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Participant recruitment in sensitive surveys: a comparative trial of ‘opt in’ versus ‘opt out’ approaches

Participant recruitment in sensitive surveys: a comparative trial of ‘opt in’ versus ‘opt out’ approaches
Participant recruitment in sensitive surveys: a comparative trial of ‘opt in’ versus ‘opt out’ approaches
BACKGROUND: Although in health services survey research we strive for a high response rate, this must be balanced against the need to recruit participants ethically and considerately, particularly in surveys with a sensitive nature. In survey research there are no established recommendations to guide recruitment approach and an 'opt-in' system that requires potential participants to request a copy of the questionnaire by returning a reply slip is frequently adopted. However, in observational research the risk to participants is lower than in clinical research and so some surveys have used an 'opt-out' system. The effect of this approach on response and distress is unknown. We sought to investigate this in a survey of end of life care completed by bereaved relatives.

METHODS: Out of a sample of 1422 bereaved relatives we assigned potential participants to one of two study groups: an 'opt in' group (n=711) where a letter of invitation was issued with a reply slip to request a copy of the questionnaire; or an 'opt out' group (n=711) where the survey questionnaire was provided alongside the invitation letter. We assessed response and distress between groups.

RESULTS: From a sample of 1422, 473 participants returned questionnaires. Response was higher in the 'opt out' group than in the 'opt in' group (40% compared to 26.4%: ?(2) =29.79, p-value<.01), there were no differences in distress or complaints about the survey between groups, and assignment to the 'opt out' group was an independent predictor of response (OR=1.84, 95% CI: 1.45-2.34). Moreover, the 'opt in' group were more likely to decline to participate (?(2)=28.60, p-value<.01) and there was a difference in the pattern of questionnaire responses between study groups.

CONCLUSION: Given that the 'opt out' method of recruitment is associated with a higher response than the 'opt in' method, seems to have no impact on complaints or distress about the survey, and there are differences in the patterns of responses between groups, the 'opt out' method could be recommended as the most efficient way to recruit into surveys, even in those with a sensitive nature.
1471-2288
1-8
Hunt, Katherine
5eab8123-1157-4d4e-a7d9-5fd817218c6e
Shlomo, Natalie
e749febc-b7b9-4017-be48-96d59dd03215
Addington-Hall, J.M.
87560cc4-7562-4f9b-b908-81f3b603fdd8
Hunt, Katherine
5eab8123-1157-4d4e-a7d9-5fd817218c6e
Shlomo, Natalie
e749febc-b7b9-4017-be48-96d59dd03215
Addington-Hall, J.M.
87560cc4-7562-4f9b-b908-81f3b603fdd8

Hunt, Katherine, Shlomo, Natalie and Addington-Hall, J.M. (2013) Participant recruitment in sensitive surveys: a comparative trial of ‘opt in’ versus ‘opt out’ approaches. BMC Medical Research Methodology, 13 (3), 1-8. (doi:10.1186/1471-2288-13-3). (PMID:23311340)

Record type: Article

Abstract

BACKGROUND: Although in health services survey research we strive for a high response rate, this must be balanced against the need to recruit participants ethically and considerately, particularly in surveys with a sensitive nature. In survey research there are no established recommendations to guide recruitment approach and an 'opt-in' system that requires potential participants to request a copy of the questionnaire by returning a reply slip is frequently adopted. However, in observational research the risk to participants is lower than in clinical research and so some surveys have used an 'opt-out' system. The effect of this approach on response and distress is unknown. We sought to investigate this in a survey of end of life care completed by bereaved relatives.

METHODS: Out of a sample of 1422 bereaved relatives we assigned potential participants to one of two study groups: an 'opt in' group (n=711) where a letter of invitation was issued with a reply slip to request a copy of the questionnaire; or an 'opt out' group (n=711) where the survey questionnaire was provided alongside the invitation letter. We assessed response and distress between groups.

RESULTS: From a sample of 1422, 473 participants returned questionnaires. Response was higher in the 'opt out' group than in the 'opt in' group (40% compared to 26.4%: ?(2) =29.79, p-value<.01), there were no differences in distress or complaints about the survey between groups, and assignment to the 'opt out' group was an independent predictor of response (OR=1.84, 95% CI: 1.45-2.34). Moreover, the 'opt in' group were more likely to decline to participate (?(2)=28.60, p-value<.01) and there was a difference in the pattern of questionnaire responses between study groups.

CONCLUSION: Given that the 'opt out' method of recruitment is associated with a higher response than the 'opt in' method, seems to have no impact on complaints or distress about the survey, and there are differences in the patterns of responses between groups, the 'opt out' method could be recommended as the most efficient way to recruit into surveys, even in those with a sensitive nature.

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e-pub ahead of print date: 11 January 2013
Organisations: Faculty of Health Sciences

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Local EPrints ID: 350935
URI: http://eprints.soton.ac.uk/id/eprint/350935
ISSN: 1471-2288
PURE UUID: 7c474941-6709-431d-a7ca-0780407e072a
ORCID for Katherine Hunt: ORCID iD orcid.org/0000-0002-6173-7319

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Date deposited: 18 Apr 2013 10:19
Last modified: 25 Jun 2024 01:43

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Author: Katherine Hunt ORCID iD
Author: Natalie Shlomo

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