Survey response rates have varied for Nevada's administration of the Pregnancy Risk Assessment Monitoring System (PRAMS) across the state. The authors evaluated whether using different logos for survey distribution would impact response rates. Using focus groups and an online survey, we asked how participants perceived three logos (which was the most likely to be opened, most trustworthy, and must credible). Results showed that the State seal would be the mostly likely opened, but they were likely to discard it if the envelope's contents were not official business. The University's logo was polarizing in some areas. A PRAMS-specific logo survey may be more effective, as it was seen as "inviting" and adequately described the contents of the envelope. Further research is needed to better explore the impact of logos on mail distributions for public health surveillance surveys.
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