title: Enclosing a pen with a postal questionnaire can significantly increase the response rate.
abstract: OBJECTIVE
  It is important to maximize response rates to postal questionnaires. We compared the impact of three low-cost interventions on response rates.
  
  
  METHODS
  A 2 x 2 x 2 factorial trial was conducted, nested within TOMBOLA (Trial Of Management of Borderline and Other Low-grade Abnormal smears). Three interventions were evaluated: (1) enclosing a TOMBOLA-branded pen with the questionnaire (as opposed to no pen); (2) sending the questionnaires by first class post (as opposed to second class); and (3) enclosing a preaddressed return envelope on which there was a second class postage stamp (rather than a freepost business-reply envelope). Nine hundred thirty women, aged 20-59 years, due to receive a TOMBOLA psychosocial questionnaire by post during June-August 2003 were randomized.
  
  
  RESULTS
  Enclosing a pen resulted in a statistically significant 7.0% increase in the cumulative proportion of questionnaires returned (from 61.5 to 68.5%; P = .002). The adjusted odds of response was significantly raised (odds ratio [OR] = 1.38, 95% confidence interval [CI] 1.04-1.82). Neither first class post nor providing a stamped envelope had a significant impact on response. There were no interactions between the interventions.
  
  
  CONCLUSIONS
  Enclosing a pen with a questionnaire can significantly increase response. This low-cost strategy was effective against a background of "good practice" with regard to the administration of postal questionnaires.
authors.affiliation: Epidemiology Group, Department of Medicine & Therapeutics, University of Aberdeen, Aberdeen AB25 2ZD, Scotland. linda.sharp@ncri.ie
authors.forename: Linda
authors.initials: L
authors.lastname: Sharp
authors.forename: Claire
authors.initials: C
authors.lastname: Cochran
authors.forename: Seonaidh C
authors.initials: SC
authors.lastname: Cotton
authors.forename: Nicola M
authors.initials: NM
authors.lastname: Gray
authors.forename: Marie E
authors.initials: ME
authors.lastname: Gallagher
mesh_terms: D000328:Adult; D003625:Data Collection; D004864:Equipment and Supplies; D005260:Female; D019538:Health Care Surveys / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D017060:Patient Satisfaction; D011177:Postal Service; D011594:Psychometrics; D018401:Sample Size; D011795:Surveys and Questionnaires; D014626:Vaginal Smears / Q000523:psychology