Response RateNCT03046368
Personalization of Cover Letter and Response Rate
A study testing Targeted cover letter in people with Response Rate, run by University of Southern Denmark at 1 site in Denmark.
Trial summary
Several studies indicate that a survey that adapts personalized design features achieves higher participation rates. A feature can be a personalized cover letter which appears more relevant and interesting for the sample member. Read more about this study
- Who is it for?
- Ages 16 years and older
- Conditions the study is for
- Response Rate
- What is being tested?
- Targeted cover letter
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 25,000 participants
- Where
- 1 siteDenmark
- Study dates
- 3 Feb 2017to 1 Jun 2018
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 16 years and older
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Who may be able to join
- individuals (including institutionalized individuals) aged 16 years or older and resident in Denmark per 1 January 2017.
Who cannot join
- -
Trial locations and contacts
1 site in 1 country.
Denmark1 site
National Institute of Public health, University of Southern Denmark
Copenhagen, 1353
About this study
Official title: Personalization of Cover Letter and Response Rate - a Randomized Controlled Trial in the Danish Health and Morbidity Survey
Several studies indicate that a survey that adapts personalized design features achieves higher participation rates. A feature can be a personalized cover letter which appears more relevant and interesting for the sample member. In the spirit of adaptive design, this study seeks to establish whether it can be advantageous for participation overall to use cover letters with targeted content and whether the effect on participation of different versions of the cover letter varies in sample subgroups in order to optimize design features in future surveys.
Read the detailed description
Background and aim: In the Danish Health and Morbidity Surveys the participation rate has declined from 61% in 2010 to 57% in 2013. A declining participation rate may affect the representativeness and the results of the survey. Several studies indicate that a survey that adapts personalized design features achieves higher participation rates. A feature can be a personalized cover letter which appears more relevant and interesting for the sample member. The research question, then, is whether cover letters with targeted content can perform better than a standard letter. The proposition is that such letters should increase the willingness of some sample members to participate, and that this will be reflected in higher response rates. However, little is known about which targeted content is the most effective.
Thus, in the spirit of adaptive design, this study seeks to establish whether it can be advantageous for participation overall to use cover letters with targeted content and whether the effect on participation of different versions of the cover letter varies in sample subgroups in order to optimize design features in future surveys. Further, given that the majority of sample members participate, these sample members who are swayed by the targeted letter must have relatively low response propensities (with the standard letter). Thus, we hypothesize that targeted letters should particularly improve response rates in low response propensity subgroups (i.e. young men, unmarried, and elderly women). A secondary research question is, therefore, whether any effect of targeted letters on response rate is greater among sample subgroups with low response propensities.
Design: A randomized trial will be incorporated the Danish Health and Morbidity Survey 2017 where a paragraph in the cover letter intended to heighten perceptions of relevance of the survey is varied among sample members. The Danish Health and Morbidity Survey 2017 will be based on a nationally representative random sample of 25,000 individuals (including institutionalized individuals) aged 16 years or older and resident in Denmark per 1 January 2017. The sample will be drawn from the adult population in Denmark using the Danish Civil Registration System and the survey will be conducted between February 3 and Maj 5, 2017. All sample members will be randomly allocated, with equal probabilities, to one of 11 treatment groups. One group will receive a standard letter that is designed to have general appeal and the other 10 groups will receive one of 10 versions of the targeted cover letter. In the previous Health and Morbidity Surveys, all sample members received the same standard letter. Much of the content of the standard letter and the targeted letter will be the same. The intention is to hold constant features designed to demonstrate the credibility of the survey, to allay fears about confidentiality, to appeal to self-interest, and to provide basic information about the task of participation. All sample members will be invited either to complete a web questionnaire or to fill out a paper questionnaire concerning health and morbidity.
Statistics: The analysis will be based on logistic regression modelling of the 25,000 persons invited to the Health and Morbidity Survey 2017. The independent variable is a dichotomous indicator of treatment group: targeted or standard letter. The dependent variable indicates whether the sample member has fully or partially completed the questionnaire. The mediator variable indicates membership of each of three operationally important low response propensity groups (i.e. young men, unmarried, and elderly women). The approach is to first test for a main effect of the independent variable in each of the treatment groups. A second step is to conduct the same analysis stratified by treatment group. A third step will then seek to identify whether any significant effects occurs between the mediator variable and dependent variable.
