Randomized trial showed that an "embedded" survey strategy optimized authorization rates compared with two "after survey" strategies in veterans with PTSD

Maureen Murdoch, Diane M. Pietila, Melissa R. Partin

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

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 languageEnglish (US)
Pages (from-to)665-671
Number of pages7
JournalJournal of Clinical Epidemiology
Volume63
Issue number6
DOIs
StatePublished - Jun 2010
Externally publishedYes

Keywords

  • Authorization
  • HIPAA
  • Health Insurance Portability and Accountability Act
  • Patient surveys
  • Posttraumatic stress disorder
  • Randomized trial

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