Increasing health examination survey participation rates by SMS reminders and flexible examination times

Aims: Declining participation rates are an increasing problem in population surveys. Different kinds of methods have been used to ensure participation rates as high as possible. Monetary incentives and reminders have been found to be effective ways to increase participation rates, but these are rather expensive to implement in large population surveys. There is a need for cheaper ways to motivate survey invitees to participate. Methods: The Kuusamo Health Examination Survey was conducted in May-June 2011. A random sample of 250 people was selected for the survey. Mobile phone numbers, when available, were obtained for people within the sample. For a random sample of 50% of survey invitees with a mobile phone number, a short message service (SMS) reminder was sent prior to their appointment. All survey participants were asked to fill in a feedback questionnaire. Results: Participation rate was 58% for men and 74% for women. Mobile phone numbers were available for 66% of the sample. Among those receiving an SMS reminder about their appointment, participation rates were up to 25 percentage points higher than among the group not receiving a reminder. In the feedback questionnaire, 9% of the survey participants reported that they would not have participated without the SMS reminder they received. Participants preferred morning hours and Monday-Tuesday as time and day options for the examinations. Conclusions: SMS reminder about the appointment time was an effective way to increase participation rate, especially among the youngest age groups. Also, providing flexible office hours for the examination clinic may increase participation rate.