Adding Postal Follow-Up to a Web-Based Survey of Primary Care and Gastroenterology Clinic Physician Chiefs Improved Response Rates but not Response Quality or Representativeness

2013 ◽  
Vol 38 (3) ◽  
pp. 382-403 ◽  
Author(s):  
Melissa R. Partin ◽  
Adam A. Powell ◽  
Diana J. Burgess ◽  
David A. Haggstrom ◽  
Amy A. Gravely ◽  
...  
Keyword(s):  
Primary Care ◽  
Response Rates ◽  
Web Based ◽  
Response Quality

scholarly journals Randomised controlled trial and economic analysis of an internet-based weight management programme: POWeR+ (Positive Online Weight Reduction)

2017 ◽  
Vol 21 (4) ◽  
pp. 1-62 ◽  
Author(s):  
Paul Little ◽  
Beth Stuart ◽  
FD Richard Hobbs ◽  
Jo Kelly ◽  
Emily R Smith ◽  
...  
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Weight Reduction ◽  
Cost Effective ◽  
Health Technology ◽  
Control Group ◽  
Random Numbers ◽  
Web Based ◽  
Face To Face

BackgroundBehavioural counselling with intensive follow-up for obesity is effective, but in resource-constrained primary care settings briefer approaches are needed.ObjectivesTo estimate the clinical effectiveness and cost-effectiveness of an internet-based behavioural intervention with regular face-to-face or remote support in primary care, compared with brief advice.DesignIndividually randomised three-arm parallel trial with health economic evaluation and nested qualitative interviews.SettingPrimary care general practices in the UK.ParticipantsPatients with a body mass index of ≥ 30 kg/m2(or ≥ 28 kg/m2with risk factors) identified from general practice records, recruited by postal invitation.InterventionsPositive Online Weight Reduction (POWeR+) is a 24-session, web-based weight management intervention completed over 6 months. Following online registration, the website randomly allocated participants using computer-generated random numbers to (1) the control intervention (n = 279), which had previously been demonstrated to be clinically effective (brief web-based information that minimised pressure to cut down foods, instead encouraging swaps to healthier choices and increasing fruit and vegetables, plus 6-monthly nurse weighing); (2) POWeR+F (n = 269), POWeR+ supplemented by face-to-face nurse support (up to seven contacts); or (3) POWeR+R (n = 270), POWeR+ supplemented by remote nurse support (up to five e-mails or brief telephone calls).Main outcome measuresThe primary outcome was a modelled estimate of average weight reduction over 12 months, assessed blind to group where possible, using multiple imputation for missing data. The secondary outcome was the number of participants maintaining a 5% weight reduction at 12 months.ResultsA total of 818 eligible individuals were randomised using computer-generated random numbers. Weight change, averaged over 12 months, was documented in 666 out of 818 participants (81%; control,n = 227; POWeR+F,n = 221; POWeR+R,n = 218). The control group maintained nearly 3 kg of weight loss per person (mean weight per person: baseline, 104.4 kg; 6 months, 101.9 kg; 12 months, 101.7 kg). Compared with the control group, the estimated additional weight reduction with POWeR+F was 1.5 kg [95% confidence interval (CI) 0.6 to 2.4 kg;p = 0.001] and with POWeR+R was 1.3 kg (95% CI 0.34 to 2.2 kg;p = 0.007). By 12 months the mean weight loss was not statistically significantly different between groups, but 20.8% of control participants, 29.2% of POWeR+F participants (risk ratio 1.56, 95% CI 0.96 to 2.51;p = 0.070) and 32.4% of POWeR+R participants (risk ratio 1.82, 95% CI 1.31 to 2.74;p = 0.004) maintained a clinically significant 5% weight reduction. The POWeR+R group had fewer individuals who reported doing another activity to help lose weight [control, 47.1% (64/136); POWeR+F, 37.2% (51/137); POWeR+R, 26.7% (40/150)]. The incremental cost to the health service per kilogram weight lost, compared with the control group, was £18 (95% CI –£129 to £195) for POWeR+F and –£25 (95% CI –£268 to £157) for POWeR+R. The probability of being cost-effective at a threshold of £100 per kilogram was 88% and 98% for POWeR+F and POWeR+R, respectively. POWeR+R was dominant compared with the control group. No harms were reported and participants using POWeR+ felt more enabled in managing their weight. The qualitative studies documented that POWeR+ was viewed positively by patients and that health-care professionals generally enjoyed supporting patients using POWeR+.Study limitationsMaintenance of weight loss after 1 year is unknown.Future workIdentifying strategies for longer-term engagement, impact in community settings and increasing physical activity.ConclusionClinically valuable weight loss (> 5%) is maintained in 20% of individuals using novel written materials with brief follow-up. A web-based behavioural programme and brief support results in greater mean weight loss and 10% more participants maintain valuable weight loss; it achieves greater enablement and fewer participants undertaking other weight-loss activities; and it is likely to be cost-effective.Trial registrationCurrent Controlled Trials ISRCTN21244703.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 21, No. 4. See the NIHR Journals Library website for further project information.

