JMIR Publications

ABSTRACT

Background:

Survey driven research is a reliable method for large scale data collection. Investigators who incorporate mixed mode survey designs report benefits for survey research including greater engagement, improved survey access, and higher response rate. Mix-mode survey designs combine two or more modes for data collection including web, phone, face-to-face, and mail. Types of mixed mode survey designs include simultaneous (also known as concurrent), sequential, delayed concurrent, and adaptive.

Objective:

This paper describes a research protocol using mixed mode survey designs to explore health information technology (HIT) maturity and care environments reported by administrators and nurse practitioners (NPs), respectively, in U.S. nursing homes (NHs).

Methods:

Our team is conducting a national survey of 1400 nursing home administrators and NPs. Two data sets (i.e., Care Compare and IQVIA) were used to identify eligible facilities at random. The protocol incorporates two surveys to explore how HIT maturity (survey 1 collected by administrators) impacts care environments where NPs work (survey 2 collected by NPs). Higher HIT maturity collected by administrators indicates greater IT capabilities, use, and integration in resident care, clinical support, and administrative activities. The NP care environment survey measures relationships, independent practice, resource availability, and visibility. The research team conducted three iterative focus groups, including 14 clinicians (NP and NH experts) and recruiters from two national survey teams experienced with these populations to achieve consensus on which mixed-mode designs to use. During focus groups we identified pros and cons of using mixed modes designs in these settings. We determined that two mixed mode designs with regular follow-up calls (Delayed Concurrent Mode and Sequential Mode) will be effective for recruiting nursing home administrators while a Concurrent Mixed Mode design is best to recruit NPs for the study.

Results:

The research study was funded in February 2023. Participant recruitment for the project began in June 2023. As of 01/05/2024 a total of 53 HIT maturity surveys and 24 NP surveys have been returned. Recruitment of NH administrators and NPs is anticipated through July 2025. 77% of the HIT maturity surveys have been submitted using the electronic link and 17% were submitted after a QR code was sent to the administrator. 100% of the NP surveys were returned with electronic survey links.

Conclusions:

Pros of mixed mode designs for nursing home research identified by the team were that delayed concurrent, concurrent, and sequential mixed mode methods of delivering surveys to potential participants save on recruitment time compared to single mode delivery methods. One disadvantage of single-mode strategies is that they decrease versatility and adaptability to different organizational capabilities (e.g., access to email, firewalls), which could reduce response rates.