Abstract
BackgroundParticipation in epidemiologic studies has been declining over the last decades. In addition to postal invitations and phone calls, home visits can be conducted to increase participation. The aim of this study was therefore to evaluate the effects of home visits in terms of response increase and composition of the additionally recruited and final sample.MethodsIn the framework of the German National Cohort (NAKO) recruitment process, two of 18 study centers, Halle (Saale) and Berlin-Center, performed home visits as additional recruitment step after postal invitation and reminders. Response increase was calculated and differences between participants recruited via home visits and standard recruitment were examined. Proportions are presented as percentages with 95%-confidence intervals.ResultsIn the general population in Halle, 21.3-22.8% participated after postal invitation and two reminders in the five assessed recruitment waves. The increase of the overall response was 2.8 percentage points (95%confidence interval: 1.9-4.0) for home visits compared to 2.4 percentage points (95%CI: 1.7-3.3) for alternatively sent third postal reminder. Participants recruited via home visits had similar characteristics to those recruited via standard recruitment. Among persons of Turkish descent in Berlin-Center site of the NAKO, home visits conducted by native speakers increased the participation of women, persons living together with their partner, were born in Turkey, had lower German language skills, lower-income, lower education, were more often smokers and reported more often diabetes and depression to a degree which changed overall estimates for this subsample.ConclusionsAs an additional recruitment measure in the general population, home visits increased response only marginally, and the through home visits recruited participants did not differ from those already recruited. Among persons with migration background, home visits by a native speaker increased participation of persons not reached by the standard recruitment, but the effects of using a native speaker approach could not be separated from the effect of home visits.
Highlights
IntroductionIn addition to postal invitations and phone calls, home visits can be conducted to increase participation
Participation in epidemiologic studies has been declining over the last decades
Among persons with migration background, home visits by a native speaker increased participation of persons not reached by the standard recruitment, but the effects of using a native speaker approach could not be separated from the effect of home visits
Summary
In addition to postal invitations and phone calls, home visits can be conducted to increase participation. Since it is unlikely that we will be able to reach the participation level of the older studies in the future, the practical question is about the incremental value of additional efforts to increase response. This can vary among populations studied, for example, the mechanisms of response can be different in the general population, patient samples, or among migrant groups due to the additional difficulty of language barriers [2, 14, 15]. Different strategies to increase participation were proposed by several authors, including additional reminders or using various ways of approaching participants, for example, phone calls or home visits in addition to invitations via regular mail [16,17,18]
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