- Conditions
- Response Rate
- Being tested
- Targeted cover letter
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Targeted cover letterBehavioural
The intervention Group will receive a cover letter with targeted content with the purpose of increasing participation
| Study group | Role | What they receive |
|---|---|---|
| Standard cover letter | No intervention | The group will receive a standard cover letter to the survey that is designed to have broad appeal: You have been randomly selected to participate in a survey of well-being, health and disease among adolescents and adults in Denmark. |
| Targeted cover letter 1 | Experimental | This group will receive a cover letter to the survey including the paragraph:
You have been randomly selected to participate in a survey of well-being, health and disease among adolescents and adults in Denmark. The questionnaire will address themes such as stress, alcohol and sleep problems. Receives: Behavioral: Targeted cover letter |
| Targeted cover letter 2 | Experimental | This group will receive a cover letter to the survey including the paragraph:
You have been randomly selected to participate in a survey of well-being, health and disease among adolescents and adults in Denmark. The questionnaire will address themes such as stress, alcohol and contact to family and friends. Receives: Behavioral: Targeted cover letter |
| Targeted cover letter 3 | Experimental | This group will receive a cover letter to the survey including the paragraph:
You have been randomly selected to participate in a survey of well-being, health and disease among adolescents and adults in Denmark. The questionnaire will address themes such as stress, alcohol and sex Receives: Behavioral: Targeted cover letter |
| Targeted cover letter 4 | Experimental | This group will receive a cover letter to the survey including the paragraph:
You have been randomly selected to participate in a survey of well-being, health and disease among adolescents and adults in Denmark. The questionnaire will address themes such as stress, sleep problems and contact to family and friends. Receives: Behavioral: Targeted cover letter |
| Targeted cover letter 5 | Experimental | This group will receive a cover letter to the survey including the paragraph:
You have been randomly selected to participate in a survey of well-being, health and disease among adolescents and adults in Denmark. The questionnaire will address themes such as stress, sleep problems and sex. Receives: Behavioral: Targeted cover letter |
| Targeted cover letter 6 | Experimental | This group will receive a cover letter to the survey including the paragraph:
You have been randomly selected to participate in a survey of well-being, health and disease among adolescents and adults in Denmark. The questionnaire will address themes such as stress, sex and contact to family and friends. Receives: Behavioral: Targeted cover letter |
| Targeted cover letter 7 | Experimental | This group will receive a cover letter to the survey including the paragraph:
You have been randomly selected to participate in a survey of well-being, health and disease among adolescents and adults in Denmark. The questionnaire will address themes such as sex, sleep problems and contact to family and friends. Receives: Behavioral: Targeted cover letter |
| Targeted cover letter 8 | Experimental | This group will receive a cover letter to the survey including the paragraph:
You have been randomly selected to participate in a survey of well-being, health and disease among adolescents and adults in Denmark. The questionnaire will address themes such as sex, sleep problems and alcohol. Receives: Behavioral: Targeted cover letter |
| Targeted cover letter 9 | Experimental | This group will receive a cover letter to the survey including the paragraph:
You have been randomly selected to participate in a survey of well-being, health and disease among adolescents and adults in Denmark. The questionnaire will address themes such as sex, alcohol and contact to family and friends. Receives: Behavioral: Targeted cover letter |
| Targeted cover letter 10 | Experimental | This group will receive a cover letter to the survey including the paragraph:
You have been randomly selected to participate in a survey of well-being, health and disease among adolescents and adults in Denmark. The questionnaire will address themes such as alcohol, sleep problem and contact to family and friends. Receives: Behavioral: Targeted cover letter |
What is being measured
The primary outcome is the main question the study is designed to answer.
Overall response rate
Response rate overall and in the different intervention arms
Measured: Up to 3 months (from February 3 2017 to maxium Maj 5 2017)
Secondary outcomes (1)
Response rate in different subgroups
Response rate in different subgroups with low response propensity
Measured: Up to 3 months (from February 3 2017 to maxium Maj 5 2017)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted8 Feb 2017 (estimated)
- Study start3 Feb 2017
- Primary completion19 May 2017
- Study completion1 Jun 2018
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Response RateStudies of the same condition, open and under way.
- More trials run by University of Southern DenmarkThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Basic science
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 25,000 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Southern Denmark
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Anne Illemann Christensen, University of Southern Denmark
- Investigators
- Janne S Tolstrup, MD PhD, Study director, University of Southern Denmark
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03046368
- Sponsor's protocol ID
- 60110-5060-FL
- Status last verified
- Mar 2020
- First submitted
- 2 Feb 2017
- Last updated
- 24 Mar 2020
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Christensen AI, Lynn P, Tolstrup JS. Can targeted cover letters improve participation in health surveys? Results from a randomized controlled trial. BMC Med Res Methodol. 2019 Jul 17;19(1):151. doi: 10.1186/s12874-019-0799-4.
