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Igwe J, Wangdak Yuthok TY, Cruz E, Mueller A, Lan RH, Brown‐Johnson C, Idris M, Rodriguez F, Clark K, Palaniappan L, Echols M, Wang P, Onwuanyi A, Pemu P, Lewis EF. Opportunities to Increase Science of Diversity and Inclusion in Clinical Trials: Equity and a Lack of a Control. J Am Heart Assoc 2023; 12:e030042. [PMID: 38108253 PMCID: PMC10863780 DOI: 10.1161/jaha.123.030042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
The United States witnessed a nearly 4-fold increase in personal health care expenditures between 1980 and 2010. Despite innovations and obvious benefits to health, participants enrolled in clinical trials still do not accurately represent the racial and ethnic composition of patients nationally or globally. This lack of diversity in cohorts limits the generalizability and significance of results among all populations and has deep repercussions for patient equity. To advance diversity in clinical trials, robust evidence for the most effective strategies for recruitment of diverse participants is needed. A major limitation of previous literature on clinical trial diversity is the lack of control or comparator groups for different strategies. To date, interventions have focused primarily on (1) community-based interventions, (2) institutional practices, and (3) digital health systems. This review article outlines prior intervention strategies across these 3 categories and considers health policy and ethical incentives for substantiation before US Food and Drug Administration approval. There are no current studies that comprehensively compare these interventions against one another. The American Heart Association Strategically Focused Research Network on the Science of Diversity in Clinical Trials represents a multicenter, collaborative network between Stanford School of Medicine and Morehouse School of Medicine created to understand the barriers to diversity in clinical trials by contemporaneous head-to-head interventional strategies accessing digital, institutional, and community-based recruitment strategies to produce informed recruitment strategies targeted to improve underrepresented patient representation in clinical trials.
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Affiliation(s)
- Joseph‐Kevin Igwe
- Department of MedicineStanford University, School of MedicineStanfordCA
- Department of MedicineMorehouse School of MedicineAtlantaGA
- American Heart Association Strategically Focused Research Network on the Science of Diversity in Clinical Trials Research FellowDurhamNC
| | | | - Erin Cruz
- Department of MedicineStanford University, School of MedicineStanfordCA
| | - Adrienne Mueller
- Department of MedicineStanford University, School of MedicineStanfordCA
| | - Roy Hao Lan
- Department of MedicineStanford University, School of MedicineStanfordCA
| | | | - Muhammed Idris
- Department of MedicineMorehouse School of MedicineAtlantaGA
| | - Fatima Rodriguez
- Department of MedicineStanford University, School of MedicineStanfordCA
| | - Kira Clark
- Department of MedicineStanford University, School of MedicineStanfordCA
| | - Latha Palaniappan
- Department of MedicineStanford University, School of MedicineStanfordCA
| | - Melvin Echols
- Department of MedicineMorehouse School of MedicineAtlantaGA
| | - Paul Wang
- Department of MedicineStanford University, School of MedicineStanfordCA
| | | | - Priscilla Pemu
- Department of MedicineMorehouse School of MedicineAtlantaGA
| | - Eldrin F. Lewis
- Department of MedicineStanford University, School of MedicineStanfordCA
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Pellegrini CA, Wilcox S, DeVivo KE, Jamieson S. Recruitment and Retention Strategies for Underrepresented Populations and Adults With Arthritis in Behavioral Interventions: A Scoping Review. Arthritis Care Res (Hoboken) 2023; 75:1996-2010. [PMID: 36752353 DOI: 10.1002/acr.25098] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 12/06/2022] [Accepted: 02/02/2023] [Indexed: 02/09/2023]
Abstract
OBJECTIVE To identify strategies used to recruit and retain underrepresented populations and populations with arthritis or fibromyalgia (FM) into behavioral programs targeting exercise, physical activity, or chronic disease self management. METHODS Five bibliographic databases were searched for articles published between January 2000 and May 2022. The search focused on strategies and best practices for recruiting and retaining underrepresented populations or populations with arthritis or FM into disease self-management or physical activity/exercise programs. Abstracts and full-text articles were screened for inclusion by 2 independent reviewers, and 2 reviewers extracted data from included articles. RESULTS Of the 2,800 articles, a total of 43 publications (31 interventions, 8 reviews, 4 qualitative/descriptive studies) met criteria and were included. The majority of studies focused on physical activity/exercise (n = 36) and targeted African American (n = 17), Hispanic (n = 9), or arthritis populations (n = 7). Recruitment strategies that were frequently used included having race- or community-matched team members, flyers and information sessions in areas frequented by the population, targeted emails/mailings, and word of mouth referrals. Retention strategies used included having race- or community-matched team members, incentives, being flexible, and facilitating attendance. Most studies used multiple recruitment and retention strategies. CONCLUSION This scoping review highlights the importance of a multifaceted recruitment and retention plan for underrepresented populations and populations with arthritis or FM in behavioral intervention programs targeting exercise, physical activity, or chronic disease self management. Additional research is needed to better understand the individual effects of different strategies and the costs associated with the various recruitment/retention methods in underrepresented populations and populations with arthritis.
