What affects response rates in primary healthcare-based programmes? An analysis of individual and unit-related factors associated with increased odds of non-response based on HCV screening in the general population in Poland

BMJ Open. 2016 Dec 7;6(12):e013359. doi: 10.1136/bmjopen-2016-013359.

Abstract

Objectives: Response rate in public health programmes may be a limiting factor. It is important to first consider their delivery and acceptability for the target. This study aimed at determining individual and unit-related factors associated with increased odds of non-response based on hepatitis C virus screening in primary healthcare.

Design: Primary healthcare units (PHCUs) were extracted from the Register of Health Care Centres. Each of the PHCUs was to enrol adult patients selected on a random basis. Data on the recruitment of PHCUs and patients were analysed. Multilevel modelling was applied to investigate individual and unit-related factors associated with non-response. Multilevel logistic model was developed with fixed effects and only a random intercept for the unit. Preliminary analysis included a random effect for unit and each of the individual or PHCU covariates separately. For each of the PHCU covariates, we applied a two-level model with individual covariates, unit random effect and a single fixed effect of this unit covariate.

Setting: This study was conducted in primary care units in selected provinces in Poland.

Participants: A total of 242 PHCUs and 24 480 adults were invited. Of them, 44 PHCUs and 20 939 patients agreed to participate. Both PHCUs and patients were randomly selected.

Results: Data on 44 PHCUs and 24 480 patients were analysed. PHCU-level factors and recruitment strategies were important predictors of non-response. Unit random effect was significant in all models. Larger and private units reported higher non-response rates, while for those with a history of running public health programmes the odds of non-response was lower. Proactive recruitment, more working hours devoted to the project and patient resulted in higher acceptance of the project. Higher number of personnel had no such effect.

Conclusions: Prior to the implementation of public health programme, several factors that could hinder its execution should be addressed.

Keywords: PREVENTIVE MEDICINE; PRIMARY CARE.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Delivery of Health Care / statistics & numerical data*
  • Female
  • Health Care Surveys
  • Hepatitis C / diagnosis*
  • Hepatitis C / epidemiology
  • Hepatitis C / prevention & control
  • Humans
  • Male
  • Odds Ratio
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Poland / epidemiology
  • Population Surveillance
  • Prevalence
  • Primary Health Care* / statistics & numerical data
  • Program Evaluation