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01.12.2012 | Research article | Ausgabe 1/2012 Open Access

BMC Health Services Research 1/2012

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

Zeitschrift:
BMC Health Services Research > Ausgabe 1/2012
Autoren:
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
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1472-6963-12-250) contains supplementary material, which is available to authorized users.
Liz Glidewell, Ruth Thomas, Graeme MacLennan, Debbie Bonetti, Marie Johnston, Martin P Eccles contributed equally to this work.

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

LG, RT, GM, DB, MJ, MPE conceived the study. LG, RT, DB, MJ, MPE contributed to the daily running of the study. All authors oversaw the analysis which was conducted by GM and RE. All authors commented on sequential drafts of the paper and approved the final manuscript. Dr Anne Walker conceived the original idea for the PRIME studies.

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 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.
Zusatzmaterial
Authors’ original file for figure 1
12913_2012_2274_MOESM1_ESM.pdf
Authors’ original file for figure 2
12913_2012_2274_MOESM2_ESM.pdf
Authors’ original file for figure 3
12913_2012_2274_MOESM3_ESM.pdf
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