The requirement for prior consent to participate on survey response rates: a population-based survey in Grampian

Val C Angus¹ , Vikki A Entwistle² , Margaret J Emslie³ , Kim A Walker⁴ and Jane E Andrew³

¹Faculty of Medicine and Medical Sciences, University of Aberdeen, West Block, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, Scotland

²Health Services Research Unit, University of Aberdeen, West Block, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, Scotland

³Grampian Local Health Council, Westburn House, Foresterhill, Westburn Road, Aberdeen, AB25 2XG, Scotland

⁴NHS Education (North Scotland), Forest Grove House, Foresterhill Road, Aberdeen, AB25 2ZP, Scotland

author email corresponding author email

BMC Health Services Research 2003, 3:21doi:10.1186/1472-6963-3-21


Published:	18 November 2003

Abstract

Background

A survey was carried out in the Grampian region of Scotland with a random sample of 10,000 adults registered with a General Practitioner in Grampian. The study complied with new legislation requiring a two-stage approach to identify and recruit participants, and examined the implications of this for response rates, non-response bias and speed of response.

Methods

A two-stage survey was carried out consistent with new confidentiality guidelines. Individuals were contacted by post and asked by the Director of Public Health to consent to receive a postal or electronic questionnaire about communicating their views to the NHS. Those who consented were then sent questionnaires. Response rates at both stages were measured.

Results

25% of people returned signed consent forms and were invited to complete questionnaires. Respondents at the consent stage were more likely to be female (odds ratio (OR) response rate of women compared to men = 1.5, 95% CI 1.4, 1.7), less likely to live in deprived postal areas (OR = 0.59, 95% CI 0.45, 0.78) and more likely to be older (OR for people born in 1930–39 compared to people born in 1970–79 = 2.82, 95% CI 2.36, 3.37). 80% of people who were invited to complete questionnaires returned them. Response rates were higher among older age groups. The overall response rate to the survey was 20%, relative to the original number approached for consent (1951/10000).

Conclusion

The requirement of a separate, prior consent stage may significantly reduce overall survey response rates and necessitate the use of substantially larger initial samples for population surveys. It may also exacerbate non-response bias with respect to demographic variables.