scholarly journals Improving postal survey response using behavioural science: a nested randomised control trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Emily McBride ◽  
Hiromi Mase ◽  
Robert S. Kerrison ◽  
Laura A. V. Marlow ◽  
Jo Waller

Abstract Background Systematic reviews have identified effective strategies for increasing postal response rates to questionnaires; however, most studies have isolated single techniques, testing the effect of each one individually. Despite providing insight into explanatory mechanisms, this approach lacks ecological validity, given that multiple techniques are often combined in routine practice. Methods We used a two-armed parallel randomised controlled trial (n = 2702), nested within a cross-sectional health survey study, to evaluate whether using a pragmatic combination of behavioural science and evidenced-based techniques (e.g., personalisation, social norms messaging) in a study invitation letter increased response to the survey, when compared with a standard invitation letter. Participants and outcome assessors were blinded to group assignment. We tested this in a sample of women testing positive for human papillomavirus (HPV) at cervical cancer screening in England. Results Overall, 646 participants responded to the survey (response rate [RR] = 23.9%). Logistic regression revealed higher odds of response in the intervention arm (n = 357/1353, RR = 26.4%) compared with the control arm (n = 289/1349, RR = 21.4%), while adjusting for age, deprivation, clinical site, and clinical test result (aOR = 1.30, 95% CI: 1.09–1.55). Conclusion Applying easy-to-implement behavioural science and evidence-based methods to routine invitation letters improved postal response to a health-related survey, whilst adjusting for demographic characteristics. Our findings provide support for the pragmatic adoption of combined techniques in routine research to increase response to postal surveys. Trial registration ISRCTN, ISRCTN15113095. Registered 7 May 2019 – retrospectively registered.

2021 ◽  
Author(s):  
Emily McBride ◽  
Hiromi Mase ◽  
Robert S. Kerrison ◽  
Laura A.V. Marlow ◽  
Jo Waller

Abstract Background Systematic reviews have identified effective strategies for increasing postal response rates to questionnaires; however, most studies have isolated single techniques, testing the effect of each one individually. Despite providing insight into explanatory mechanisms, this approach lacks ecological validity, given that multiple techniques are often combined in routine practice. Methods We used a two-armed randomised controlled trial (N = 2,702), nested within a cross-sectional health survey study, to evaluate whether using a pragmatic combination of behavioural science and evidenced-based techniques (e.g., personalisation, social norms messaging) in a study invitation letter increased response to the survey, when compared with a standard invitation letter. Results Overall, 646 participants responded to the survey (response rate [RR] = 23.9%). Logistic regression revealed higher odds of response in the intervention arm (N = 357/1,353, RR = 26.4%) compared with the control arm (N = 289/1,349, RR = 21.4%), while adjusting for age, deprivation, clinical site, and clinical test result (aOR = 1.30, 95% CI: 1.09–1.55). Conclusion Applying easy-to-implement behavioural science and evidence-based methods to routine invitation letters improved postal response to a health-related survey, whilst adjusting for demographic characteristics. Our findings provide support for the pragmatic and cost-effective adoption of combined techniques in routine research to increase response to postal surveys. Trial registration: ISRCTN, ISRCTN15113095. Registered 7 May 2019 – retrospectively registered: https://doi.org/10.1186/ISRCTN15113095


Author(s):  
Dalga Surofchy ◽  
Christina Mnatzaganian ◽  
Lord Sarino ◽  
Grace Kuo

Background Pharmacists represent some of the most accessible healthcare workers and are in an opportune position to spearhead new clinical initiatives, such as pharmacogenomics (PGx) services. It is important that we understand the perceptions and attitudes both pharmacists and patients have regarding PGx and potential barriers of implementing it into routine clinical practice. Methods A cross-sectional survey study was conducted across one regional division of a large community pharmacy chain to assess the perceptions and attitudes of pharmacists and patients regarding PGx in California. A secondary aim was to determine perceived barriers to PGx implementation into community pharmacies. Results The majority (67%) of pharmacists agreed or strongly agreed to understanding PGx compared to 35% of patients being aware of PGx (p<0.001). More patients (62%) preferred their pharmacist compared to pharmacists (43%) preferring themselves as a provider to manage patients' medications based on their PGx results (p<0.01). Many patients (88%) expressed interest in participating in a PGx test; both pharmacists (84%) and patients (85%) were unlikely to have participated or know someone who has participated in PGx testing. Pharmacists and patients expressed similar concerns about privacy of their PGx data by employers (p=0.287) and insurers (p=0.953), a potential barrier to PGx implementation. Conclusion Pharmacists are well positioned to spearhead PGx consultations and patients are interested in pharmacists using PGx to help manage their medications; however, various barriers were identified that must be overcome for PGx to become incorporated in routine practice.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Natalie Gold ◽  
Caroline Durlik ◽  
Jet G. Sanders ◽  
Katherine Thompson ◽  
Tim Chadborn

