Exploring Response Rates in Nicaragua, Central America

Background:Achieving a high response rate in epidemiological studies with youth is important, and developing countries unfamiliar with or distrustful of research may face particular barriers. This study explores what researchers in such contexts can do to achieve acceptable response rates by presenting “lessons learned” from conducting a school-based health behavior survey in Nicaragua, Central America.

Methods: Mixed methods are used to explore what predicts and increases response rates, including steps taken by three organizations that achieved 95-100% response rates. A total of 18 schools and 5 community groups participated in the survey, 35% of organizations contacted. On average, 53% of youth in these organizations returned affirmative parental consents and participated in the survey.

Findings: We computed a logistic regression to explore factors that might reliably distinguished which organizations achieved high (> 55%) and low (< 55%) individual response rates. We entered predictors of organization type (i.e., school/community-group), religious affiliation (Catholic/non-Catholic), monthly tuition in U.S. dollars (range = $1 - $535, M = $124), and program buy-in (measured by school personnel survey responses to five items, such as “I believe in the goals of the program”, a = .93). The overall model was not statistically significant (c²[4] = 6.87, p = .14) although it accounted for 36% of the variance (Nagelkerke pseudo R²) and prediction success increased 14% over the null model reaching 73% (56% for high and 85% for low response rate). In addition, we tracked the process of recruiting schools and obtaining active parental consent to learn, from a qualitative perspective, what might differentiate the high versus low response groups. We observed this pattern: schools with the lowest response rates merely handed out consent forms without explaining what they were or sharing information about the study while higher response rates came from schools that allowed the research team to share information with students or inform parents directly.

Implications: When confronting design or organizational barriers, findings imply that prevention researchers should utilize collaborative strategies to achieve high response rates. Negotiating direct access to participants or parents to share about the study and, importantly, the research process. Findings highlight an important issue for prevention researchers working in a global context, include analysis of potential influences of response rates, and provide illustrations of how to promote adequate response rates with organizations.