Effects of Sequential Prepaid Incentives on Response Rates, Data Quality, Sample Representativeness, and Costs in a Mail Survey of Physicians.

While collecting high quality data from physicians is critical, response rates for physician surveys are frequently low. A proven method for increasing response in mail surveys is to provide a small, prepaid monetary incentive in the initial mailing. More recently, researchers have begun experimenting with adding a second cash incentive in a follow-up contact in order to increase participation among more reluctant respondents. To assess the effects of sequential incentives on response rates, data quality, sample representativeness, and costs, physicians (N = 1,500) were randomly assigned to treatments that crossed the amount of a first ($5 or $10) and second ($0, $5, or $10) incentive to form the following groups: Group $5/$5; Group $5/$10; Group $10/$0; Group $10/$5; and Group $10/$10. Overall, second incentives were associated with higher response rates and lower costs per completed survey, and while they had no effect on item nonresponse, they increased sample representativeness.

Soy-Based Infant Formula is Associated with an Increased Prevalence of Comorbidities in Fragile X Syndrome.

A large number of adults and children consume soy in various forms, but little information is available regarding potential neurological side effects. Prior work indicates an association between the consumption of soy-based diets and seizure prevalence in mouse models of neurological disease and in children with autism. Herein, we sought to evaluate potential associations between the consumption of soy-based formula during infancy and disease comorbidities in persons with fragile X syndrome (FXS), while controlling for potentially confounding issues, through a retrospective case-control survey study of participants with FXS enrolled in the Fragile X Online Registry with Accessible Research Database (FORWARD). There was a 25% usage rate of soy-based infant formula in the study population. We found significant associations between the consumption of soy-based infant formula and the comorbidity of autism, gastrointestinal problems (GI) and allergies. Specifically, there was a 1.5-fold higher prevalence of autism, 1.9-fold GI problems and 1.7-fold allergies in participants reporting the use of soy-based infant formula. The major reason for starting soy-based infant formula was GI problems. The average age of seizure and allergy onset occurred long after the use of soy-based infant formula. We conclude that early-life feeding with soy-based infant formula is associated with the development of several disease comorbidities in FXS.

Use of monetary and nonmonetary incentives to increase response rates among African Americans in the Wisconsin Pregnancy Risk Assessment Monitoring System.

From 2009 to 2010, an experiment was conducted to increase response rates among African American mothers in the Wisconsin Pregnancy Risk Assessment Monitoring System (PRAMS). Sample members were randomly assigned to groups that received a prepaid, cash incentive of $5 (n = 219); a coupon for diapers valued at $6 (n = 210); or no incentive (n = 209). Incentives were included with the questionnaire, which was mailed to respondents. We examined the effects of the incentives on several outcomes, including response rates, cost effectiveness, survey response distributions, and item nonresponse. Response rates were significantly higher for the cash group than for the coupon (42.5 vs. 32.4%, P < .05) or no incentive group (42.5 vs. 30.1%, P < .01); the coupon and no incentive groups performed similarly. While absolute costs were the highest for the cash group, the cost per completed survey was the lowest. The incentives had limited effects on response distributions for specific survey questions. Although respondents completing the survey by mail in the cash and coupon groups exhibited a trend toward being less likely to have missing data, the effect was not significant. Compared to a coupon or no incentive, a small cash incentive significantly improved response rates and was cost effective among African American respondents in Wisconsin PRAMS. Incentives had only limited effects, however, on survey response distributions, and no significant effects on item nonresponse.

Wisconsin physician opinions on health care reform.

OBJECTIVE: To determine Wisconsin physicians' opinions regarding health care reform. METHODS: The University of Wisconsin Survey Research Center performed a 46-question mail survey of 2500 randomly selected physicians from the Wisconsin Medical Society master list of practicing physicians. Respondents rated opinions on a 5-point Likert scale. Demographics of respondents (sex practice type, geographic location, age) were compared to non-responders and the overall Wisconsin physician population. Data analysis quantified opinions regarding the health care system in Wisconsin and nationally, elements of health care reform proposals, and the role of public policy and government in health care. The analysis emphasized a comparison of primary care versus specialist physician responses. RESULTS: The survey yielded a 38% response rate. Respondent demographics were representative of Wisconsin physicians and very similar to nonresponders. Respondents revealed support for several topics, regardless of the respondent's practice type. Respondents also were in agreement on which elements of reform were most frequently favored and most frequently opposed. Nevertheless, there were many areas where primary care physicians strongly differed from specialists, such as favoring legislation for national health insurance (65.6% primary care versus 46.2% specialist). CONCLUSIONS: Wisconsin physicians responding to this survey expressed dissatisfaction with the health care system in which they currently practice and noted a clear desire for system reform. While most respondents agree on a few key priorities, primary care physicians significantly differ in their preferred strategies for reform and, in particular, the role of government in a reformed system. These results indicate a need for more dialogue and education among physicians in order to achieve a consensus that might help promote reform.