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Hanna JJ, Saleh SN, Lehmann CU, Nijhawan AE, Medford RJ. Reaching Populations at Risk for HIV Through Targeted Facebook Advertisements: Cost-Consequence Analysis. JMIR Form Res 2023; 7:e38630. [PMID: 36662551 PMCID: PMC9898830 DOI: 10.2196/38630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND An undiagnosed HIV infection remains a public health challenge. In the digital era, social media and digital health communication have been widely used to accelerate research, improve consumer health, and facilitate public health interventions including HIV prevention. OBJECTIVE We aimed to evaluate and compare the projected cost and efficacy of different simulated Facebook (FB) advertisement (ad) approaches targeting at-risk populations for HIV based on new HIV diagnosis rates by age group and geographic region in the United States. METHODS We used the FB ad platform to simulate (without actually launching) an automatically placed video ad for a 10-day duration targeting at-risk populations for HIV. We compared the estimated total ad audience, daily reach, daily clicks, and cost. We tested ads for the age group of 13 to 24 years (in which undiagnosed HIV is most prevalent), other age groups, US geographic regions and states, and different campaign budgets. We then estimated the ad cost per new HIV diagnosis based on HIV positivity rates and the average health care industry conversion rate. RESULTS On April 20, 2021, the potential reach of targeted ads to at-risk populations for HIV in the United States was approximately 16 million for all age groups and 3.3 million for age group 13 to 24 years, with the highest potential reach in California, Texas, Florida, and New York. When using different FB ad budgets, the daily reach and daily clicks per US dollar followed a cumulative distribution curve of an exponential function. Using multiple US $10 ten-day ads, the cost per every new HIV diagnosis ranged from US $13.09 to US $37.82, with an average cost of US $19.45. In contrast, a 1-time national ad had a cost of US $72.76 to US $452.25 per new HIV diagnosis (mean US $166.79). The estimated cost per new HIV diagnosis ranged from US $13.96 to US $55.10 for all age groups (highest potential reach and lowest cost in the age groups 20-29 and 30-39 years) and from US $12.55 to US $24.67 for all US regions (with the highest potential reach of 6.2 million and the lowest cost per new HIV diagnosis at US $12.55 in the US South). CONCLUSIONS Targeted personalized FB ads are a potential means to encourage at-risk populations for HIV to be tested, especially those aged 20 to 39 years in the US South, where the disease burden and potential reach on FB are high and the ad cost per new HIV diagnosis is low. Considering the cost efficiency of ads, the combined cost of multiple low-cost ads may be more economical than a single high-cost ad, suggesting that local FB ads could be more cost-effective than a single large-budget national FB ad.
