Exploring Barriers to IVR Surveys and the Effectiveness of Human Follow-Up Calls: Insights from a Mixed Methods Study in Uganda

Background This study explored reasons why respondents neither initiate nor complete an interactive voice response (IVR) survey and whether call-backs by a human can increase subsequent IVR survey participation. Methods We conducted a mixed methods study. Using random digit dialing (RDD), participants were sent an IVR survey (IVR-RDD) to their mobile phone. Participants from the IVR-RDD who either did not pick the phone or terminated the survey within two questions were contacted for a computer-assisted telephone interview (CATI) survey to assess reasons for non-participation. Following CATI completion, a similar IVR survey was sent (post-CATI IVR). Descriptive statistics and adjusted logistic regression models were conducted to assess differences in survey outcomes between the IVR-RDD and the post-CATI IVR groups. Results A total of 23,288 IVR-RDD, 9,740 CATI and 1,000 post CATI IVR calls were made to yield 1.9%, 11.8% and 44.9% response rates respectively. The most common reasons for non-response or drop-off to the IVR-RDD were being busy, misunderstanding IVR instructions, and mistrust of the IVR caller. Compared to the IVR-RDD, the post-CATI IVR increased both contact rate, from [(2.9%; 669/23,062) to (7.74%; 1,758/22,704); adjusted OR (AOR) 2.81, 95%CI 2.56, 3.08, p<0.001] and response rate, from [(2.25%; 518/23,062) to 4.54% (1,031/22,704); AOR 2.07, 95%CI 1.86, 2.30, p<0.001], but no impact on the cooperation rate. Conclusions Understanding reasons for survey non-response can allow for interventions to improve survey response. Introducing a human interviewer to those who did not complete the IVR survey improves subsequent IVR survey participation rates.