Inclusion of a lottery scratch card with a postal questionnaire increases the response rate in long-term cancer survivors

A successful and effective strategy to improve questionnaire response rates among cancer survivors.

Thank you note

The number of cancer survivors is growing globally and there is extensive interest in investigating the experiences and patient-reported outcomes of those living with and after cancer. Postal surveys have been used to collect data on many patient-reported outcomes. However, non-response can pose problems including reducing the statistical power of the study and limiting the generalisability of findings. It is crucial to identify successful, cost-effective strategies to maximise the response of cancer patients and survivors to questionnaires.

As part of the HRB-funded PiCTure (Prostate Cancer Treatment, your experience) study researchers at the Registry compared two modest monetary incentives (i) the unconditional inclusion of a €1 lottery scratch card with the postal questionnaire the ‘lottery arm’ verses (ii) entry into a prize draw with the chance of winning a €300 voucher conditional upon questionnaire completion ‘prize arm’ – for their effect on the response rate to a postal questionnaire and their relative cost-effectiveness, among 4,820 prostate cancer survivors’ in Ireland.

Inclusion of a €1 lottery scratch card resulted in a statistically significant but modest 2.6% increase in response compared to the conditional incentive of entry into a prize draw when all responders were considered. However, the effect was most pronounced in long-term cancer survivors i.e. those who were 5 years or more beyond their diagnosis. The costs per completed questionnaire were higher in the lottery than the prize arms. 

This is the first time that a lottery scratch card incentive has been shown to have a positive effect on questionnaire response among cancer survivors. The findings suggest that, although more expensive, to optimise response to postal questionnaires among cancer survivors, researchers might consider inclusion of a lottery scratch card.

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