%0 Journal Article
%T Participant recruitment in sensitive surveys: a comparative trial of ¡®opt in¡¯ versus ¡®opt out¡¯ approaches
%A Hunt Katherine J
%A Shlomo Natalie
%A Addington-Hall Julia
%J BMC Medical Research Methodology
%D 2013
%I BioMed Central
%R 10.1186/1471-2288-13-3
%X Background Although in health services survey research we strive for a high response rate, this must be balanced against the need to recruit participants ethically and considerately, particularly in surveys with a sensitive nature. In survey research there are no established recommendations to guide recruitment approach and an ¡®opt-in¡¯ system that requires potential participants to request a copy of the questionnaire by returning a reply slip is frequently adopted. However, in observational research the risk to participants is lower than in clinical research and so some surveys have used an ¡®opt-out¡¯ system. The effect of this approach on response and distress is unknown. We sought to investigate this in a survey of end of life care completed by bereaved relatives. Methods Out of a sample of 1422 bereaved relatives we assigned potential participants to one of two study groups: an ¡®opt in¡¯ group (n=711) where a letter of invitation was issued with a reply slip to request a copy of the questionnaire; or an ¡®opt out¡¯ group (n=711) where the survey questionnaire was provided alongside the invitation letter. We assessed response and distress between groups. Results From a sample of 1422, 473 participants returned questionnaires. Response was higher in the ¡®opt out¡¯ group than in the ¡®opt in¡¯ group (40% compared to 26.4%: ¦Ö2 =29.79, p-value<.01), there were no differences in distress or complaints about the survey between groups, and assignment to the ¡®opt out¡¯ group was an independent predictor of response (OR=1.84, 95% CI: 1.45-2.34). Moreover, the ¡®opt in¡¯ group were more likely to decline to participate (¦Ö2=28.60, p-value<.01) and there was a difference in the pattern of questionnaire responses between study groups. Conclusion Given that the ¡®opt out¡¯ method of recruitment is associated with a higher response than the ¡®opt in¡¯ method, seems to have no impact on complaints or distress about the survey, and there are differences in the patterns of responses between groups, the ¡®opt out¡¯ method could be recommended as the most efficient way to recruit into surveys, even in those with a sensitive nature.
%K Recruitment
%K Survey research
%K Opt out
%K Sensitive research
%K Passive consent
%U http://www.biomedcentral.com/1471-2288/13/3