(see Poster Gallery) Utilizing Automated Modalities to Improve Post-Injury Follow-up Survey Response

Background and Purpose: Traumatic injury is the leading cause of death and acquired disability in the United States (US) and disparities in injury and recovery are pervasive. Data from trauma patients’ medical records are abstracted into trauma registries, but current gaps in this system limit researchers’ ability to identify groups at highest risk for disparities. Although trauma care experts have established the need for low-cost, automated methods to follow up with patients after injury, post-trauma follow up has challenged care teams for decades. The goal of this study was to pilot test a feasible, cost-effective, and culturally resonant follow up data collection process among racially and ethnically diverse trauma patients to be incorporated into existing trauma care systems, with priority for automated response modalities (e.g., email vs. phone call).

Methods: This investigation was part of a parent study that consisted of two aims with two distinct cohorts of participants who experienced traumatic injury. Upon initial interview, participants were asked to provide contact information for phone, email, text, and mail follow-up surveys. Participants in both aims were contacted six-months after study enrollment to complete the survey, which assessed patient-reported outcomes after injury. To increase follow up response rates between Aim 1 and Aim 2, the study team modified the contact procedure for the Aim 2 cohort. Modifications based on a literature review included: 1) a mailed letter two weeks prior to participants being eligible for their 6-month follow up and 2) only offering one response modality (either text or email) for the first 1-2 weeks of follow-up survey eligibility. Once participants completed the survey, research staff recorded the modality by which the participant responded. Frequency distributions were utilized to report the frequency of follow up response modalities and overall response rates in both Aims.

Results: A total of 178 individuals responded to the 6-month follow up survey: 88 in Aim 1 and 90 in Aim 2. The majority (n=124; 69.6%) self-identified as persons of color. After implementing new follow up contact procedures, the response rate increased by 17.9 percentage points from Aim 1 (64.7%) to Aim 2 (82.6%). In Aim 1, the primary response modality was by phone (47.8%), and email and text only made up a combined 7.3% of responses. In contrast, the combination of email (47.8%) and text (37.6%) made up more than half of the responses in Aim 2 (50.4%), with phone accounting for only 30.3%. Mail responses also decreased from Aim 1 (9.6%) to Aim 2 (2.2%).

Conclusions and Implications: Results from this investigation suggest that follow up data can feasibly be collected from trauma patients by implementing a cost-efficient and automated data collection process. Use of feasible and effective follow up methods holds promise to expand the national trauma registry and ultimately broaden the understanding of disparities in patients’ post-trauma experiences to achieve health equity. More research is needed to identify follow up mechanisms that ensure response rates are similar across demographic groups.