PubMed 31315577
Study at a glance
From the registry record, last updated by the sponsor on 24 Mar 2020. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Personalization of Cover Letter and Response Rate - a Randomized Controlled Trial in the Danish Health and Morbidity Survey
- ClinicalTrials.gov ID
- NCT03046368
- Acronym / sponsor ID
- 60110-5060-FL
- Conditions
- Response Rate
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 25,000 participants (actual)
- Lead sponsor
- University of Southern DenmarkUniversity, hospital or other
- Study start
- 3 Feb 2017 (actual)
- Primary completion
- 19 May 2017 (actual)
- Study completion
- 1 Jun 2018 (actual)
- First posted
- 8 Feb 2017 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Several studies indicate that a survey that adapts personalized design features achieves higher participation rates. A feature can be a personalized cover letter which appears more relevant and interesting for the sample member. In the spirit of adaptive design, this study seeks to establish whether it can be advantageous for participation overall to use cover letters with targeted content and whether the effect on participation of different versions of the cover letter varies in sample subgroups in order to optimize design features in future surveys.
Detailed description
Background and aim: In the Danish Health and Morbidity Surveys the participation rate has declined from 61% in 2010 to 57% in 2013. A declining participation rate may affect the representativeness and the results of the survey. Several studies indicate that a survey that adapts personalized design features achieves higher participation rates. A feature can be a personalized cover letter which appears more relevant and interesting for the sample member. The research question, then, is whether cover letters with targeted content can perform better than a standard letter. The proposition is that such letters should increase the willingness of some sample members to participate, and that this will be reflected in higher response rates. However, little is known about which targeted content is the most effective.
Thus, in the spirit of adaptive design, this study seeks to establish whether it can be advantageous for participation overall to use cover letters with targeted content and whether the effect on participation of different versions of the cover letter varies in sample subgroups in order to optimize design features in future surveys. Further, given that the majority of sample members participate, these sample members who are swayed by the targeted letter must have relatively low response propensities (with the standard letter). Thus, we hypothesize that targeted letters should particularly improve response rates in low response propensity subgroups (i.e. young men, unmarried, and elderly women). A secondary research question is, therefore, whether any effect of targeted letters on response rate is greater among sample subgroups with low response propensities.
Design: A randomized trial will be incorporated the Danish Health and Morbidity Survey 2017 where a paragraph in the cover letter intended to heighten perceptions of relevance of the survey is varied among sample members. The Danish Health and Morbidity Survey 2017 will be based on a nationally representative random sample of 25,000 individuals (including institutionalized individuals) aged 16 years or older and resident in Denmark per 1 January 2017. The sample will be drawn from the adult population in Denmark using the Danish Civil Registration System and the survey will be conducted between February 3 and Maj 5, 2017. All sample members will be randomly allocated, with equal probabilities, to one of 11 treatment groups. One group will receive a standard letter that is designed to have general appeal and the other 10 groups will receive one of 10 versions of the targeted cover letter. In the previous Health and Morbidity Surveys, all sample members received the same standard letter. Much of the content of the standard letter and the targeted letter will be the same. The intention is to hold constant features designed to demonstrate the credibility of the survey, to allay fears about confidentiality, to appeal to self-interest, and to provide basic information about the task of participation. All sample members will be invited either to complete a web questionnaire or to fill out a paper questionnaire concerning health and morbidity.
Statistics: The analysis will be based on logistic regression modelling of the 25,000 persons invited to the Health and Morbidity Survey 2017. The independent variable is a dichotomous indicator of treatment group: targeted or standard letter. The dependent variable indicates whether the sample member has fully or partially completed the questionnaire. The mediator variable indicates membership of each of three operationally important low response propensity groups (i.e. young men, unmarried, and elderly women). The approach is to first test for a main effect of the independent variable in each of the treatment groups. A second step is to conduct the same analysis stratified by treatment group. A third step will then seek to identify whether any significant effects occurs between the mediator variable and dependent variable.
