Abstract
Background and aims: Postal questionnaires are widely used in health research to provide measurable outcomes in areas such as quality of life. Participants who fail to return postal questionnaires can introduce non-response bias. Previous studies within populations over the age of 65 years have shown that response rates amongst older people can be 60% or less. The current study sought to investigate whether envelope colour affected response rates in a study about the effectiveness of screening older women for osteoporosis. Methods: A total of 2803 eligible female participants aged between 70 and 85 were sent an invitation pack from their GP practice. The invitation was either in a brown or white envelope and contained a matching pre-paid reply envelope. A study questionnaire was also sent out in brown or white envelopes 1 week after consenting to participate in the trial. Results: The overall response rate was 78%. There was little evidence of an effect of envelope colour on response to the invitation to participate in the trial (OR 1.04, 95% CI 0.87–1.24). Similarly, there was no influence of envelope colour on the number of participants returning their questionnaires (OR 0.99, 95% CI 0.60–1.63). There was weak evidence of an effect of envelope colour on the response rates of the consent process (OR 0.86, 95% CI 0.74–1.00). When we updated a recent meta-analysis with the results of this study, there was a non-statistically- significant trend for greater response rates with brown envelopes compared with white envelopes (OR 1.19, 95% CI 0.86–1.64, I2=92%). However, the results where influenced by one study and when this study was excluded the pooled estimate was 0.98 (95% CI 0.89–1.08, I2=0%). Conclusion: This study found no evidence to suggest envelope colour has an effect on response to participate in a trial or questionnaire returns. There is weak evidence to suggest envelope colour may affect consent into a trial.
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References
Edwards PJ, Roberts IG, Clarke MJ et al. Methods to increase response rates to postal questionnaires. Cochrane Database Syst Rev 2009 (Issue 3. Art. No.: MR000008. DOI: 10.1002/ 14651858.MR000008.pub4.).
Smeeth L, Fletcher AE. Improving the response rates to questionnaires. BMJ 2002; 324: 1168–9.
Taylor KSM, Counsell CE, Harris CE, Gordon JC, Fonseca SCC, Lee AJ. In a randomized study of envelope and ink colour, coloured ink was found to increase the response rate to a postal questionnaire. J Clin Epidemiol 2006; 59: 1326–30.
Hardie JA, Bakke PS, Mørkve O. Non-response bias in a postal questionnaire survey on respiratory health in the old and very old. Scand J Public Health 2003; 31: 411–7.
Paganini-Hill A, Hsu G, Chao A, Ross RK. Comparison of early and late respondents to a postal health survey questionnaire. Epidemiology 1993; 4: 375–9.
McCoy M, Hargie O. Effects of personalization and envelope color on response rate, speed and quality among a business population. Industrial Marketing Management 2007; 36: 799–809.
Newland CA, Waters WE, Standford AP, Batchelor BG. A study of mail survey method. Int J Epidemiol 1977; 6: 65–7.
Roberts I, Coggan C, Fanslow J. Epidemiological methods: The effect of envelope type on response rates in an epidemiological study of back pain. J Occup Health Safety Aust NZ 1994; 10: 55–7.
Wright SJ. Mail survey response rates: A test of four techniques designed to increase response rates and a discussion of the associated cost considerations. Student Research Report. Massey, New Zealand: Department of Marketing, Massey University, 1984.
SCOOP: Screening of Older Women for Osteoporotic Fracture Prevention. Available at: http://www.scoopstudy.ac.uk. Accessed: 2008 1st August.
Torgerson DJ, Torgerson CJ. Designing randomised trials in health, education and the social sciences. Basingstoke: Palgrave Macmillan, 2008.
Iglesias CP, Birks YF, Torgerson DJ. Improving the measurement of quality of life in older people: the York SF-12. Q J Med 2001; 94: 695–8.
EuroQol: EQ5D. Available at: http://www.euroqol.org/. Accessed: 2008 1st August.
Spielberger CD. Manuel for the State-Trait Anxiety Inventory (STAI). Palo Alto, CA: Consulting Psychologists Press, 1983.
Edwards P, Roberts I, Clarke M et al. Increasing response rates to postal questionnaires: Systematic review. BMJ 2002; 324: 1183–91.
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Mitchell, N., Hewitt, C.E., Torgerson, D.J. et al. A controlled trial of envelope colour for increasing response rates in older women. Aging Clin Exp Res 23, 236–240 (2011). https://doi.org/10.1007/BF03337749
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DOI: https://doi.org/10.1007/BF03337749