scholarly journals Effect of Recruitment Methods on Response Rate in a Web-Based Study for Primary Care Physicians: Factorial Randomized Controlled Trial (Preprint)

2017 ◽  
Author(s):  
Ryuhei So ◽  
Kiyomi Shinohara ◽  
Takuya Aoki ◽  
Yasushi Tsujimoto ◽  
Aya M Suganuma ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Response Rate ◽  
Controlled Trial ◽  
Response Rates ◽  
Risk Difference ◽  
Web Based ◽  
Subject Line ◽  
Significant Difference ◽  
The Subject

BACKGROUND Low participation rates are one of the most serious disadvantages of Web-based studies. It is necessary to develop effective strategies to improve participation rates to obtain sufficient data. OBJECTIVE The objective of this trial was to investigate the effect of emphasizing the incentive in the subject line of the invitation email and the day of the week of sending the invitation email on the participation rate in a Web-based trial. METHODS We conducted a 2×2 factorial design randomized controlled trial. We contacted 2000 primary care physicians from members of the Japan Primary Care Association in January 2017 and randomly allocated them to 1 of 4 combinations of 2 subject lines (presence or absence of an emphasis on a lottery for an Amazon gift card worth 3000 yen or approximately US $30) and 2 delivery days (sending the invitation email on Tuesday or Friday). The primary outcome was the response rate defined as the number of participants answering the first page of the questionnaire divided by the number of invitation emails delivered. All outcomes were collected between January 17, 2017, and February 8, 2017. RESULTS We analyzed data from 1943 out of 2000 participants after excluding those whose email addresses were invalid. The overall response rate was 6.3% (123/1943). There was no significant difference in the response rates between the 2 groups regarding incentive in the subject line: the risk ratio was 1.12 (95% CI 0.80 to 1.58) and the risk difference was 0.7% (95% CI –1.5% to 2.9%). Similarly, there was no significant difference in the response rates between the 2 groups regarding sending the email on Tuesday or Friday: the risk ratio was 0.98 (95% CI 0.70 to 1.38) and the risk difference was –0.1% (95% CI –2.3% to 2.1%). CONCLUSIONS Neither emphasizing the incentive in the subject line of the invitation email nor varying the day of the week the invitation email was sent led to a meaningful increase in response rates in a Web-based trial with primary care physicians. CLINICALTRIAL University Hospital Medical Information Network Clinical Trials Registry UMIN000025317; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000029121 (Archived by WebCite at http://www.webcitation. org/6wOo1jl9t)

scholarly journals Feasibility, acceptability, and effectiveness of a web-based therapeutic intervention for post-traumatic stress disorder among American Indian/Alaska Native adults in primary care (Preprint)

