Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Mar 14, 2025
Date Accepted: Sep 19, 2025
Smartphone App-Based Survey Deployment Patterns and Longitudinal Response Rate: A Randomized Controlled Trial
ABSTRACT
Background:
Survey fatigue is a common challenge in longitudinal studies, particularly when using smartphone apps to collect digital survey data. Evidence-based strategies to maintain engagement are needed.
Objective:
To evaluate the effect of a more frequent smartphone survey deployment strategy with less intense survey batches on participant response rates over an extended period.
Methods:
We conducted a randomized controlled trial (RCT NCT04752657) embedded in the electronic Framingham Heart Study (eFHS) cohorts. Participants were randomly allocated to receive a full set of surveys every 4 weeks (control group) or half of the survey set biweekly, such that the full set is completed every 4 weeks (experimental group). Participants were randomly allocated with stratification by age (≤75 years vs. >75 years) and phone type (Android vs. iPhone). Married couples were assigned to the same group using a blocked randomization approach. The primary outcome was the proportion of surveys returned per participant assessed longitudinally across four periods (baseline to week 8, week 8-16, week 16-24, and week 24-32), with 19, 17, 16, and 15 unique surveys deployed respectively. We used mixed-effects regression models with random intercepts to compare the repeated outcome between groups.
Results:
Among 492 participants (mean age 74 years, 58% women, 84% non-Hispanic White), there was evidence that the experimental group had higher response rates over time compared to the control group (P=.003 for interaction between deployment pattern and time). Both groups showed similar proportions of surveys returned during the first period (75% vs. 76%). The experimental group had higher response rates compared to the control group in subsequent periods (70% vs. 67% in week 8-16, 64% vs. 59% in week 16-24, 58% vs. 50% in week 24-32).
Conclusions:
Administering half of the surveys every 2 weeks, as compared to all surveys every 4 weeks, was associated with maintained digital engagement and higher survey response rates. Clinical Trial: Trial Registration: ClinicalTrials.gov NCT04752657; https://clinicaltrials.gov/study/NCT04752657
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