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Affiliation(s)
- John J Hanna
- Clinical Informatics Center, University of Texas Southwestern Medical Center, Dallas, TX, United States
- Division of Infectious Diseases and Geographic Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Sameh N Saleh
- Clinical Informatics Center, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Christoph U Lehmann
- Clinical Informatics Center, University of Texas Southwestern Medical Center, Dallas, TX, United States
- Department of Bioinformatics, University of Texas Southwestern Medical Center, Dallas, TX, United States
- Department of Population and Data Sciences, University of Texas Southwestern, Dallas, TX, United States
- Department of Pediatrics, University of Texas Southwestern, Dallas, TX, United States
| | - Ank E Nijhawan
- Division of Infectious Diseases and Geographic Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Richard J Medford
- Clinical Informatics Center, University of Texas Southwestern Medical Center, Dallas, TX, United States
- Division of Infectious Diseases and Geographic Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States
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Mindu T, Mutero IT, Ngcobo WB, Musesengwa R, Chimbari MJ. Digital Mental Health Interventions for Young People in Rural South Africa: Prospects and Challenges for Implementation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1453. [PMID: 36674209 PMCID: PMC9859354 DOI: 10.3390/ijerph20021453] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/04/2023] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
Globally, most young people living with mental health conditions lack access to mental health care but have access to a mobile device. The growing access to mobile devices in South Africa has the potential to increase access to mental health care services through digital platforms. However, uptake of digital mental health interventions may be hampered by several factors, such as privacy, confidentiality, informed consent, and affordability. This study identified the prospects and challenges of implementing a mobile phone-based mental health intervention for young people in Ingwavuma area. Data were collected from 93 young people in three villages purposefully selected in Ingwavuma area. Participants included in the study were aged 16-24. Data were collected through a questionnaire. Thematic and descriptive analysis was performed on the qualitative and quantitative data, respectively. Mental health education was low, with only 22% of participants having received prior education on mental health. About 50% of the participants had come across a mental health app, but none of them had used any of these apps; 87% of participants had Internet access; 60% preferred to use social media to contact a health worker; and 92% suggested that use of digital apps would improve mental health literacy among young people. Barriers to access of digital mental health interventions were identified as the high cost of data, restrictive religious beliefs, limited privacy, lack of native languages on most digital platforms, low digital literacy, and complicated user interface. In uMkhanyakude, uptake of digital mental health apps among the young people was low. We recommend that, developers create context-specific digital applications catered for young people from different cultural backgrounds. Socio-economic issues such as affordability also need to be addressed in developing these tools.
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Affiliation(s)
- Tafadzwa Mindu
- Department of Nursing and Public Health, University of KwaZulu-Natal, Durban 4041, South Africa
| | - Innocent Tinashe Mutero
- Department of Nursing and Public Health, University of KwaZulu-Natal, Durban 4041, South Africa
| | | | | | - Moses John Chimbari
- Department of Nursing and Public Health, University of KwaZulu-Natal, Durban 4041, South Africa
- Research and Innovation, Great Zimbabwe University, Masvingo P.O. Box 1235, Zimbabwe
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Dietary interventions using Facebook: a systematic review. Porto Biomed J 2023; 8:e185. [DOI: 10.1097/j.pbj.0000000000000185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 03/12/2022] [Accepted: 03/30/2022] [Indexed: 02/09/2023] Open
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Sartorao Filho CI, Sartorao Neto CI, Sartorao ALV, Terribile DC, Mello R, Mello BB, Zoqui MC, Duarte DO, Cachoni LEG, Bisseto VCQ, Ribeiro EAC. Using mobile phone-based text message to recruit representative samples: Assessment of a cross-sectional survey about the COVID-19 vaccine hesitation. Int J Med Inform 2022; 165:104832. [PMID: 35842978 PMCID: PMC9278996 DOI: 10.1016/j.ijmedinf.2022.104832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 06/30/2022] [Accepted: 07/09/2022] [Indexed: 11/29/2022]
Abstract
Background Limited research has examined mobile phone-based platforms for survey recruitment, especially during the COVID-19 pandemic in Brazil. Our objective was to investigate the feasibility and representativeness of mobile phone-based advertisement during a preliminary study about COVID-19 vaccine hesitation in Brazil. Moreover, we evaluate whether the older population can be reached through mobile phone-based platforms of the survey. Methods We conducted a study in December 2021 based on a preliminary survey about the COVID-19 vaccine hesitation in Assis, Brazil, Sao Paulo state. From a list of the adult population hesitant about the second dose of the COVID-19 vaccine, we sent a mobile phone-based advertisement inviting the participants to answer the survey for one week. The respondent's data were collected in a Google form platform. The comparison between the target population and the respondents was made using the Chi-squared test and the Welch's test, using a P-value of 0.05 as significative. Results The response rate was 9.99% after one week. The mean age of the respondent group was 33.97 (SD 14.99) and 35.05 (SD 14.19) of the population, with a P-value of 0.192 and a Cohen's d coefficient of 0.0754, corresponding to a small effect size between groups. We demonstrate that the mobile phone-based survey is a feasible and representative strategy during the pandemics in Brazil. Moreover, the older population respondent was representative. Conclusion We achieved a representative sample of respondents using the mobile phone-based survey in Brazil. Furthermore, it was representative of all sociodemographic and health characteristics assessed. Finally, these findings suggest that the method is a highly feasible and economical means of recruiting for survey research.
