Improving Electronic Survey Response Rates Among Cancer Center Patients During the COVID-19 Pandemic: A Pilot Study.

BACKGROUND: Surveys play a vital role in cancer research. During the COVID-19 pandemic, the use of electronic surveys is crucial to improve understanding of the patient experience. However, response rates to electronic survey are often lower compared to paper surveys. OBJECTIVE: Our goal was to determine the best approach to improve response rates for an electronic survey administered to patients at a cancer center during the COVID-19 pandemic. METHODS: We contacted 2,750 patients seen at Moffitt Cancer Center in the prior five years via email to complete a survey regarding their experience during the COVID-19 pandemic, with patients randomly assigned to a series of variations of pre-notifications (i.e., postcard, letter) or incentives (i.e., small gift, modest gift card). In total, eight combinations were evaluated. Qualitative interviews were conducted to understand the level of patient understanding and burden with the survey, and quantitative analysis evaluated the response rates between conditions. RESULTS: A total of 262 (9.5%) patients completed the survey, and 9 participated in a qualitative interview. Interviews revealed minimal barriers in understanding or burden and resulted in minor survey design changes. Compared to sending an email only, sending a postcard or letter prior to the email improved response rates from 3.7% to 9.8%. Similarly, inclusion of an incentive significantly increased response the rate from 5.4% to 16.7%, especially among racial (3.0% to 12.2%) and ethnic minorities (6.4% to 21.0%) as well as patients with low socioeconomic status (3.1% to 14.9%). CONCLUSIONS: Strategies to promote effective response rates include pre-notification postcards or letters as well as monetary incentives. This work can inform future survey development to increase response rates for electronic surveys, particularly among hard-to-reach populations.