East Tennessee State University College of Public Health’s Center for Applied Research and Evaluation in (CARE) Women’s Health, in collaboration with ETSU’s Applied Social Research Lab (ASRL), has recently published an article in Family and Community Health titled “Breaking Bread” With Respondents: Strategies to Increase Response Rates and Create Long-Term Cooperation With Health Clinic Administrators.”
Kelly Foster, ASRL’s Director, is lead author. Co-authors include Candace Bright and Morgan Kidd of ASRL along with Kate Beatty and Jordan de Jong of CARE Women’s Health. In addition to faculty, co-authors include two ETSU College of Public Health alumna, Kristen Surles and Liane Ventura.
Health clinics, particularly health department and federally qualified health center clinics, are essential safety-net providers serving low-income, uninsured and underinsured people. These clinics provide a range of preventive services, including reproductive health, maternal and child health services, and are often the only point of access to care for their patient populations. The role of safety-net clinics is particularly important in the Southeast US where large segments of the population remain uninsured/underinsured and face multiple barriers to access to care. To fully understand the policies, practices, challenges and needs of safety-net clinics, as well as to evaluate the implementation and outcomes of programs aimed at expanding access to care, researchers must be able to collect comprehensive data from health clinics that provide services in diverse communities.
This paper details recruitment and incentive strategies, as well as the theories that guided them, which allowed the CARE Women’s Health team, in collaboration with ASRL, to achieve a high survey response rate among health clinic administrators in two Southeastern states.
“Surveying health clinics about their service provision, policies, and practices is essential for understanding patterns of health care service delivery, particularly for low-income and uninsured/underinsured individuals, yet survey studies have struggled with declining response rates, limiting the representativeness of the data and the generalizability of findings,” said Dr. Amal Khoury, Director of CARE Women’s Health. “Our team has leveraged theory with innovative strategies to maximize response rates to health surveys. This ensures meaningful survey results that can effectively guide public health interventions and evaluation studies and ultimately help expand access to care for underserved populations.”
Grounded in organizational theory, and utilizing the Tailored Design Method, the team achieved a 68% response rate utilizing paper and web survey administration with multiple contact modes. The incentive structure comprised both traditional cash-based and food-based incentives. Findings indicate high response rates are achievable despite the high survey burden. The team found that sample screening was critical and that food-based incentives made an impression on respondents that positively impacted the researcher–respondent relationship.
Dr. Khoury concludes, “We are excited to share these successful strategies with survey researchers and evaluators and trust that they will find them helpful for their work.”