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

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

Abstract

Background: Surveys 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.

Objective: The 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.

Methods: 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 (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.

Results: A 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%).

Conclusions: Strategies 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.

Keywords: COVID-19; cancer; cancer patients; digital health; electronic survey; health outcomes; health promotion; pandemic; patient experience; response rates; surveillance.

Conflict of interest statement

Conflicts of Interest: BDG is an advisory board member for Elly Health, Inc, a former paid consultant for KemPharm, and a paid consultant for SureMed Compliance, none of which is relevant to this manuscript. DER serves on the Board of Directors for NanoString Technologies, Inc., although this position does not relate to her contributions to this paper, and NanoString's business does not relate to the contents of the current manuscript. All other authors have no conflicts of interest to declare.

©Cassandra A Hathaway, Melody N Chavez, Mika Kadono, Dana Ketcher, Dana E Rollison, Erin M Siegel, Anita R Peoples, Cornelia M Ulrich, Frank J Penedo, Shelley S Tworoger, Brian D Gonzalez. Originally published in JMIR Cancer (https://cancer.jmir.org), 06.08.2021.

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Source: PubMed

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