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

Cassandra A Hathaway,Dana Ketcher,Melody N Chavez,Dana E Rollison,Brian D Gonzalez,Shelley S Tworoger,Erin M Siegel,Mika Kadono,Frank J Penedo,Cornelia M Ulrich,Anita R Peoples

doi:10.2196/30265

Abstract

BackgroundSurveys 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.ObjectiveThe 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.MethodsWe 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.ResultsA 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%).ConclusionsStrategies 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.

Highlights

Surveys are a critical aspect of many research studies, and electronic surveys are increasingly being used in research
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 or incentives
Prior studies have shown that prenotifications and incentives improve response rates, there has been little work performed in this regard with cancer center patients, especially during the pandemic; we considered multiple methods and their combinations

Summary

Introduction

Surveys are a critical aspect of many research studies, and electronic surveys are increasingly being used in research. Benefits of electronic compared to paper surveys include greater reach, higher survey completeness, lower costs, flexibility in survey design, real-time data access, and increased willingness of participants to share information [1,2,3,4]. Prior work has demonstrated that the vast majority of research participants, including cancer patients, prefer a computer-assisted survey compared to a paper-based survey [2,5,6]. A study among breast cancer patients found that those who were older, had lower education levels, and had worse quality of life were more likely to prefer paper-based surveys to collect health data, indicating a potential barrier to electronic surveys in these populations [17]. Response rates to electronic surveys are often lower compared with those of paper surveys

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Conclusion