敏感调查中的参与者招募：“选择加入”与“选择退出”方法的比较试验。
Participant recruitment in sensitive surveys: a comparative trial of 'opt in' versus 'opt out' approaches.
机构信息
Faculty of Health Sciences, University of Southampton, University Road, Southampton SO17 1BJ, UK.
出版信息
BMC Med Res Methodol. 2013 Jan 11;13:3. doi: 10.1186/1471-2288-13-3.
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%: χ(2) =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 (χ(2)=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.
背景
尽管在卫生服务调查研究中，我们努力追求高回应率，但这必须与以合乎道德和体贴的方式招募参与者的需求相平衡，特别是在具有敏感性的调查中。在调查研究中，没有既定的建议来指导招聘方法，并且经常采用一种“选择加入”系统，要求潜在参与者通过回复便条请求问卷副本。然而，在观察性研究中，参与者面临的风险低于临床研究，因此一些调查采用了“选择退出”系统。这种方法对回应和困扰的影响尚不清楚。我们试图在一项由临终关怀的丧亲亲属完成的调查中对此进行研究。
方法
在 1422 名丧亲亲属的样本中，我们将潜在参与者分配到两个研究组之一：“选择加入”组（n=711），其中发出邀请函和回复便条以请求问卷副本；或“选择退出”组（n=711），其中将调查问卷与邀请函一起提供。我们评估了两组之间的回应和困扰。
结果
从 1422 名样本中，有 473 名参与者返回了问卷。“选择退出”组的回应率高于“选择加入”组（40%比 26.4%：χ(2) =29.79，p 值<.01），两组之间在困扰或对调查的投诉方面没有差异，并且分配到“选择退出”组是回应的独立预测因素（OR=1.84，95% CI：1.45-2.34）。此外，“选择加入”组更有可能拒绝参与（χ(2)=28.60，p 值<.01），并且两组之间的问卷回答模式存在差异。
结论
鉴于“选择退出”的招募方法与“选择加入”方法相比，与更高的回应率相关，似乎对调查的投诉或困扰没有影响，并且组之间的回应模式存在差异，“选择退出”方法可以作为招募参与者的最有效方法，即使在具有敏感性的调查中也是如此。
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