2019 ◽  
Author(s):  
Vanessa Hiratsuka ◽  
Laurie Moore ◽  
Jaedon P Avey ◽  
Lisa G Dirks ◽  
Barbara D Beach ◽  
...  
Keyword(s):  
Primary Care ◽  
American Indian ◽  
Alaska Native ◽  
Repeated Measures ◽  
Stress Disorder ◽  
Health Concern ◽  
Web Based ◽  
Study Enrollment ◽  
Primary Care Patients

BACKGROUND Posttraumatic stress disorder (PTSD) is a major public health concern among American Indian and Alaska Native (AI/AN) populations. Primary care clinics are often the first point of contact for AI/AN people seeking health care and are feasible locations for trauma-focused interventions. OBJECTIVE Web-based therapeutic interventions (WBTI) for PTSD have the potential to reduce PTSD symptoms in AI/AN primary care patients by offering culturally tailored psychoeducation and symptom self-management tools. In this study, we investigate the feasibility and acceptability in two AI/AN serving primary care sites and effectiveness of a WBTI on trauma symptom changes in a 12-week period. METHODS A community-based participatory research process was used to refine the WBTI adaptations and content, and conduct a feasibility test of the resultant 16-guide intervention “Health is Our Tradition: Balance and Harmony after Trauma” within two AI/AN healthcare settings. AI/AN people ages 18 years and older who were not in crisis and scored positive on the primary care PTSD instrument completed baseline measures and were trained on WBTI usage. Participants were provided weekly tip via text message during the 12-week intervention. Content was devised to reinforce website use, complement website content, and remind participants about follow-up visits. At each visit, participants completed follow-up versions of all baseline measures (except demographics) including the PC-PTSD and a satisfaction/acceptability questionnaire. Electronic health records were collected for the periods extending to 12 months prior to study enrollment and 3 months following study enrollment. Changes in perceptions of acceptability/feasibility between the 6-week and 12-week follow-up were examined with paired t-tests. Analysts explored changes in symptomatology over the 12-week intervention with one-way ANOVAs for repeated measures or repeated measures logistic regression tests. To examine the effect of the intervention on service utilization, analysts compared clinic visit frequency from the health record data in the 12 months before the intervention (divided by 4 for comparison) and the 3 months after it with paired t-tests. The Wilcoxon Signed Rank Test for non-parametric data was used to test significance for non-normally distributed data. RESULTS In a sample of N=24, the WBTI was well received with no difference in use, engagement, satisfaction or technical skills needed for use by age or gender. Website usage decreased significantly over the course of the 12-week intervention period yet participants reported significant reductions in PTSD, depression, and physical symptoms related to PTSD, and problematic alcohol use over the same period of WBTI usage. CONCLUSIONS The website shows promise for integration into primary care and behavioral health settings to augment and improve access to treatment of the health consequences of trauma exposure among adult AI/AN primary care patients.

scholarly journals Development of an interactive, web-based shared care plan to facilitate the follow-up care of colorectal cancer patients

2019 ◽  
Author(s):  
Jane Taggart ◽  
Melvin Chin ◽  
Winston Liauw ◽  
Alex Dolezal ◽  
John Plahn ◽  
...  
Keyword(s):  
Primary Care ◽  
Clinical Information ◽  
Shared Care ◽  
Care Plan ◽  
Web Based ◽  
Care Plans ◽  
Cancer Services ◽  
Follow Up Care ◽  
Primary Care Practitioners