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Affiliation(s)
- C I Sartorao Filho
- Educational Foundation of the Municipality of Assis, Faculty of Medicine, Brazil; Sao Paulo Medical Association, Brazil; Sao Paulo State University - Botucatu Medical School, Brazil.
| | | | - A L V Sartorao
- Educational Foundation of the Municipality of Assis, Faculty of Medicine, Brazil
| | - D C Terribile
- Educational Foundation of the Municipality of Assis, Faculty of Medicine, Brazil
| | - R Mello
- Sao Paulo Medical Association, Brazil
| | - B B Mello
- Educational Foundation of the Municipality of Assis, Faculty of Medicine, Brazil
| | - M C Zoqui
- Educational Foundation of the Municipality of Assis, Faculty of Medicine, Brazil
| | - D O Duarte
- Educational Foundation of the Municipality of Assis, Faculty of Medicine, Brazil
| | - L E G Cachoni
- Educational Foundation of the Municipality of Assis, Faculty of Medicine, Brazil
| | - V C Q Bisseto
- Educational Foundation of the Municipality of Assis, Faculty of Medicine, Brazil
| | - E A C Ribeiro
- Educational Foundation of the Municipality of Assis, Faculty of Medicine, Brazil
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Simulating Facebook Advertisements to Establish Cost per New HIV Diagnosis Using Routine and Targeted Models in a Local Population. Healthcare (Basel) 2022; 10:healthcare10071195. [PMID: 35885724 PMCID: PMC9320612 DOI: 10.3390/healthcare10071195] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/16/2022] [Accepted: 06/23/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Undiagnosed human immunodeficiency virus (HIV) infection remains a public health challenge. We explore Facebook (FB) advertisement (Ads) cost per new HIV diagnosis using non-targeted Ads, a routine testing model against targeted Ads, and a focused testing model in Texas. METHODS On 14 October 2021, we created (without launching) Texas-based, USD 10 targeted (using criteria matching HIV populations at risk) and non-targeted FB Ads for 10 days. In the process of creating the Ads, we collected estimated audience size, daily reach, and daily clicks. We estimated Ad cost for each new HIV diagnosis for targeted and non-targeted Ads using new HIV diagnosis rates from focused and routine testing campaigns. RESULTS The Ad costs per new HIV diagnosis from the targeted model were 4.74, 2.86, 5.28, and 2.88 times lower for men, Black, Hispanic, and all age groups, respectively, when compared to the non-targeted model. The wider the gap was between new HIV diagnosis rates in a population for focused and routine testing, the more cost-effective targeted Ads became. CONCLUSIONS Among HIV populations at risk, targeted FB Ads are more cost-effective for detecting new HIV infections than non-targeted Ads. This cost-effectiveness increases in locations where focused testing increases new HIV diagnosis rates, compared to routine testing.
