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

Lookup NU author(s): Professor Martin Eccles, Dr Nick Steen

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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.


Publication metadata

Author(s): Glidewell L, Thomas R, MacLennan G, Bonetti D, Johnston M, Eccles MP, Edlin R, Pitts NB, Clarkson J, Steen N, Grimshaw J

Publication type: Article

Publication status: Published

Journal: BMC Health Services Research

Year: 2012

Volume: 12

Issue: 1

Pages: 250

Print publication date: 01/08/2012

Date deposited: 10/01/2013

ISSN (electronic): 1472-6963

Publisher: BioMed Central Ltd.

URL: http://dx.doi.org/10.1186/1472-6963-12-250

DOI: 10.1186/1472-6963-12-250


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Funding

Funder referenceFunder name
Chief Scientist Office of the Scottish Government Health Directorates
The Health Services Research unit
UK Medical Research Council Health Services Research Collaboration
G0001325UK Medical Research Council
GR063790MAWellcome Trust

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