Study design
- Primary purpose
- Basic science
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 11
| Arm | Type | Receives |
|---|---|---|
| Standard cover letter | No intervention | –The group will receive a standard cover letter to the survey that is designed to have broad appeal: You have been randomly selected to participate in a survey of well-being, health and disease among adolescents and adults in Denmark. |
| Targeted cover letter 1 | Experimental | Behavioral: Targeted cover letterThis group will receive a cover letter to the survey including the paragraph: You have been randomly selected to participate in a survey of well-being, health and disease among adolescents and adults in Denmark. The questionnaire will address themes such as stress, alcohol and sleep problems. |
| Targeted cover letter 2 | Experimental | Behavioral: Targeted cover letterThis group will receive a cover letter to the survey including the paragraph: You have been randomly selected to participate in a survey of well-being, health and disease among adolescents and adults in Denmark. The questionnaire will address themes such as stress, alcohol and contact to family and friends. |
| Targeted cover letter 3 | Experimental | Behavioral: Targeted cover letterThis group will receive a cover letter to the survey including the paragraph: You have been randomly selected to participate in a survey of well-being, health and disease among adolescents and adults in Denmark. The questionnaire will address themes such as stress, alcohol and sex |
| Targeted cover letter 4 | Experimental | Behavioral: Targeted cover letterThis group will receive a cover letter to the survey including the paragraph: You have been randomly selected to participate in a survey of well-being, health and disease among adolescents and adults in Denmark. The questionnaire will address themes such as stress, sleep problems and contact to family and friends. |
| Targeted cover letter 5 | Experimental | Behavioral: Targeted cover letterThis group will receive a cover letter to the survey including the paragraph: You have been randomly selected to participate in a survey of well-being, health and disease among adolescents and adults in Denmark. The questionnaire will address themes such as stress, sleep problems and sex. |
| Targeted cover letter 6 | Experimental | Behavioral: Targeted cover letterThis group will receive a cover letter to the survey including the paragraph: You have been randomly selected to participate in a survey of well-being, health and disease among adolescents and adults in Denmark. The questionnaire will address themes such as stress, sex and contact to family and friends. |
| Targeted cover letter 7 | Experimental | Behavioral: Targeted cover letterThis group will receive a cover letter to the survey including the paragraph: You have been randomly selected to participate in a survey of well-being, health and disease among adolescents and adults in Denmark. The questionnaire will address themes such as sex, sleep problems and contact to family and friends. |
| Targeted cover letter 8 | Experimental | Behavioral: Targeted cover letterThis group will receive a cover letter to the survey including the paragraph: You have been randomly selected to participate in a survey of well-being, health and disease among adolescents and adults in Denmark. The questionnaire will address themes such as sex, sleep problems and alcohol. |
| Targeted cover letter 9 | Experimental | Behavioral: Targeted cover letterThis group will receive a cover letter to the survey including the paragraph: You have been randomly selected to participate in a survey of well-being, health and disease among adolescents and adults in Denmark. The questionnaire will address themes such as sex, alcohol and contact to family and friends. |
| Targeted cover letter 10 | Experimental | Behavioral: Targeted cover letterThis group will receive a cover letter to the survey including the paragraph: You have been randomly selected to participate in a survey of well-being, health and disease among adolescents and adults in Denmark. The questionnaire will address themes such as alcohol, sleep problem and contact to family and friends. |
Who may qualify
- Ages
- 16 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (1 listed)
- individuals (including institutionalized individuals) aged 16 years or older and resident in Denmark per 1 January 2017.
Key exclusion criteria (1 listed)
- -
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Targeted cover letterThe intervention Group will receive a cover letter with targeted content with the purpose of increasing participation | Behavioural | Targeted cover letter 1, Targeted cover letter 10, Targeted cover letter 2, Targeted cover letter 3, Targeted cover letter 4, Targeted cover letter 5, Targeted cover letter 6, Targeted cover letter 7, Targeted cover letter 8, Targeted cover letter 9 |
Primary outcome
Overall response rate
Time frame: Up to 3 months (from February 3 2017 to maxium Maj 5 2017)
Response rate overall and in the different intervention arms
1 secondary outcome
Response rate in different subgroups
Time frame: Up to 3 months (from February 3 2017 to maxium Maj 5 2017)
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 24 Mar 2020.
- Derived from this study: PubMed 31315577Christensen AI, Lynn P, Tolstrup JS. Can targeted cover letters improve participation in health surveys? Results from a randomized controlled trial. BMC Med Res Methodol. 2019 Jul 17;19(1):151. doi: 10.1186/s12874-019-0799-4.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Janne S Tolstrup, MD PhD study director
University of Southern Denmark
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Targeted cover letter in people with Response Rate, run by University of Southern Denmark at 1 site in Denmark.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 24 Mar 2020. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Denmark. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Overall response rate (time frame: Up to 3 months (from February 3 2017 to maxium Maj 5 2017)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03046368, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Mar 2020.