Improving Electronic Survey Response Rates Among Cancer Center Patients During the COVID-19 Pandemic: Mixed Methods Pilot Study

Abstract

Background Surveys play a vital role in cancer research. During the COVID-19 pandemic, the use of electronic surveys is crucial to improve understanding of the patient experience. However, response rates to electronic surveys are often lower compared with those of paper surveys. Objective The aim of this study was to determine the best approach to improve response rates for an electronic survey administered to patients at a cancer center during the COVID-19 pandemic. Methods We contacted 2750 patients seen at Moffitt Cancer Center in the prior 5 years via email to complete a survey regarding their experience during the COVID-19 pandemic, with patients randomly assigned to a series of variations of prenotifications (ie, postcard, letter) or incentives (ie, small gift, modest gift card). In total, eight combinations were evaluated. Qualitative interviews were conducted to understand the level of patient understanding and burden with the survey, and quantitative analysis was used to evaluate the response rates between conditions. Results A total of 262 (9.5%) patients completed the survey and 9 participated in a qualitative interview. Interviews revealed minimal barriers in understanding or burden, which resulted in minor survey design changes. Compared to sending an email only, sending a postcard or letter prior to the email improved response rates from 3.7% to 9.8%. Similarly, inclusion of an incentive significantly increased the response rate from 5.4% to 16.7%, especially among racial (3.0% to 12.2%) and ethnic (6.4% to 21.0%) minorities, as well as among patients with low socioeconomic status (3.1% to 14.9%). Conclusions Strategies to promote effective response rates include prenotification postcards or letters as well as monetary incentives. This work can inform future survey development to increase response rates for electronic surveys, particularly among hard-to-reach populations.

Comparing COVID-19 Response Behaviors between a Cancer Patient Sample and a Population-Based Cancer-Free Sample in a Rural Midwestern State

“…The surveys were specifically designed for comparability across respondent samples, and the use of a stratified random sample increased the ability to generalize results from our population-based sample. Additionally, the 40% response to our general population survey was high compared to other mailed/online population-based surveys during COVID-19 [37, 38]. However, this study also had limitations that should be considered in interpretation of results.…”

Health status based on EQ-5D-5L for the cancer patient population in Malaysia

“…Consequently, certain respondents without social media accounts or direct internet access could not participate in the survey. Previous studies reported that online surveys tend to have a lower response rate [38][39][40] , and incentives such as consolation money can sometimes improve the response rate 41 . Furthermore, response rates are typically lower among racial and ethnic minority groups, as well as those www.nature.com/scientificreports/ with poorer health status, lower income, and less education 42 .…”

Electronic Health Record–Triggered Research Infrastructure Combining Real-world Electronic Health Record Data and Patient-Reported Outcomes to Detect Benefits, Risks, and Impact of Medication: Development Study

“…In general, response rates have declined over the past few years. Response rates may be increased by providing an incentive for patients to participate [ 21 ] and by using paper instead of web-based questionnaires [ 22 , 23 ]. However, web-based PRO collection also has several advantages, including lower costs and higher data quality [ 23 , 24 ].…”