Postal surveys in primary care: the hidden burden

Objective  To investigate and analyse concerns raised by unsolicited mailing of a health survey to a community sample of older people.
Design  Observation and monitoring of all telephone calls received throughout a 6-week survey mailing period.
Setting and participants  A total sample of all those aged over 50 years registered with three general practices in North Staffordshire ( n =8995).
Main variable studied  The frequency of telephone contact following the receipt of a postal questionnaire, and the nature of any associated distress.
Results and conclusions  Individuals who receive unsolicited postal surveys may experience anxiety because of the actual receipt of the questionnaire, concerns about taking part or not taking part, personal issues, anger, worthiness or frustration with NHS services. Anxiety may also be triggered because of administrative issues, for example lost mail or overlap between mailing periods. Researchers can adopt measures both to reduce the potential anxiety and often hidden burden of postal surveys, and to facilitate individuals' positive participation in research.