Abstract Introduction A shared model of care between cancer services and primary health care is safe and acceptable and can address the increasing demands on cancer services for long term follow-up. This paper describes the challenges developing an interactive shared care plan for colorectal cancer follow-up care that supports collaboration between the care team and patient. Methods A systematic literature review was undertaken to identify web-based care plans for follow-up cancer care that would inform the implementation of a system to share an individualised care plan. We conducted individual consultations with 25 key informants/stakeholders to understand the requirements and challenges of establishing the web-based care plan and to identify the technical options to share the care plan. This was followed by a structured group consultation with 13 key stakeholders to obtain agreement on the model of care and the technical solution to share the care plan. Results We identified five web-based shared care plans for cancer follow-up care. These systems supported the creation and/or access to view or share the care plan via internet log-in, email or hard copy. None of the SCP had interactive functionalities to support collaboration and none of the included papers reported formalised models of shared care between cancer services and primary care. The challenges identified included the security, privacy and sharing of patient information between public health services and primary health care and poor integration of clinical information systems. A primary care practitioners’ care planning system was selected for the pilot as it addressed the challenge of sharing clinical information between the public health system and external clinicians, partially addressed integration (integrated with the primary care clinical information systems but did not integrate with the cancer centre systems), supported collaboration between the care team and patient and was relatively inexpensive. Conclusion Primary care shared care planning systems seem a suitable option for sharing clinical information between a cancer service and primary care practitioners. We plan to evaluate the feasibility and acceptability of this interactive shared care plan to support shared cancer follow-up care.

scholarly journals Development of an interactive, web-based shared care plan to facilitate the follow-up care of colorectal cancer patients

2019 ◽  
Author(s):  
Jane Taggart ◽  
Melvin Chin ◽  
Winston Liauw ◽  
John Lewis ◽  
Alex Dolezal ◽  
...  
Keyword(s):  
Primary Care ◽  
Clinical Information ◽  
Shared Care ◽  
Care Plan ◽  
Web Based ◽  
Care Plans ◽  
Cancer Services ◽  
Follow Up Care ◽  
Primary Care Practitioners

Abstract Introduction A shared model of care between cancer services and primary health care is safe and acceptable and can address the increasing demands on cancer services for long term follow-up. This paper describes the challenges developing an interactive shared care plan for colorectal cancer follow-up care. Methods A systematic literature review identified the use, functionality, and impact of web-based shared care plans to support cancer follow-up. Workshops with key stakeholders and consultations with clinicians, consumers and information service providers were conducted to agree on a model of care and technology options to interactively share a care plan. Results Seventeen papers reported five web-based shared care plan systems for cancer follow-up. These systems supported the creation and/or access to view or share the care plans using email or by downloading and printing a copy. The challenges we found included issues with the security, privacy and sharing of patient information between public health services and primary health care and poor integration of clinical information systems. We selected a primary care practitioners’ care planning system as it was interactive, integrated with primary care practitioner’ clinical information systems, was relatively inexpensive and addressed the sharing of clinical information with external clinicians to the public health system. Conclusion Primary care shared care planning systems seem a suitable option for sharing clinical information between a cancer service and primary care practitioners. We plan to evaluate the feasibility and acceptability of this interactive shared care plan to support shared cancer follow-up care.

scholarly journals Feasibility of Implementing a Web-based Tool Built from Pharmacy Claims Data (e-MEDRESP) to Monitor Adherence to Respiratory Medications in Primary Care

2021 ◽  
Author(s):  
Alia Yousif ◽  
Catherine Lemière ◽  
Amélie Forget ◽  
Marie-France Beauchesne ◽  
Lucie Blais
Keyword(s):  
Primary Care ◽  
Medication Adherence ◽  
Claims Data ◽  
Inhaled Corticosteroids ◽  
Physician Satisfaction ◽  
Chronic Obstructive ◽  
Web Based ◽  
Telephone Interviews ◽  
Pharmacy Claims

