Abstract
Objectives: To test methods to optimize mail survey response and authorization rates (i.e., allowing one's survey to be linked to medical records) when the survey is sensitive and the targeted population has a mental disorder. Study Design and Setting: Randomized controlled trial of 1,099 veterans treated for posttraumatic stress disorder (PTSD) at a Midwestern Veteran Affairs Medical Center. Subjects were randomized to one of three groups: (1) Health Insurance Portability and Accountability Act (HIPAA) authorization form embedded in the survey (checking "yes" for consent); (2) HIPAA form requiring signature for consent sent after the survey; or (3) HIPAA form requiring a signature and social security number (SSN) for consent sent after the survey. Results: The "embedded" strategy yielded the lowest survey response rate (67.5%) but highest authorization rate (59.1%). Requiring respondents' signatures and SSNs after the survey was returned generated the highest survey response rate (74.2%) but lowest authorization rate (48.7%). However, the response rate difference was not statistically significant. Reported emotional upset was low (1.5%) and primarily directed to the survey, not the HIPAA form. Older age and greater trustfulness were associated with higher authorization rates. Conclusion: Even with our most optimized strategy, authorization rates were disappointingly low.
Original language | English (US) |
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Pages (from-to) | 665-671 |
Number of pages | 7 |
Journal | Journal of Clinical Epidemiology |
Volume | 63 |
Issue number | 6 |
DOIs | |
State | Published - Jun 2010 |
Externally published | Yes |
Keywords
- Authorization
- HIPAA
- Health Insurance Portability and Accountability Act
- Patient surveys
- Posttraumatic stress disorder
- Randomized trial