Increasing response rates to lifestyle surveys: a review of methodology and 'good practice'.

Background
Lifestyle surveys are traditionally used for collecting detailed population information about
individual behaviours that impact on health. However, declining response rates and the
under-representation of certain population groups in lifestyle survey data has led to
uncertainty over the accuracy of any findings. In order to maximise response rates, a
mixed-methods approach is now recommended. This review was carried out in order to
examine the methodological literature related to the administration of lifestyle surveys and
the implications for response rates. It was envisaged that the results of this review could
provide a valuable resource for those involved in undertaking lifestyle surveys.
Methods
A review of the empirical evidence and published literature on the methodological
considerations associated with administration of lifestyle surveys, specifically in relation to
maximising response rates, was carried out. A search for ‘grey literature’ was also
conducted using the internet, and citation tracking was performed on all retrieved articles.
A request for examples of relevant lifestyle survey work, particularly those incorporating
mixed-methods designs and/or strategies to increase response rates, was distributed to
several Primary Care Trusts (PCTs) across England. The responses are illustrated as
‘good practice’ case studies.
Results
The postal questionnaire remains an important lifestyle survey tool, but response rates
have decreased rapidly in recent years. Interviews and telephone surveys are
recommended in order to supplement data from postal questionnaires to overcome any
literacy and language barriers. These approaches are advocated to increase response
rates in some population groups, but costs may be prohibitive. Electronic surveys are a
cheaper alternative, but the evidence seems to suggest that the use of the internet does
not appear to increase overall response rates to surveys. Evidence on the use of
incentives suggests they can be effective at increasing response rates, but only if their use
is tailored to the design of the survey and to the characteristics of target populations.
Conclusions
The empirical evidence was not robust enough to make definitive recommendations, but
information from the published literature, along with examples of ‘good practice’ in lifestyle
survey work suggests that supplementing, or offering different survey modes, alongside
targeted maximisation strategies can increase coverage and also, with careful planning,
can prove to be cost-effective.