Objectives: e-MEDRESP is a novel web-based tool that provides easily interpretable information on patient adherence to asthma/chronic obstructive pulmonary disease medications, using pharmacy claims data. This study investigated the feasibility of implementing e-MEDRESP in primary care. Materials and Methods: In this 16-month prospective cohort study, e-MEDRESP was integrated into electronic medical records. Nineteen family physicians and 346 of their patients were enrolled. Counters embedded in the tool tracked physician use during the follow-up. Patient/physician satisfaction with e-MEDRESP was evaluated though telephone interviews and online questionnaires. The capacity of e-MEDRESP to improve adherence was explored using a pre–post analysis. Results: Overall, 252 patients had at least one medical visit during follow-up. e-MEDRESP was consulted by 15 (79%) physicians for 85 (34%) patients during clinic visits. Seventy-three patients participated in telephone interviews; 84% reported discussing their medication use with their physician; 33% viewed their e-MEDRESP report and indicated that it was easy to interpret. The physicians reported that the tool facilitated their evaluation of their patients’ medication adherence (mean ± standard deviation rating: 4.8 ± 0.7, on a 5-point Likert scale). Although the pre–post analysis did not reveal improved adherence in the overall cohort, adherence improved significantly in patients whose adherence level was <80% and patients prescribed inhaled corticosteroids (26.9% [95% CI 14.3%–39.3%]) or long-acting muscarinic agents (26.4% [95% CI 12.4%–40.2%]). Conclusions: e-MEDRESP was successfully integrated in clinical practice. It could serve as a powerful tool to help physicians monitor their patients’ medication adherence.

Breast cancer survivorship care plan: Patient satisfaction with a web-based application.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 50-50 ◽  
Author(s):  
Anne Moore ◽  
Anna Carlson ◽  
Naomi Kornhauser ◽  
Sarah E. Schneider ◽  
Eleni Andreopoulou ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Patient Satisfaction ◽  
Patient Data ◽  
Survivorship Care Plan ◽  
Survivorship Care ◽  
Web Based ◽  
Care Plans ◽  
Survey Results

50 Background: The American College of Surgeons Commission on Cancer Standard 3.3 mandates that by 2018, oncologists provide Survivorship Care Plans (SCPs) to more than 75% of Stage 1-3 breast cancer survivors. Preparation and delivery of SCPs is time-consuming and requires dedicated staff commitment. Working with PatientsWithPower(PWP), a digital health company supporting patient decision-making for breast cancer, we developed a web-based SCP and surveyed patients regarding their satisfaction with the SCP. The objective of this study was to assess patient satisfaction with the PWP SCP. Methods: SCP’s were prepared using data extracted from the electronic medical record (EMR) and PWP software. A one-page SCP was presented to each patient by the Nurse Practitioner (NP) during a routine visit after patients completed active treatment. Results were reviewed after all surveys were completed. Fifty women with Stage 0-3 breast cancer participated in the IRB approved study and reported their satisfaction with the PWP SCP via online survey. Results: Using patient data in the EMR, the PWP plan took about 45 minutes to prepare. Once completed, NPs spent 10-15 minutes with each patient reviewing the SCP. Patient surveys indicated that 98% of patients felt it was important to receive a SCP, 84% planned to use it to plan follow up management, and 75% intended to share the SCP with their primary care physician. According to patients, the most valuable parts of the SCP were diagnosis and treatment history, and the follow up schedule. More than 70% of women requested additional information about future screening for recurrence, nutrition, and long-term side effect management. 92% of women appreciated the electronic “living document” that can be easily updated at subsequent visits. Conclusions: Presenting SCPs to patients is an essential component of high-quality cancer care. PWP’s online platform facilitates the development and delivery of SCPs by organizing and storing on-going patient data to make future SCP updates easy and efficient. Our patient satisfaction survey results underscore the value of SCPs, particularly for follow-up management and communications with primary care doctors.