Abstract Background The NHS Health Check (NHSHC) is a national programme for the prevention of non-communicable diseases. Patients aged 40–74 without an existing cardiovascular-related condition should be invited quinquennially. Uptake is lower than anticipated. We assessed the impact on uptake of two new behaviourally-enhanced leaflets (with the current national leaflet as a control), enclosed with the invitation letter: the first trial on the leaflet. Methods A double-blind three-armed randomized controlled trial was conducted. The new leaflets were shorter (two pages, instead of four); one was loss-framed (‘don’t miss out’) and the other was gain-framed (‘make the most of life’). The participants were patients from 39 practices in Lewisham and 17 practices in NE Lincolnshire, who were allocated to interventions using a random-number generator and received one of the leaflets with their invitation letter from April–September 2018. The outcome measure was uptake of an NHSHC by November 2018. The trial was powered to detect a 2% effect. Results Uptake was 17.6% in the control condition (n = 3677), 17.4% in the loss-framed condition (n = 3664), and 18.2% in the gain-framed condition (n = 3697). Leaflet type was not a significant predictor of NHSHC uptake in a logistic regression that controlled for demographic variables, with GP practice as a random effect. Statistically significant predictors of uptake included location (higher uptake in Lewisham), age (increased age was associated with increased attendance) and sex (higher uptake in females). The Bayes Factor comparing the null to a hypothesis of differences between conditions was 416, which is extreme evidence in favour of the null hypothesis. Conclusion There was no evidence for a meaningful effect of either a loss-framed or gain-framed behaviourally-informed leaflet type on uptake, which is surprising, given that behaviourally informed letters have improved uptake of NHSHCs. It is possible that people do not pay attention to leaflets that are enclosed with letters, or that the leaflet continues to support informed decision-making but this does not affect uptake. Trial registration Clinicaltrials.gov, NCT03524131. Registered May 14, 2018. Retrospectively registered.


2018 ◽  
Vol 20 (2) ◽  
Author(s):  
Winnie Thembisile Maphumulo ◽  
Busisiwe Bhengu

The National Department of Health in South Africa has introduced the National Core Standards (NCS) tool to improve the quality of healthcare delivery in all public healthcare institutions. Knowledge of the NCS tool is essential among healthcare providers. This study investigated the level of knowledge on NCS and how the NCS tool was communicated among professional nurses. This was a cross-sectional survey study. Purposive sampling technique was used to select hospitals that only offered tertiary services in KwaZulu-Natal. Six strata of departments were selected using simple stratified sampling. The population of professional nurses in the selected hospitals was 3 050. Systematic random sampling was used to recruit 543 participants. The collected data were analysed using SPSS version 25. The study showed that only 16 (3.7%) respondents had knowledge about NCS, using McDonald’s standard of learning outcome measured criteria regarding the NCS tool. The Pearson correlation coefficient between the communication and knowledge was r = 0.055. The results revealed that although the communication scores for the respondents were high their knowledge scores remained low. This study concluded that there is a lack of knowledge regarding the NCS tool and therefore healthcare institutions need to commit themselves to the training of professional nurses regarding the NCS tool. The findings suggest that healthcare institutions implement the allocation of incentives for nurses that attend the workshops for NCS.


2020 ◽  
Author(s):  
Khanh Ngoc Cong Duong ◽  
Tien Nguyen Le Bao ◽  
Phuong Thi Lan Nguyen ◽  
Thanh Vo Van ◽  
Toi Phung Lam ◽  
...  

BACKGROUND The first nationwide lockdown due to the COVID-19 pandemic was implemented in Vietnam from April 1 to 15, 2020. Nevertheless, there has been limited information on the impact of COVID-19 on the psychological health of the public. OBJECTIVE This study aimed to estimate the prevalence of psychological issues and identify the factors associated with the psychological impact of COVID-19 during the first nationwide lockdown among the general population in Vietnam. METHODS We employed a cross-sectional study design with convenience sampling. A self-administered, online survey was used to collect data and assess psychological distress, depression, anxiety, and stress of participants from April 10 to 15, 2020. The Impact of Event Scale-Revised (IES-R) and the Depression, Anxiety, and Stress Scale-21 (DASS-21) were utilized to assess psychological distress, depression, anxiety, and stress of participants during social distancing due to COVID-19. Associations across factors were explored using regression analysis. RESULTS A total of 1385 respondents completed the survey. Of this, 35.9% (n=497) experienced psychological distress, as well as depression (n=325, 23.5%), anxiety (n=195, 14.1%), and stress (n=309, 22.3%). Respondents who evaluated their physical health as average had a higher IES-R score (beta coefficient [B]=9.16, 95% CI 6.43 to 11.89), as well as higher depression (B=5.85, 95% CI 4.49 to 7.21), anxiety (B=3.64, 95% CI 2.64 to 4.63), and stress (B=5.19, 95% CI 3.83 to 6.56) scores for DASS-21 than those who rated their health as good or very good. Those who self-reported their health as bad or very bad experienced more severe depression (B=9.57, 95% CI 4.54 to 14.59), anxiety (B=7.24, 95% CI 3.55 to 10.9), and stress (B=10.60, 95% CI 5.56 to 15.65). Unemployment was more likely to be associated with depression (B=3.34, 95% CI 1.68 to 5.01) and stress (B=2.34, 95% CI 0.84 to 3.85). Regarding worries about COVID-19, more than half (n=755, 54.5%) expressed concern for their children aged &lt;18 years, which increased their IES-R score (B=7.81, 95% CI 4.98 to 10.64) and DASS-21 stress score (B=1.75, 95% CI 0.27 to 3.24). The majority of respondents (n=1335, 96.4%) were confident about their doctor’s expertise in terms of COVID-19 diagnosis and treatment, which was positively associated with less distress caused by the outbreak (B=–7.84, 95% CI –14.58 to –1.11). CONCLUSIONS The findings highlight the effect of COVID-19 on mental health during the nationwide lockdown among the general population in Vietnam. The study provides useful evidence for policy decision makers to develop and implement interventions to mitigate these impacts. CLINICALTRIAL


