus 7.3%, RD 3 (95% CI -0.1, 6.8). At a second reminder stage, GPs sent the abridged questionnaire responded more often (14.8% versus 7.2%, RD -7.7 (95% CI -12.8, -2.6). GPs who received a postcard reminder followed by an abridged questionnaire were most likely to respond (19.8% versus 6.3%, RD 8.1%, and 9.1% for full/postcard/full, three full or full/full/abridged questionnaire respectively). An abridged questionnaire containing fewer questions following a postcard reminder was the only cost-effective strategy for increasing the response rate (15.99 pound per response).Conclusions: When expecting or facing a low response rate to postal questionnaires, researchers should carefully identify the most efficient way to boost their response rate. In these studies, an abridged questionnaire containing fewer questions following a postcard reminder was the only cost-effective strategy. An increase in response rates may be explained by a combination of the number and type of contacts. Increasing the sampling frame may be more cost-effective than interventions to prompt non-responders. However, this may not strengthen the validity and generalisability of the survey findings and affect the representativeness of the sample.

AB - Background: Healthcare professional response rates to postal questionnaires are declining and this may threaten the validity and generalisability of their findings.Methods to improve response rates do incur costs (resources) and increase the cost of research projects. The aim of these randomised controlled trials (RCTs) was to assess whether 1) incentives, 2) type of reminder and/or 3) reduced response burden improve response rates; and to assess the cost implications of such additional effective interventions. Methods: Two RCTs were conducted. In RCT A general dental practitioners (dentists) in Scotland were randomised to receive either an incentive; an abridged questionnaire or a full length questionnaire. In RCT B non-responders to a postal questionnaire sent to general medical practitioners (GPs) in the UK were firstly randomised to receive a second full length questionnaire as a reminder or a postcard reminder. Continued non-responders from RCT B were then randomised within their first randomisation to receive a third full length or an abridged questionnaire reminder. The cost-effectiveness of interventions that effectively increased response rates was assessed as a secondary outcome.Results: There was no evidence that an incentive (52% versus 43%, Risk Difference (RD) -8.8 (95%CI -22.5, 4.8); or abridged questionnaire (46% versus 43%, RD -2.9 (95%CI -16.5, 10.7); statistically significantly improved dentist response rates compared to a full length questionnaire in RCT A. In RCT B there was no evidence that a full questionnaire reminder statistically significantly improved response rates compared to a postcard reminder (10.4% versus 7.3%, RD 3 (95% CI -0.1, 6.8). At a second reminder stage, GPs sent the abridged questionnaire responded more often (14.8% versus 7.2%, RD -7.7 (95% CI -12.8, -2.6). GPs who received a postcard reminder followed by an abridged questionnaire were most likely to respond (19.8% versus 6.3%, RD 8.1%, and 9.1% for full/postcard/full, three full or full/full/abridged questionnaire respectively). An abridged questionnaire containing fewer questions following a postcard reminder was the only cost-effective strategy for increasing the response rate (15.99 pound per response).Conclusions: When expecting or facing a low response rate to postal questionnaires, researchers should carefully identify the most efficient way to boost their response rate. In these studies, an abridged questionnaire containing fewer questions following a postcard reminder was the only cost-effective strategy. An increase in response rates may be explained by a combination of the number and type of contacts. Increasing the sampling frame may be more cost-effective than interventions to prompt non-responders. However, this may not strengthen the validity and generalisability of the survey findings and affect the representativeness of the sample.

KW - clinical-practice

KW - applying psychological theories

U2 - 10.1186/1472-6963-12-250

DO - 10.1186/1472-6963-12-250

M3 - Article

VL - 12

JO - BMC Health Services Research

JF - BMC Health Services Research

SN - 1472-6963

M1 - 250

ER -