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Wasfi R, Poirier Stephens Z, Sones M, Laberee K, Pugh C, Fuller D, Winters M, Kestens Y. Recruiting Participants for Population Health Intervention Research: Effectiveness and Costs of Recruitment Methods for a Cohort Study. J Med Internet Res 2021; 23:e21142. [PMID: 34587586 PMCID: PMC8663714 DOI: 10.2196/21142] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 12/26/2020] [Accepted: 09/29/2021] [Indexed: 01/24/2023] Open
Abstract
Background Public health research studies often rely on population-based participation and draw on various recruitment methods to establish samples. Increasingly, researchers are turning to web-based recruitment tools. However, few studies detail traditional and web-based recruitment efforts in terms of costs and potential biases. Objective This study aims to report on and evaluate the cost-effectiveness, time effectiveness, and sociodemographic representation of diverse recruitment methods used to enroll participants in 3 cities of the Interventions, Research, and Action in Cities Team (INTERACT) study, a cohort study conducted in Canadian cities. Methods Over 2017 and 2018 in Vancouver, Saskatoon, and Montreal, the INTERACT study used the following recruitment methods: mailed letters, social media (including sponsored Facebook advertisements), news media, partner communications, snowball recruitment, in-person recruitment, and posters. Participation in the study involved answering web-based questionnaires (at minimum), activating a smartphone app to share sensor data, and wearing a device for mobility and physical activity monitoring. We describe sociodemographic characteristics by the recruitment method and analyze performance indicators, including cost, completion rate, and time effectiveness. Effectiveness included calculating cost per completer (ie, a participant who completed at least one questionnaire), the completion rate of a health questionnaire, and the delay between completion of eligibility and health questionnaires. Cost included producing materials (ie, printing costs), transmitting recruitment messages (ie, mailing list rental, postage, and sponsored Facebook posts charges), and staff time. In Montreal, the largest INTERACT sample, we modeled the number of daily recruits through generalized linear models accounting for the distributed lagged effects of recruitment campaigns. Results Overall, 1791 participants were recruited from 3 cities and completed at least one questionnaire: 318 in Vancouver, 315 in Saskatoon, and 1158 in Montreal. In all cities, most participants chose to participate fully (questionnaires, apps, and devices). The costs associated with a completed participant varied across recruitment methods and by city. Facebook advertisements generated the most recruits (n=687), at a cost of CAD $15.04 (US $11.57; including staff time) per completer. Mailed letters were the costliest, at CAD $108.30 (US $83.3) per completer but served to reach older participants. All methods resulted in a gender imbalance, with women participating more, specifically with social media. Partner newsletters resulted in the participation of younger adults and were cost-efficient (CAD $5.16 [US $3.97] per completer). A generalized linear model for daily Montreal recruitment identified 2-day lag effects on most recruitment methods, except for the snowball campaign (4 days), letters (15 days), and reminder cards (5 days). Conclusions This study presents comprehensive data on the costs, effectiveness, and bias of population recruitment in a cohort study in 3 Canadian cities. More comprehensive documentation and reporting of recruitment efforts across studies are needed to improve our capacity to conduct inclusive intervention research.
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Affiliation(s)
- Rania Wasfi
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, Canada.,Centre de recherche du CHUM, Université de Montréal, Montréal, QC, Canada.,École de Santé Publique, Université de Montréal, Montreal, QC, Canada
| | | | - Meridith Sones
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Karen Laberee
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Caitlin Pugh
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Daniel Fuller
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St John's, NL, Canada
| | - Meghan Winters
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Yan Kestens
- Centre de recherche du CHUM, Université de Montréal, Montréal, QC, Canada.,École de Santé Publique, Université de Montréal, Montreal, QC, Canada
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Ellington M, Connelly J, Clayton P, Lorenzo CY, Collazo-Velazquez C, Trak-Fellermeier MA, Palacios C. Use of Facebook, Instagram, and Twitter for recruiting healthy participants in nutrition-, physical activity-, or obesity-related studies: a systematic review. Am J Clin Nutr 2021; 115:514-533. [PMID: 34669955 PMCID: PMC8827067 DOI: 10.1093/ajcn/nqab352] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 10/14/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND There are limited systematic reviews exploring the use of social media for recruiting participants specifically for nutrition-, physical activity-, and obesity-related studies. OBJECTIVES The aim was to conduct a systematic review on the effectiveness of using social media (Facebook, Instagram, and Twitter) for recruiting healthy participants in nutrition-, physical activity-, or obesity-related studies. METHODS Studies were identified from 5 databases and included if they reported the number of participants recruited by social media (Facebook, Instagram, or Twitter) vs. traditional (print, e-mail, etc.). The effectiveness of recruitment was compared between methods by study procedures (in-person vs. online procedures). The cost-effectiveness of methods was also explored. The protocol was published in the Prospero database (ID# CRD42020204414). RESULTS Twenty-six studies were included. Among studies with both types of recruitment methods, 49% of the sample was reached through traditional methods, 40% through social media, and the rest by other methods. For in-person study procedures, the median number of participants recruited using social media was 19 (range: 3-278) and for online study procedures, it was 298 (range: 3-17,069). Median recruitment cost using social media (n = 14 studies) was $11.90 (range: $0-517) per participant, while this varied considerably for traditional methods depending on how it was calculated ($214, $18.9-$777). The ratio of participants reached vs. recruited was 0.12%; the overall ratio of participants interactions vs. recruited was 21.2%. CONCLUSIONS For in-person study procedures, traditional recruitment methods were more effective than social media, but for online study procedures, about half reported that social media was more effective. While more potential participants were reached through social media, only 21.2% of those who interacted with ads were enrolled. With the increased use of social media, their use for recruitment may be more frequent; therefore, future reviews may show different results.
