Using Web-Based and Paper-Based Questionnaires for Collecting Data on Fertility Issues Among Female Childhood Cancer Survivors: Differences in Response Characteristics

Abstract

BackgroundWeb-based questionnaires have become increasingly popular in health research. However, reported response rates vary and response bias may be introduced.ObjectiveThe aim of this study was to evaluate whether sending a mixed invitation (paper-based together with Web-based questionnaire) rather than a Web-only invitation (Web-based questionnaire only) results in higher response and participation rates for female childhood cancer survivors filling out a questionnaire on fertility issues. In addition, differences in type of response and characteristics of the responders and nonresponders were investigated. Moreover, factors influencing preferences for either the Web- or paper-based version of the questionnaire were examined.MethodsThis study is part of a nationwide study on reproductive function, ovarian reserve, and risk of premature menopause in female childhood cancer survivors. The Web-based version of the questionnaire was available for participants through the Internet by means of a personalized user name and password. Participants were randomly selected to receive either a mixed invitation (paper-based questionnaire together with log-in details for Web-based questionnaire, n = 137) or a Web-only invitation (log-in details only, n = 140). Furthermore, the latter group could request a paper-based version of the questionnaire by filling out a form.ResultsOverall response rates were comparable in both randomization groups (83% mixed invitation group vs 89% in Web-only invitation group, P = .20). In addition, participation rates appeared not to differ (66% or 90/137, mixed invitation group vs 59% or 83/140, Web-only invitation group, P =.27). However, in the mixed invitation group, significantly more respondents filled out the paper-based questionnaire compared with the Web-only invitation group (83% or 75/90 and 65% or 54/83, respectively, P = .01). The 44 women who filled out the Web-based version of the questionnaire had a higher educational level than the 129 women who filled out the paper-based version (P = .01). Furthermore, the probability of filling out the Web-based questionnaire appeared to be greater for women who were allocated to the Web-only invitation group (OR = 2.85, 95% CI 1.31 - 6.21), were older (OR = 1.08, 95% CI 1.02 - 1.15), had a higher educational level (OR high vs low = 0.06, 95% CI 0.01 - 0.52), or were students (OR employed vs student = 3.25, 95% CI 1.00 - 10.56).ConclusionsAlthough overall response as well as participation rates to both types of invitations were similar, adding a paper version of a questionnaire to a Web-only invitation resulted in more respondents filling out the paper-based version. In addition, women who were older, had a higher level of education, or were students, were more likely to have filled out the Web-based version of the questionnaire. Given the many advantages of Web-based over paper-based questionnaires, researchers should strongly consider using Web-based questionnaires, although possible response bias when using these types of questionnaires sho...

Effect of Web-Based Versus Paper-Based Questionnaires and Follow-Up Strategies on Participation Rates of Dutch Childhood Cancer Survivors: A Randomized Controlled Trial

“…However, no differences in participation rates were found between these questionnaire modes when offered in a mixed-mode invitation. In a recent study by Van den Berg et al [24], no differences were found in participation rates of female CCSs invited to complete either a paper- or a Web-based questionnaire. However, the CCSs who were invited through a paper-based questionnaire preferred completing the paper-based over the Web-based version.…”

“…It is thus important to investigate potential differences in participant characteristics opting for different questionnaire modes. Previous studies have shown that gender, age, educational level, and socioeconomic status can influence questionnaire mode preferences [11,24,25,27-29,38,39]. Participants of Web-based questionnaires more often are male, younger, higher educated, and employed.…”

“…In addition, recent studies have shown that using paper-based as well as Web-based questionnaire modes in the same study might increase response rates [11,23,24]. Web-based questionnaires are preferred by investigators because there are no printing and mailing costs involved and the time spent on data entry is minimized [25].…”

Women in an infertility survey responded more by mail but preferred a choice: randomized controlled trial

“…However, few have looked at the use of mail to prompt the use of an online survey [23]. The approach by mail, rather than by e-mail for instance, may explain the lowered use of the online mode in this study: women could not just click through to the survey from an e-mail.…”

Clinicians’ Perspectives on a Web-Based System for Routine Outcome Monitoring in Old-Age Psychiatry in the Netherlands

“…Recent research showed that when female cancer survivors were given a choice between filling out a questionnaire online and filling out a paper version of the questionnaire, they preferred to fill out the paper version. When they were not given the choice, their response rates were similar for both the Web-based and paper-based questionnaire [25]. This provides further evidence that it was the availability of a research assistant that made our routine outcome monitoring procedure feasible, since clinicians had a choice and probably preferred to fill out the questionnaires on paper.…”