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Open Access Research article

The effect of two lottery-style incentives on response rates to postal questionnaires in a prospective cohort study in preschool children at high risk of asthma: a randomized trial

Lonneke B van der Mark1*, Karina E van Wonderen1, Jacob Mohrs1, Patrick JE Bindels2, Milo A Puhan3 and Gerben ter Riet1

Author Affiliations

1 Department of General Practice, Academic Medical Center, Amsterdam, the Netherlands

2 Department of General Practice, Erasmus Medical Center, Rotterdam, the Netherlands

3 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA

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BMC Medical Research Methodology 2012, 12:186  doi:10.1186/1471-2288-12-186

Published: 18 December 2012

Abstract

Background

In research with long-term follow-up and repeated measurements, quick and complete response to questionnaires helps ensure a study’s validity, precision and efficiency. Evidence on the effect of non-monetary incentives on response rates in observational longitudinal research is scarce.

Objectives

To study the impact of two strategies to enhance completeness and efficiency in observational cohort studies with follow-up durations of around 2 years.

Method and intervention

In a factorial design, 771 children between 2 and 5 years old and their parents participating in a prospective cohort study were randomized to three intervention groups and a control group. Three types of lotteries were run: (i) daytrip tickets for the whole family to a popular amusement park if they returned all postal questionnaires, (ii) €12.50-worth gift vouchers for sending back the questionnaire on time after each questionnaire round and (iii) a combination of (i) and (ii).

Main outcome measures

Primary outcome was the proportion of participants who returned all questionnaires without any reminder. Secondary outcomes were ‘100% returned with or without reminder’, ‘probability of 100% non-response’, ‘probability of withdrawal’, ‘proportion of returned questionnaires’ and ‘overall number of reminders sent’.

Statistical analysis

After testing for interaction between the two lottery interventions, the two trials were analysed separately. We calculated risk differences (RD) and numbers needed to “treat” and their 95% confidence intervals.

Results

Daytrip nor voucher intervention had an effect on the proportion of participants who returned all questionnaires (RD −0.01; 95% CI-0.07 – 0.06) and (RD 0.02; 95% CI-0.50 – 0.08), respectively. No effects were found on the secondary outcomes.

Conclusion

Our findings do not support the idea that lottery-style incentives lead to more complete response to postal questionnaires in observational cohort studies with repeated data collection and follow-up durations of around 2 years.

Keywords:
Incentive; Longitudinal cohort study; Loss to follow up; Postal questionnaire; Randomized controlled trial; Response rate