BMJ Open 2:e001181 doi:10.1136/bmjopen-2012-001181
  • Epidemiology
    • Research

Effect of stamped reply envelopes and timing of newsletter delivery on response rates of mail survey: a randomised controlled trial in a prospective cohort study

  1. Yoko Iwasaki2
  1. 1Department of Basic Medical Sciences, School of Health Sciences, Gunma University, Maebashi, Gunma, Japan
  2. 2National Center for Child Health and Development, Tokyo, Japan
  1. Correspondence to Prof Kunihiko Hayashi; khayashi{at}
  • Received 15 March 2012
  • Accepted 27 July 2012
  • Published 4 September 2012


Objective To examine the effects of stamped reply envelope and the timing of newsletter distribution.

Design A randomised controlled trial in a prospective cohort study with a 2×2 factorial design of two interventions.

Setting The Japan Nurses’ Health Study (JNHS), a prospective cohort study for women's health.

Participants The present study included 6938 women who were part of the first-year entry cohort for the fifth wave of the biannual follow-up survey of the JNHS.

Intervention The participants were randomly allocated into four groups; Group-1 (business-reply, newsletter with initial mailing), Group-2 (business-reply, newsletter with reminder), Group-3 (stamped envelopes, newsletter with initial mailing) and Group-4 (stamped envelopes, newsletter with reminder). The thank-you and reminder letters were mailed out at the end of the sixth week. This study was censored at the end of 12 weeks.

Main outcome measures Main outcome measures were cumulative response at the end of 6 and 12 weeks after mailing out the questionnaire.

Results The cumulative response at 12 weeks were 58.3% for Group-1, 54.1% for Group-2, 60.5% for Group-3 and 56.7% for Group-4 (p=0.001). The odds of the response was higher for stamped envelopes than for business-reply envelopes (OR (95% CI)=1.10(1.00 to 1.21)). The odds was higher for newsletter delivery with initial mailing than for with reminder (1.18(1.07 to 1.29)). The response in first 6 weeks for stamped envelope was significantly higher than for business-reply envelope (p=0.047). Although the response in 6 weeks for women received the newsletter with initial mailing was lower than for women who did not, the proportions did not differ significantly (p=0.291).

Conclusions The style of return envelope affected response rates of mail survey. The results of this study suggest that practices of provision of the additional information, should be handled individually in advance, as a separate event from sending follow-up questionnaire or reminder letters.

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