How to increase participation and compliance in a national, school-based survey: strategies from the HBSC study 2018, 2022 and 2024 in Kalaallit Nunaat.

The Health Behaviour in School-aged Children (HBSC) study has an important role in monitoring health and well-being among children and adolescents in Kalaallit Nunaat (Greenland), and the results are continuously used to inform and direct public health policies in Kalaallit Nunaat. However, the study has faced challenges in ensuring sufficient school-based participation and individual-level compliance, potentially diminishing the representativeness and validity of the study results. We examined how variations in data collection and survey strategies across waves of data collection in 2018, 2022 and 2024 may have influenced participation and compliance rates by comparing differences observed across the three waves. We found that secondary onsite support, targeted follow-ups, scheduling dates for data collection, supporting school engagement and leveraging local authority networks were effectful in increasing school-based participation. Compliance was significantly associated with the survey administration mode and was likely related to school engagement. Respondent fatigue remained a barrier for sufficient compliance; however, electronic, revisitable survey administration has mitigated this challenge. This study concludes that applying meaningful strategies during recruitment and data collection has real potential to increase school-based participation and compliance and underscores the importance of nesting the study within the local context, community and relations.