Increasing follow-up questionnaire response rates in a randomized controlled trial of telehealth for depression: three embedded controlled studies
Background: Attrition is problematic in trials, and may be exacerbated in longer studies, telehealth trials and participants with depression – three features of The Healthlines Study. Advance notification, including a photograph and using action-oriented email subject lines might increase response...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Published: |
BioMed Central
2016
|
| Subjects: | |
| Online Access: | https://eprints.nottingham.ac.uk/44817/ |
| _version_ | 1848797004258344960 |
|---|---|
| author | Edwards, Louisa Salisbury, Chris Horspool, Kimberley Foster, Alexis Garner, Katy Montgomery, Alan A. |
| author_facet | Edwards, Louisa Salisbury, Chris Horspool, Kimberley Foster, Alexis Garner, Katy Montgomery, Alan A. |
| author_sort | Edwards, Louisa |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Background: Attrition is problematic in trials, and may be exacerbated in longer studies, telehealth trials and participants with depression – three features of The Healthlines Study. Advance notification, including a photograph and using action-oriented email subject lines might increase response rates, but require further investigation. We examined the effectiveness of these interventions in three embedded Healthlines studies.
Methods: Based in different trial sites, participants with depression were alternately allocated to be pre-called or not ahead of the 8-month follow-up questionnaire (Study 1), randomized to receive a research team photograph or not with their 12-month questionnaire (Study 2), and randomized to receive an action-oriented (‘ACTION REQUIRED’) or standard (‘Questionnaire reminder’) 12-month email reminder (Study 3). Participants could complete online or postal questionnaires, and received up to five questionnaire reminders. The primary outcome was completion of the Patient Health Questionnaire (PHQ-9). Secondary outcome measures were the number of reminders and time to questionnaire completion.
Results: Of a total of 609 Healthlines depression participants, 190, 251 and 231 participants were included in Studies 1–3 (intervention: 95, 126 and 115), respectively. Outcome completion was ≥90 % across studies, with no differences between trial arms (Study 1: OR 0.38, 95 % CI 0.07–2.10; Study 2: OR 0.84, 95 % CI 0.26–2.66; Study 3: OR 0.53 95 % CI 0.19–1.49). Pre-called participants were less likely to require a reminder (48.4 % vs 62.1 %, OR 0.41, 95 % CI 0.21–0.78), required fewer reminders (adjusted difference in means −0.67, 95 % CI −1.13 to −0.20), and completed follow-up quicker (median 8 vs 15 days, HR 1.35, 95 % CI 1.00–1.82) than control subjects. There were no significant between-group differences in Studies 2 or 3.
Conclusions: Eventual response rates in this trial were high, with no further improvement from these interventions. While the photograph and email interventions were ineffective, pre-calling participants reduced time to completion. This strategy might be helpful when the timing of study completion is important. Researchers perceived a substantial benefit from the reduction in reminders with pre-calling, despite no overall decrease in net effort after accounting for pre-notification. |
| first_indexed | 2025-11-14T19:56:59Z |
| format | Article |
| id | nottingham-44817 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:56:59Z |
| publishDate | 2016 |
| publisher | BioMed Central |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-448172020-05-04T17:35:47Z https://eprints.nottingham.ac.uk/44817/ Increasing follow-up questionnaire response rates in a randomized controlled trial of telehealth for depression: three embedded controlled studies Edwards, Louisa Salisbury, Chris Horspool, Kimberley Foster, Alexis Garner, Katy Montgomery, Alan A. Background: Attrition is problematic in trials, and may be exacerbated in longer studies, telehealth trials and participants with depression – three features of The Healthlines Study. Advance notification, including a photograph and using action-oriented email subject lines might increase response rates, but require further investigation. We examined the effectiveness of these interventions in three embedded Healthlines studies. Methods: Based in different trial sites, participants with depression were alternately allocated to be pre-called or not ahead of the 8-month follow-up questionnaire (Study 1), randomized to receive a research team photograph or not with their 12-month questionnaire (Study 2), and randomized to receive an action-oriented (‘ACTION REQUIRED’) or standard (‘Questionnaire reminder’) 12-month email reminder (Study 3). Participants could complete online or postal questionnaires, and received up to five questionnaire reminders. The primary outcome was completion of the Patient Health Questionnaire (PHQ-9). Secondary outcome measures were the number of reminders and time to questionnaire completion. Results: Of a total of 609 Healthlines depression participants, 190, 251 and 231 participants were included in Studies 1–3 (intervention: 95, 126 and 115), respectively. Outcome completion was ≥90 % across studies, with no differences between trial arms (Study 1: OR 0.38, 95 % CI 0.07–2.10; Study 2: OR 0.84, 95 % CI 0.26–2.66; Study 3: OR 0.53 95 % CI 0.19–1.49). Pre-called participants were less likely to require a reminder (48.4 % vs 62.1 %, OR 0.41, 95 % CI 0.21–0.78), required fewer reminders (adjusted difference in means −0.67, 95 % CI −1.13 to −0.20), and completed follow-up quicker (median 8 vs 15 days, HR 1.35, 95 % CI 1.00–1.82) than control subjects. There were no significant between-group differences in Studies 2 or 3. Conclusions: Eventual response rates in this trial were high, with no further improvement from these interventions. While the photograph and email interventions were ineffective, pre-calling participants reduced time to completion. This strategy might be helpful when the timing of study completion is important. Researchers perceived a substantial benefit from the reduction in reminders with pre-calling, despite no overall decrease in net effort after accounting for pre-notification. BioMed Central 2016-02-24 Article PeerReviewed Edwards, Louisa, Salisbury, Chris, Horspool, Kimberley, Foster, Alexis, Garner, Katy and Montgomery, Alan A. (2016) Increasing follow-up questionnaire response rates in a randomized controlled trial of telehealth for depression: three embedded controlled studies. Trials, 17 . p. 107. ISSN 1745-6215 Depression Email reminders Embedded study Photographs Pre-notification Recruitment Response rates Retention Telehealth Trials https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-016-1234-3 doi:10.1186/s13063-016-1234-3 doi:10.1186/s13063-016-1234-3 |
| spellingShingle | Depression Email reminders Embedded study Photographs Pre-notification Recruitment Response rates Retention Telehealth Trials Edwards, Louisa Salisbury, Chris Horspool, Kimberley Foster, Alexis Garner, Katy Montgomery, Alan A. Increasing follow-up questionnaire response rates in a randomized controlled trial of telehealth for depression: three embedded controlled studies |
| title | Increasing follow-up questionnaire response rates in a randomized controlled trial of telehealth for depression: three embedded controlled studies |
| title_full | Increasing follow-up questionnaire response rates in a randomized controlled trial of telehealth for depression: three embedded controlled studies |
| title_fullStr | Increasing follow-up questionnaire response rates in a randomized controlled trial of telehealth for depression: three embedded controlled studies |
| title_full_unstemmed | Increasing follow-up questionnaire response rates in a randomized controlled trial of telehealth for depression: three embedded controlled studies |
| title_short | Increasing follow-up questionnaire response rates in a randomized controlled trial of telehealth for depression: three embedded controlled studies |
| title_sort | increasing follow-up questionnaire response rates in a randomized controlled trial of telehealth for depression: three embedded controlled studies |
| topic | Depression Email reminders Embedded study Photographs Pre-notification Recruitment Response rates Retention Telehealth Trials |
| url | https://eprints.nottingham.ac.uk/44817/ https://eprints.nottingham.ac.uk/44817/ https://eprints.nottingham.ac.uk/44817/ |