Family Practice Vol. 18, No. 4, 454-456
© Oxford University Press 2001
GP survey response rate: a miscellany of influencing factors
School of Pharmacy and Pharmaceutical Sciences, University of Manchester, Oxford Road, Manchester M13 9PL and
a Division of Primary Healthcare, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, UK.
Morris CJ, Cantrill JA and Weiss MC. GP survey response rate: a miscellany of influencing factors. Family Practice 2001; 18: 454–456.
Received 17 November 2000; Revised 14 February 2001; Accepted 12 March 2001.
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Abstract |
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Background. GP response to surveys is acknowledged to vary widely. The minimization of non-response bias and the generalizability of findings are fundamental research issues.
Objective. The aim of this study was to identify the factors that had influenced GPs' decisions to complete a questionnaire.
Methods. A short questionnaire eliciting GPs' views on minor ailment consultations was sent to 759 GPs from eight English health authorities. The response rate was 54.5%. Factors perceived by respondents to have influenced their decision to complete this questionnaire were also assessed. Subsequently, a feedback summary, together with a short evaluation form, was sent to those GPs requesting it.
Results. The response from GPs located in the London area was significantly lower than that from those elsewhere. Respondents identified questionnaire length and the originating institution as the two major factors influencing their decision to return the survey. A single mailing of the evaluation form yielded a response rate of >60% predominantly positive comments.
Conclusion. Many factors influence a GP's decision to complete a survey. The effect of location has, to date, largely been ignored. Furthermore, this study suggested feedback to be an important issue. Within health services research, all possible factors need to be considered to maximize response, reduce non-response bias and ultimately facilitate the dissemination of findings.
Keywords. Feedback, GPs, response, survey..
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Introduction |
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Many factors have been identified as affecting GP survey response rate. These include volume of requests, questionnaire length, insufficient background information, the perceived value of the research and lack of financial incentives.1 The potential importance of providing feedback has also been highlighted.2 While two previous UK studies3,4 have surveyed non-respondents to identify the reason for their non-response, the present study aimed to identify factors that had influenced respondents' decisions to complete a questionnaire.
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Method |
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A questionnaire, designed to be completed within 10 minutes, eliciting GPs' views on minor ailment consultations was sent to one randomly selected GP from each practice in eight randomly selected English health authorities (HAs) in 1999. A final question ascertained how influential (not at all, a minor or major influence) each of five factors (saliency of the research subject; length of the questionnaire; the offer of feedback; the academic origin of the research; and the fact it was ‘student’ research) had been on their decision to return the questionnaire. In addition, respondents were given the opportunity to identify spontaneously any other influencing factors. A summary of the survey's key findings was later sent to those respondents who, in response to a direct question, had requested it, together with a short questionnaire to evaluate this feedback.
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Results |
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The usable survey response rate, after two postal reminders, was 54.5% (414/759). Table 1
shows the response rate and some salient demographic details at individual HA level.
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The response rate from GPs practising in HAs located in the London area (East London and the City; Barking and Havering; Hillingdon) was significantly lower than that from those located elsewhere [39.9% (116/291) versus 63.7% (298/468), chi-square = 41, df 1, P = 0.000]. Each of the factors specified were stated to have influenced, to some degree, at least 72% of respondents to return the questionnaire. The major influencing factors, identified by ~70% of respondents, were questionnaire length and originating institution. Forty-six respondents spontaneously identified other factors, some of which are beyond a researcher's control. The following illustrate the range of factors specified.
Factors within the researcher's control
- Questionnaire design "I can understand the questions."
- Mailing of follow-up reminders "You sent a reminder: wouldn't have bothered otherwise—sorry!"
- The initial approach "General tone of the request."
Individual GP factors beyond the researcher's control
- Previous personal experience of the research process "I have done a PhD and recognize the difficulty of getting results!"
- A link with the institution conducting the research "I qualified from Manchester so it caught my eye."
- A perception that personal benefit would be derived from completing it "It helped me to clarify my own thoughts about management of minor illnesses."
- Individual personality traits "Liking to help", feeling "guilty" for not helping, "enjoying" questionnaires.
Others factors, which may be subject to change on a daily basis, were the available time and the level of pressure an individual felt under. The majority of GPs requested the feedback summary (78.8%, 324/411) which was presented in a short and eye-catching format. The feedback evaluation yielded a response rate of 61.3% largely positive comments from a single mailing.
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Discussion |
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Within health services research, all possible factors need to be considered to maximize response, reduce non-response bias and ultimately facilitate dissemination. The present findings have provided insights that add to the existing literature on GP survey response rates. In addition to the factors included in the questionnaire and identified by respondents, the potential influence of geographical location should not be underestimated. It is notable that there are 11 primary care research departments located in the London area. Thus, London GPs may be subject to a greater number of requests to help with research. Furthermore, time pressures may be more acute due to larger practice list sizes and higher proportions of single-handed GPs when compared with the surveyed HAs outside of London (Table 1
). A high proportion of GPs requested feedback. Although potentially the socially acceptable response, this fact together with the largely positive, and high response, to the evaluation form suggested that the GPs valued receiving it. The provision of feedback should therefore be incorporated into studies wherever possible. As this has resource implications, it needs to be considered at the outset.
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Acknowledgments |
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We are grateful to all those GPs who contributed by taking the time to complete the feedback evaluation form and/or the original questionnaire.
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References |
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1 McAvoy BR, Kaner EFS. General practice postal surveys: a questionnaire too far? Br Med J 1996; 313: 732–733.
2 Whitfield M. Giving feedback to questionnaire responders—an essential task? Br J Gen Pract 1997; 47: 241–243.[Web of Science][Medline]
3
MacPherson I, Bisset A. Not another questionnaire!: eliciting the views of general practitioners. Fam Pract 1995; 12: 335–338.
4 Kaner EFS, Haighton CA, McAvoy BR. ‘So much post, so busy with practice—so, no time!’: a telephone survey of general practitioners' reasons for not participating in postal questionnaire surveys. Br J Gen Pract 1998; 48: 1067–1069.[Web of Science][Medline]
5 Department of Health. General and Personal Medical Services Statistics England and Wales 1 October 1998. London: Department of Health, 1999.
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