2020 ◽  
Author(s):  
Ke Zeng ◽  
Weiguo Zhu ◽  
Caiyou Wang ◽  
Liyan Zhu

BACKGROUND The rapid spread of COVID-19 has created a severe challenge to China’s healthcare system. Hospitals across the country reacted quickly under the leadership of the Chinese government and implemented a range of informatization measures to effectively respond to the COVID-19. OBJECTIVE To understand the impact of the pandemic on the medical business of Chinese hospitals and the difficulties faced by hospital informatization construction. To discuss the application of hospital informatization measures during the COVID-19 pandemic. To summarize the practical experience of hospitals using information technology to fight the pandemic. METHODS Performing a cross-sectional on-line questionnaire survey in Chinese hospitals, of which the participants are invited including hospital information staff, hospital administrators, medical staff, etc. Statistical analyzing the collected data by using SPSS version 24. RESULTS A total of 804 valid questionnaires (88.45%) are collected in this study from 30 provinces in mainland China, of which 731 (90.92%) were filled out by hospital information staff. 473 (58.83%) hospitals are tertiary hospitals while the remaining 331 (41.17%) are secondary hospitals. The majority hospitals (82.46%) had a drop in their business volume during the pandemic and a more substantial drop is found in tertiary hospitals. 70.40% (n=566) of hospitals have upgraded or modified their information systems in response to the epidemic. The proportion of tertiary hospitals that upgraded or modified systems is significantly higher than that of secondary hospitals. Internet hospital consultation (70.52%), pre-check and triage (62.56%), telemedicine (60.32%), health QR code (57.71%), and telecommuting (50.87%) are the most used informatization anti-pandemic measures. There are obvious differences in the application of information measures between tertiary hospitals and secondary hospitals. Among these measures, most of them (41.17%) are aiming at serving patients and most of them (62.38%) are universal which continue to be used after pandemic. The informatization measures are mostly used to control the source of infection (48.19%), such as health QR Code, etc. During the pandemic, the main difficulties faced by the hospital information department are “information construction projects are hindered” (58.96%) and “increased difficulty in ensuring network information security” (58.58%). There are significant differences in this issue between tertiary hospitals and secondary hospitals. The shortcomings of hospital informatization that should be made up for are “shorten patient consultation time and optimize consultation process” (72.51%), “Ensure network information security” (72.14%) and “build internet hospital consultations platform” (59.95%). CONCLUSIONS A significant number of innovative medical information technology have been used and played a significant role in all phases of COVID-19 prevention and control in China. Since the COVID-19 brought many challenges and difficulties for informatization work, hospitals need to constantly improve their own information technology skills to respond to public health emergencies that arise at any moment.


Antibiotics ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 356
Author(s):  
Catherine J. Woods ◽  
Zoe Morrice ◽  
Nick A. Francis ◽  
Paul Little ◽  
Theo Verheij ◽  
...  

Children presenting with uncomplicated lower respiratory tract infections (LRTIs) commonly receive antibiotics despite public campaigns on antibiotic resistance. Qualitative interview studies were nested in a placebo-controlled trial of amoxicillin for LRTI in children. Thirty semi-structured telephone interviews were conducted with sixteen parents and fourteen clinicians to explore views of management and decisions to participate in the trial. All interviews were audio-recorded, transcribed and analysed using thematic analysis. Parents found it difficult to interpret symptoms and signs, and commonly used the type of cough (based on sound) to judge severity, highlighting the importance of better information to support parents. Provision of a clinical examination and reassurance regarding illness severity were key motivations for consulting. Many parents now acknowledge that antibiotics should only be used when ‘necessary’, and clinicians reported noticing a shift in parent attitudes with less demand for antibiotics and greater satisfaction with clinical assessment, reassurance and advice. Decisions to take part in the trial were influenced by the perceived risks associated with allocation to a placebo, and concerns about unnecessary use of antibiotics. Clear communication about self-management and safety-netting were identified as important when implementing ‘no antibiotic’ prescribing strategies to reassure parents and to support prescribing decisions.


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