title: Postal surveys in primary care: the hidden burden.
abstract: OBJECTIVE
  To investigate and analyse concerns raised by unsolicited mailing of a health survey to a community sample of older people.
  
  
  METHODS
  Observation and monitoring of all telephone calls received throughout a 6-week survey mailing period.
  
  
  METHODS
  A total sample of all those aged over 50 years registered with three general practices in North Staffordshire (n=8995). MAIN VARIABLE STUDIED: The frequency of telephone contact following the receipt of a postal questionnaire, and the nature of any associated distress.
  
  
  CONCLUSIONS
  Individuals who receive unsolicited postal surveys may experience anxiety because of the actual receipt of the questionnaire, concerns about taking part or not taking part, personal issues, anger, worthiness or frustration with NHS services. Anxiety may also be triggered because of administrative issues, for example lost mail or overlap between mailing periods. Researchers can adopt measures both to reduce the potential anxiety and often hidden burden of postal surveys, and to facilitate individuals' positive participation in research.
authors.affiliation: Primary Care Sciences Research Centre, Hornbeam Building, Keele University, Keele ST5 5BG, UK. c.jinks@cphc.keele.ac.uk
authors.forename: C
authors.initials: C
authors.lastname: Jinks
authors.forename: B N
authors.initials: BN
authors.lastname: Ong
authors.forename: P
authors.initials: P
authors.lastname: Croft
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000786:Anger; D001007:Anxiety; D004739:England; D005260:Female; D005639:Frustration; D019538:Health Care Surveys; D006305:Health Status Indicators; D006801:Humans; D007717:Knee; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000592:standards*; D011177:Postal Service; D011320:Primary Health Care / Q000592:standards*; D011569:Psychiatric Status Rating Scales / Q000592:standards; D013222:State Medicine / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D013689:Telephone