We’ve been looking at cost and response rates for mail
and telephone for patient survey administration. Are there
any other factors we should consider?
Response:
One of the most important factors to consider when choosing a methodology for patient research (including HCAHPS) is survey comprehension. After all, if a patient doesn’t fully understand what you’re asking, the accuracy of the survey results will suffer greatly. Phone surveys provide a much higher respondent comprehension level than mail surveys.
The National Assessment of Adult Literacy (NAAL) measures the English literacy of America's adults. An estimated 14% of US residents are at the lowest level of literacy (Level 1), as measured by the NAAL. That means that 14% will have at least some degree of difficulty (often, extreme difficulty) with a written survey. In fact, difficulty with forms is a particular obstacle for people with Level 1 literacy (“Below Basic”).
Now look at literacy rates when compared to the oral language skills of US residents:
|
Speaks English either Very Well or Well: |
92% |
|
Doesn’t speak English at all: |
8% |
|
Percentage at Capable Literacy Levels: |
86% |
|
Percentage at Lowest Literacy Level: |
14% |
Mail surveys, in effect, can only effectively target the 86% above Level 1 literacy. Phone surveys, on the other hand, rely on oral comprehension skills, which are at 92% in the US. There are also demographic factors to consider, as different groups often have significant differences in literacy levels. Compared to the national average of 14% at the lowest level of literacy, here are a few select demographic groups that would greatly benefit from a phone (non-literary) approach:
National Percentage of Each Demographic Group at the "Below Basic" Literacy Level
|
51% |
Unemployed/not part of US workforce |
|
48% |
Immigrants that did not speak English before starting school |
|
45% |
Hispanic |
|
29% |
Age 65+ (the lowest literacy rates of ALL age groups) |
But beware—these numbers represent the national average. Your service area could have even higher percentages at the lowest literacy level. The Jackson Organization has successfully performed telephone survey research in areas with as much as 55% Level I literacy rates among all residents. Chicago? 37% at the lowest literacy level. Newark? 52% at the lowest literacy level. New York City? 36% at the lowest literacy level. With telephone, you get the widest coverage and the fastest survey returns.
If you would like to receive a full report of the literacy levels in your service area (at the state, county, and/or city level), contact us at researchinfo@healthstream.com.
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