title: Getting physicians to open the survey: little evidence that an envelope teaser increases response rates.
abstract: BACKGROUND
  Physician surveys are an important tool to assess attitudes, beliefs and self-reported behaviors of this policy relevant group. In order for a physician to respond to a mailed survey, they must first open the envelope. While there is some evidence that package elements can impact physician response rates, the impact of an envelope teaser is unknown. Here we assess this by testing the impact of adding a brightly colored "$25 incentive" sticker to the outside of an envelope on response rates and nonresponse bias in a survey of physicians.
  
  
  METHODS
  In the second mailing of a survey assessing physicians' moral beliefs and views on controversial health care topics, initial nonrespondents were randomly assigned to receive a survey in an envelope with a colored "$25 incentive" sticker (teaser group) or an envelope without a sticker (control group). Response rates were compared between the teaser and control groups overall and by age, gender, region of the United States, specialty and years in practice. Nonresponse bias was assessed by comparing the demographic composition of the respondents to the nonrespondents in the experimental and control condition.
  
  
  RESULTS
  No significant differences in response rates were observed between the experimental and control conditions overall (p = 0.38) or after stratifying by age, gender, region, or practice type. Within the teaser condition, there was some variation in response rate by years since graduation. There was no independent effect of the teaser on response when simultaneously controlling for demographic characteristics (OR = 0.875, p = 0.4112).
  
  
  CONCLUSIONS
  Neither response rates nor nonresponse bias were impacted by the use of an envelope teaser in a survey of physicians in the United States.
authors.affiliation: Mayo Clinic, Rochester, Minnesota 55905, USA. ziegenfuss.jeanette@mayo.edu
authors.forename: Jeanette Y
authors.initials: JY
authors.lastname: Ziegenfuss
authors.forename: Kelly
authors.initials: K
authors.lastname: Burmeister
authors.forename: Katherine M
authors.initials: KM
authors.lastname: James
authors.forename: Lindsey
authors.initials: L
authors.lastname: Haas
authors.forename: Jon C
authors.initials: JC
authors.lastname: Tilburt
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Beebe
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D015709:Correspondence as Topic; D005260:Female; D019538:Health Care Surveys / Q000379:methods* / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000523:psychology* / Q000706:statistics & numerical data; D011177:Postal Service; D011331:Private Practice / Q000706:statistics & numerical data; D011594:Psychometrics / Q000379:methods; D012107:Research Design; D012932:Social Facilitation; D011795:Surveys and Questionnaires; D014481:United States