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American Journal of Epidemiology Advance Access originally published online on June 22, 2005
American Journal of Epidemiology 2005 162(3):261-266; doi:10.1093/aje/kwi194
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American Journal of Epidemiology Copyright © 2005 by the Johns Hopkins Bloomberg School of Public Health All rights reserved

PRACTICE OF EPIDEMIOLOGY

Increasing Response to Mailed Questionnaires by Including a Pencil/Pen

Emily White1,2, Patricia A. Carney3 and Ann Shattuck Kolar1

1 Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA
2 Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, WA
3 Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH

Correspondence to Dr. Emily White, Cancer Prevention Program, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, P.O. Box 19024, Seattle, WA 98109 (e-mail: ewhite{at}fhcrc.org).

Nonmonetary incentives lead to small increases in response rates to mailed questionnaires. However, inclusion of a pen or pencil, which may be a facilitating factor as well as a reward, has not been shown to improve response to health surveys in prior trials. In 2001 and 2002, the authors conducted two US trials in which a study-logo pen or pencil was randomly included in a second questionnaire mailed to nonresponders to a first mailing. In the first study, of 10,686 nonresponders to a cohort recruitment mailing, response to the second mailing was 55% with inclusion of a pen versus 40% without one (p < 0.001). In the second study, of 141 nonresponders to a pilot follow-up survey conducted 2 years after entry into a cohort, response was 43% with inclusion of a pencil versus 24% without one (p = 0.02). This 15–19 percentage point increase for mailing 2 translated to a 5–6 percentage point increase after the two mailings combined. In a simulated study of three mailings based on these studies, the overall response rate increased by 4 percentage points at no added cost through inclusion of a pencil in the second mailing. The additional cost of the pencil was compensated for by the reduced number of nonrespondents sent packets at the third mailing. This study supports including a study-logo pen or pencil in a second questionnaire mailing to nonrespondents as a cost-effective method of increasing response rates.

data collection; epidemiologic methods; questionnaires


Abbreviations: NHWH, New Hampshire Women for Health; VITAL, VITamins And Lifestyle


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This article has been cited by other articles:


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Am J EpidemiolHome page
P. Sacco
RE: "INCREASING RESPONSE TO MAILED QUESTIONNAIRES BY INCLUDING A PENCIL/PEN"
Am. J. Epidemiol., August 1, 2006; 164(3): 296 - 296.
[Full Text] [PDF]


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Am J EpidemiolHome page
E. White and A. S. Kolar
TWO AUTHORS REPLY
Am. J. Epidemiol., August 1, 2006; 164(3): 296 - 296.
[Full Text] [PDF]



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