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

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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.

Related collections

Most cited references 48

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Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support.

Paul A. Harris, Robert Taylor, Robert Thielke … (2009)

Research electronic data capture (REDCap) is a novel workflow methodology and software solution designed for rapid development and deployment of electronic data capture tools to support clinical and translational research. We present: (1) a brief description of the REDCap metadata-driven software toolset; (2) detail concerning the capture and use of study-related metadata from scientific research teams; (3) measures of impact for REDCap; (4) details concerning a consortium network of domestic and international institutions collaborating on the project; and (5) strengths and limitations of the REDCap system. REDCap is currently supporting 286 translational research projects in a growing collaborative network including 27 active partner institutions.

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The REDCap consortium: Building an international community of software platform partners

Paul Harris, Robert Taylor, Brenda Minor … (2019)

The Research Electronic Data Capture (REDCap) data management platform was developed in 2004 to address an institutional need at Vanderbilt University, then shared with a limited number of adopting sites beginning in 2006. Given bi-directional benefit in early sharing experiments, we created a broader consortium sharing and support model for any academic, non-profit, or government partner wishing to adopt the software. Our sharing framework and consortium-based support model have evolved over time along with the size of the consortium (currently more than 3200 REDCap partners across 128 countries). While the "REDCap Consortium" model represents only one example of how to build and disseminate a software platform, lessons learned from our approach may assist other research institutions seeking to build and disseminate innovative technologies.

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Health literacy and public health: A systematic review and integration of definitions and models

Karen Kristine Sørensen, Stephan Van den Broucke, James Fullam … (2012)

Background Health literacy concerns the knowledge and competences of persons to meet the complex demands of health in modern society. Although its importance is increasingly recognised, there is no consensus about the definition of health literacy or about its conceptual dimensions, which limits the possibilities for measurement and comparison. The aim of the study is to review definitions and models on health literacy to develop an integrated definition and conceptual model capturing the most comprehensive evidence-based dimensions of health literacy. Methods A systematic literature review was performed to identify definitions and conceptual frameworks of health literacy. A content analysis of the definitions and conceptual frameworks was carried out to identify the central dimensions of health literacy and develop an integrated model. Results The review resulted in 17 definitions of health literacy and 12 conceptual models. Based on the content analysis, an integrative conceptual model was developed containing 12 dimensions referring to the knowledge, motivation and competencies of accessing, understanding, appraising and applying health-related information within the healthcare, disease prevention and health promotion setting, respectively. Conclusions Based upon this review, a model is proposed integrating medical and public health views of health literacy. The model can serve as a basis for developing health literacy enhancing interventions and provide a conceptual basis for the development and validation of measurement tools, capturing the different dimensions of health literacy within the healthcare, disease prevention and health promotion settings.

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Author and article information

Contributors

Shelley S Tworoger:

ORCID: https://orcid.org/0000-0002-6986-7046

Department of Cancer EpidemiologyMoffitt Cancer Center13131 USF Magnolia DriveMRC 2nd FloorTampa, FL, 33612United States1 813 745 1810Shelley.Tworoger@moffitt.org

Journal

Journal ID (nlm-ta): JMIR Cancer

Journal ID (iso-abbrev): JMIR Cancer

Journal ID (publisher-id): JC

Title: JMIR Cancer

Publisher: JMIR Publications (Toronto, Canada )

ISSN (Electronic): 2369-1999

Publication date Collection: Jul-Sep 2021

Publication date (Electronic): 6 August 2021

Publication date PMC-release: 6 August 2021

Volume: 7

Issue: 3

Electronic Location Identifier: e30265

Affiliations

[1 ] Department of Cancer Epidemiology Moffitt Cancer Center Tampa, FL United States

[2 ] Participant Research, Interventions, and Measurements Core Moffitt Cancer Center Tampa, FL United States

[3 ] The AltaMed Institute for Health Equity Los Angeles, CA United States

[4 ] Department of Health Outcomes and Behavior Moffitt Cancer Center Tampa, FL United States

[5 ] Huntsman Cancer Institute Salt Lake City, UT United States

[6 ] Department of Population Health Sciences University of Utah Salt Lake City, UT United States

[7 ] Departments of Medicine and Psychology University of Miami Coral Gables, FL United States

[8 ] Department of Epidemiology Harvard T.H. Chan School of Public Health Boston, MA United States

Author notes

Corresponding Author: Shelley S Tworoger Shelley.Tworoger@ 123456moffitt.org

Author information

Cassandra A Hathaway https://orcid.org/0000-0002-2919-0499

Melody N Chavez https://orcid.org/0000-0002-8707-7072

Mika Kadono https://orcid.org/0000-0003-3978-8379

Dana Ketcher https://orcid.org/0000-0003-3569-9344

Dana E Rollison https://orcid.org/0000-0002-3171-8045

Erin M Siegel https://orcid.org/0000-0003-1779-2510

Anita R Peoples https://orcid.org/0000-0003-3645-3960

Cornelia M Ulrich https://orcid.org/0000-0002-4502-1695

Frank J Penedo https://orcid.org/0000-0002-2780-0417

Shelley S Tworoger https://orcid.org/0000-0002-6986-7046

Brian D Gonzalez https://orcid.org/0000-0001-5108-5735

Article

Publisher ID: v7i3e30265

DOI: 10.2196/30265

PMC ID: 8360334

PubMed ID: 34156965

SO-VID: 55be7a38-3562-4726-bba2-772e209d249c

Copyright © ©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.

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Cancer, is properly cited. The complete bibliographic information, a link to the original publication on https://cancer.jmir.org/, as well as this copyright and license information must be included.

History

Date received : 7 May 2021

Date revision requested : 4 June 2021

Date revision received : 9 June 2021

Date accepted : 15 June 2021

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