Assessing non-response to a mailed health survey including self-collection of biological material.
BACKGROUND
Collection of biological material via mailed health surveys is an emerging trend. This study was conducted to assess non-response bias in a study of sexually transmitted infection utilizing self-collected, home-obtained specimens.


METHODS
Data from a nationwide administrative database on health care utilization together with data from a research study were used. The research study was an outreach screening programme including home-obtained, participant-collected, mail-delivered testing for Chlamydia trachomatis. A random sample of 1690 persons aged 18-35 years from the population registry was selected. Study materials (specimen collection kit, informed consent, questionnaire) were mailed in three waves.


RESULTS
The first mailing yielded a response rate of 18.5% (n = 259), the second 10.1% (n = 141) and the third 11.4% (n = 160). Women were more likely to respond than men, and responders were less likely to have had medical care in the past year and more likely to have had a prior sexually transmitted infection than non-responders. Chlamydia trachomatis infection rates tended to be higher in early responders. Late responders appeared more like non-responders in terms of demographic factors, health care utilization patterns and potential disease status.


CONCLUSIONS
Non-response in a health survey including biological material self-collection warrants research as it may differ from non-response in general health questionnaires.
Uusküla
Anneli
A
Department of Public Health, University of Tartu, Tartu, Estonia. anneli.uuskula@ut.ee
Kals
Mart
M
McNutt
Louise-Anne
LA
D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000175:diagnosis*; D002692:Chlamydia trachomatis; D004957:Estonia; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D011177:Postal Service; D045808:Refusal to Participate / Q000706:statistics & numerical data*; D013048:Specimen Handling / Q000379:methods*; D055815:Young Adult
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