Increasing response rates to postal questionnaires: systematic review

doi:10.1136/bmj.324.7347.1183

BMJ 2002;324:1183 ( 18 May )

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Increasing response rates to postal questionnaires: systematic review

Editorial by Smeeth and Fletcher

Phil Edwards, senior research fellow, ^a Ian Roberts, professor of epidemiology and public health, ^a Mike Clarke, associate director (research), ^c Carolyn DiGuiseppi, associate professor of preventive medicine and biometrics, ^d Sarah Pratap, research fellow, ^b Reinhard Wentz, information specialist, ^b Irene Kwan, research fellow. ^b

^a CRASH Trial Co-ordinating Centre, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1B 1DP, ^b Cochrane Injuries Group, Department of Epidemiology and Population Health, ^c UK Cochrane Centre, Oxford OX2 7LG, ^d Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Campus Box C245, 4200 East Ninth Avenue, Denver, CO 80262, USA

Correspondence to: P Edwards phil.edwards{at}lshtm.ac.uk

Objective: To identify methods to increase response topostalquestionnaires.
Design: Systematic review of randomised controlledtrials of any method to influence response to postalquestionnaires.
Studies reviewed: 292 randomised controlled trials including258 315 participants
Intervention reviewed: 75 strategies for influencing response topostalquestionnaires.
Main outcome measure: The proportion of completed or partially completedquestionnairesreturned.
Results: The odds of response were more than doubledwhen a monetary incentive was used (odds ratio 2.02; 95% confidenceinterval 1.79 to 2.27) and almost doubled when incentives werenot conditional on response (1.71; 1.29 to 2.26). Response wasmore likely when short questionnaires were used (1.86; 1.55 to2.24). Personalised questionnaires and letters increased response(1.16; 1.06 to 1.28), as did the use of coloured ink (1.39; 1.16to 1.67). The odds of response were more than doubled when thequestionnaires were sent by recorded delivery (2.21; 1.51 to 3.25)and increased when stamped return envelopes were used (1.26; 1.13to 1.41) and questionnaires were sent by first class post (1.12;1.02 to 1.23). Contacting participants before sending questionnairesincreased response (1.54; 1.24 to 1.92), as did follow up contact(1.44; 1.22 to 1.70) and providing non-respondents with a secondcopy of the questionnaire (1.41; 1.02 to 1.94). Questionnairesdesigned to be of more interest to participants were more likelyto be returned (2.44; 1.99 to 3.01), but questionnaires containingquestions of a sensitive nature were less likely to be returned(0.92; 0.87 to 0.98). Questionnaires originating from universitieswere more likely to be returned than were questionnaires fromother sources, such as commercial organisations (1.31; 1.11 to1.54).
Conclusions: Health researchers using postal questionnairescan improve the quality of their research by using the strategiesshown to be effective in this systematicreview.

What is already known on this topic
Postal questionnaires are widely used in the collection of data in epidemiological studies and health research

Non-response to postal questionnaires reduces the effective sample size and can introduce bias

What this study adds
This systematic review includes more randomised controlled trials than any previously published review or meta-analysis no questionnaire response

The review has identified effective ways to increase response to postal questionnaires

The review will be updated regularly in the Cochrane Library

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Rapid Responses:

Read all Rapid Responses

Changing the Layout of Questionnaires increases Response Rates: Cynthia P Iglesias, et al.
bmj.com, 18 May 2002 [Full text]
Journals to Search: Mary Grace Kovar
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The effect of incentives on response rates: Paula-J Roberts, et al.
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