The Feasibility of using Web-Based Methods to Capture Quality of Recovery in the Perioperative Period: Comparing Email, SMS Text, and Concurrent Mixed Modes Approaches (Preprint)

2020 ◽  
Author(s):  
Jamie L. Romeiser ◽  
James Cavalcante ◽  
Deborah C. Richman ◽  
Sunitha M. Singh ◽  
Xiaohui Liang ◽  
...  
Keyword(s):  
Hospital Discharge ◽  
Text Messaging ◽  
Response Rates ◽  
Web Based ◽  
Quality Of Recovery ◽  
Mixed Modes ◽  
The Web ◽  
Sms Text Messaging

BACKGROUND As patients are being discharged from the hospital earlier, the ability to monitor patient recovery between hospital discharge and the first follow-up clinic visit is becoming increasingly important. Despite substantial increases in both internet use and smartphone ownership over the past 5 years, clinicians have been slow to embrace the use of these devices to capture patient recovery information in the period between hospital discharge and the first clinical follow-up appointment. OBJECTIVE To investigate the generalizability of using a web-based platform to capture patient recovery in a broad surgical patient population, and compare response rates for three different web-based strategies for delivering recovery surveys over the perioperative time-period: email, short message service (SMS) text messaging, and a concurrent mixed approach of using both email and SMS text messaging. METHODS Patients undergoing surgeries managed with an Enhanced Recovery After Surgery (ERAS) pathway program were asked to participate in the web-based quality assurance monitoring program at the time of their pre-operative surgery appointment. Different follow-up methods were implemented over three sequential phases. Patients received HIPAA compliant web-based survey links by either email (phase 1), SMS text (phase 2), or concurrently using both email and SMS text (phase 3) using RedCap® and Twillio® software. Recovery assessments using the established Quality of Recovery-9 (QOR-9) tool were measured 4 days prior to surgery, and at 7 and 30 days postoperatively. Generalizability of the web-based system was examined by comparing demographic and clinical characteristics of those who participated vs. those that did not. Differences in response rates by web-based collection method were analyzed in adjusted models. RESULTS A total of 615 patients asked to participate, with 526 (85.53%) opting in to the follow-up program. Those who opted in were younger, slightly healthier, and more likely to be in a partnership. The concurrent mixed modes (CMM) was the most successful method for obtaining responses at every time point compared to text or email alone (pre: 74% vs. 67% vs 43%, P <.001; 7 day: 67% vs. 50% vs. 47%, P = .001; 30 day: 65% vs. 50% vs. 43%, P = .001, respectively). In the adjusted model, the CMM method of contact significantly predicted response compared to using email alone (Odds Ratio (OR) =3.4, P <.0001), and SMS text alone (OR=1.9, P =.0003). Additional significant predictors of response were race, partnership and time. CONCLUSIONS For internet users and smartphone owners, electronic capture of recovery surveys appears to be possible through this HIPAA compliant resource friendly mechanism. Discrepancies in both inclusion and response rates still exist among certain subgroups of patients, but the concurrent approach of using both email and text messages was the most effective approach to reach the largest number of patients across all subgroups.

Response Rates for Mixed-Mode Surveys Using Mail and E-mail/Web

2008 ◽  
Vol 29 (1) ◽  
pp. 99-107 ◽  
Author(s):  
Patrick D. Converse ◽  
Edward W. Wolfe ◽  
Xiaoting Huang ◽  
Frederick L. Oswald
Keyword(s):  
Mixed Mode ◽  
Design Method ◽  
Mail Survey ◽  
Response Rates ◽  
Initial Contact ◽  
Web Survey ◽  
Web Based ◽  
Tailored Design ◽  
E Mail

This study examines response rates for mixed-mode survey implementation involving mail and e-mail/Web components. Using Dillman's Tailored Design Method, 1,500 participants were sent a survey either (a) via mail with a follow-up contact via e-mail that directed them to a Web-based questionnaire or (b) via e-mail that directed them to a Web-based questionnaire with a follow-up contact via mail. Results indicate that these mixed-mode procedures produce moderately high response rates. However, the mail survey tended to be more effective than the e-mail/Web survey, when serving either as the initial contact or as the follow-up contact. These results suggest that survey implementation involving mail followed by e-mail/Web, or even mail-only approaches, may result in larger samples than implementation involving e-mail/Web followed by mail.

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