Does a monetary incentive improve the response to a postal questionnaire in a randomised controlled trial? The MINT incentive study.
BACKGROUND
Sending a monetary incentive with postal questionnaires has been found to improve the proportion of responders, in research in non-healthcare settings. However, there is little research on use of incentives to improve follow-up rates in clinical trials, and existing studies are inconclusive. We conducted a randomised trial among participants in the Managing Injuries of the Neck Trial (MINT) to investigate the effects on the proportion of questionnaires returned and overall non-response of sending a 5 pounds gift voucher with a follow-up questionnaire.


METHODS
Participants in MINT were randomised to receive either: (a) a 5 POUNDSgift voucher (incentive group) or (b) no gift voucher (no incentive group), with their 4 month or 8 month follow-up questionnaire. We recorded, for each group, the number of questionnaires returned, the number returned without any chasing from the study office, the overall number of non-responders (after all chasing efforts by the study office), and the costs of following up each group.


RESULTS
2144 participants were randomised, 1070 to the incentive group and 1074 to the no incentive group. The proportion of questionnaires returned (RR 1.10 (95% CI 1.05, 1.16)) and the proportion returned without chasing (RR 1.14 (95% CI 1.05, 1.24) were higher in the incentive group, and the overall non-response rate was lower (RR 0.68 (95% CI 0.53, 0.87)). Adjustment for injury severity and hospital of recruitment to MINT made no difference to these results, and there were no differences in results between the 4-month and 8-month follow up questionnaires. Analysis of costs suggested a cost of 67.29 POUNDS per additional questionnaire returned.


CONCLUSIONS
Monetary incentives may be an effective way to increase the proportion of postal questionnaires returned and minimise loss to follow-up in clinical trials.


BACKGROUND
ISRCTN61305297.
Gates
Simon
S
Warwick Medical School Clinical Trials Unit, University of Warwick, Coventry, UK. s.gates@warwick.ac.uk
Williams
Mark A
MA
Withers
Emma
E
Williamson
Esther
E
Mt-Isa
Shahrul
S
Lamb
Sarah E
SE
D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D009042:Motivation; D019838:Neck Injuries / Q000628:therapy*; D010352:Patient Dropouts / Q000523:psychology*; D011177:Postal Service; D011788:Quality of Life; D012052:Reimbursement, Incentive; D011795:Surveys and Questionnaires / Q000191:economics*; D016896:Treatment Outcome; D006113:United Kingdom