Childs John D, Wu Samuel S, Andrade Robert L, Bonner Vanessa E, Bowman Julie A, Butler Aaron M, Teyhen Deydre S, George Steven Z
US Army-Baylor University Doctoral Program in Physical Therapy, Fort Sam Houston, Texas.
US Army Med Dep J. 2015 Oct-Dec:24-30.
Studies that have relied exclusively on web-based surveys to secure follow-up have yielded inadequate follow-up rates, resulting in the need to explore whether supplementing with other methods results in incremental improvements. The primary purpose of this study was to determine the effectiveness of each follow up strategy that was used to collect the follow up data in our ongoing Prevention of Low Back Pain in the Military (POLM) trial.
This study represents a secondary analysis of the POLM trial. Twenty companies of Soldiers (N=4,325) were cluster randomized to complete one of four exercise programs. Since web-based response rates were lower than anticipated, a telephone call center was established to contact Soldiers who had not responded to the web-based survey. A military healthcare utilization database (M2) was also used to capture additional follow-up. Descriptive statistics and pairwise comparisons were performed to determine the incremental benefits of supplementing the primary web-based follow-up strategy in our ongoing POLM trial and determine whether differences existed in demographic characteristics, pain intensity, and low back pain incidence based on follow-up strategy.
Of the 4,325 Soldiers who were enrolled, 632 (14.6%) subjects completed the monthly web-based survey only; 571 (13.2%) responded only to the telephone call; and 233 (5.4%) responded to both the web-based and telephone survey. Adding the telephone call center contributed 804 unique contributions to follow-up, increasing the overall follow-up to 33.2% (n=1,436) and resulting in a net 18.6% increase in follow-up rate. Querying the M2 database yielded follow-up data for an additional 2,788 Soldiers, increasing the follow-up rate by 64.5%. This rate, combined with the web-based and telephone strategies, resulted in an overall follow-up rate of 97.7%. Compared to the web-based survey, those who responded to the telephone call center tended to be younger, white, have a lower income, more likely to smoke, more likely to exercise regularly, and less likely to have low back pain (all with P<.05).
The results of this study can inform the design of future clinical trials by establishing the benefit of supplementing a web-based survey with a telephone call center to secure additional follow-up.
仅依靠基于网络的调查来确保随访的研究，其随访率不足，因此需要探索补充其他方法是否能带来进一步改善。本研究的主要目的是确定在我们正在进行的军事人员腰痛预防（POLM）试验中，用于收集随访数据的每种随访策略的有效性。
本研究是对POLM试验的二次分析。20个连队的士兵（N = 4325）被整群随机分组，以完成四个运动项目之一。由于基于网络的回复率低于预期，因此设立了一个电话呼叫中心，以联系未对基于网络的调查做出回应的士兵。还使用了一个军事医疗利用数据库（M2）来获取额外的随访信息。进行描述性统计和成对比较，以确定在我们正在进行的POLM试验中补充主要的基于网络的随访策略的增量效益，并确定基于随访策略的人口统计学特征、疼痛强度和腰痛发病率是否存在差异。
在登记的4325名士兵中，632名（14.6%）受试者仅完成了每月一次的基于网络的调查；571名（13.2%）仅回复了电话；233名（5.4%）对基于网络的调查和电话调查都做出了回应。增加电话呼叫中心为随访贡献了804个独特的回复，使总体随访率提高到33.2%（n = 1436），随访率净增18.6%。查询M2数据库又获得了另外2788名士兵的随访数据，随访率提高了64.5%。这个比率与基于网络和电话的策略相结合，使总体随访率达到97.7%。与基于网络的调查相比，回复电话呼叫中心的人往往更年轻、是白人、收入较低、吸烟可能性更大、经常锻炼的可能性更大，且患腰痛的可能性更小（所有P <.05）。
本研究结果可为未来临床试验的设计提供参考，通过确定用电话呼叫中心补充基于网络的调查以确保额外随访的益处。