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Affiliation(s)
- Malik Ellington
- Dietetics and Nutrition Department, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | - Jeneene Connelly
- Dietetics and Nutrition Department, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | - Priscilla Clayton
- Dietetics and Nutrition Department, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | - C Yaisli Lorenzo
- Dietetics and Nutrition Department, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | - Christina Collazo-Velazquez
- Dietetics and Nutrition Department, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | - María Angélica Trak-Fellermeier
- Dietetics and Nutrition Department, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
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10
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Hwang DA, Lee A, Song JM, Han HR. Recruitment and Retention Strategies Among Racial and Ethnic Minorities in Web-Based Intervention Trials: Retrospective Qualitative Analysis. J Med Internet Res 2021; 23:e23959. [PMID: 34255658 PMCID: PMC8314154 DOI: 10.2196/23959] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/26/2020] [Accepted: 04/30/2021] [Indexed: 12/17/2022] Open
Abstract
Background Racial and ethnic minority groups are underrepresented in health research, contributing to persistent health disparities in the United States. Identifying effective recruitment and retention strategies among minority groups and their subpopulations is an important research agenda. Web-based intervention approaches are becoming increasingly popular with the ubiquitous use of the internet. However, it is not completely clear which recruitment and retention strategies have been successful in web-based intervention trials targeting racial and ethnic minorities. Objective This study aims to describe lessons learned in recruiting and retaining one of the understudied ethnic minority women—Korean Americans—enrolled in a web-based intervention trial and to compare our findings with the strategies reported in relevant published web-based intervention trials. Methods Multiple sources of data were used to address the objectives of this study, including the study team’s meeting minutes, participant tracking and contact logs, survey reports, and postintervention interviews. In addition, an electronic search involving 2 databases (PubMed and CINAHL) was performed to identify published studies using web-based interventions. Qualitative analysis was then performed to identify common themes addressing recruitment and retention strategies across the trials using web-based intervention modalities. Results A total of 9 categories of recruitment and retention strategies emerged: authentic care; accommodation of time, place, and transportation; financial incentives; diversity among the study team; multiple, yet standardized modes of communication; mobilizing existing community relationships with efforts to build trust; prioritizing features of web-based intervention; combined use of web-based and direct recruitment; and self-directed web-based intervention with human support. Although all the studies included in the analysis combined multiple strategies, prioritizing features of web-based intervention or use of human support were particularly relevant for promoting recruitment and retention of racial and ethnic minorities in web-based intervention trials. Conclusions The growing prevalence of internet use among racial and ethnic minority populations represents an excellent opportunity to design and deliver intervention programs via the internet. Future research should explore and compare successful recruitment and retention methods among race and ethnic groups for web-based interventions. Trial Registration ClinicalTrials.gov NCT03726619; https://clinicaltrials.gov/ct2/show/NCT03726619.
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Affiliation(s)
- DaSol Amy Hwang
- Johns Hopkins University School of Nursing, Baltimore, MD, United States
| | - Alex Lee
- Johns Hopkins University School of Nursing, Baltimore, MD, United States
| | - Jae Min Song
- Johns Hopkins University School of Nursing, Baltimore, MD, United States
| | - Hae-Ra Han
- Johns Hopkins University School of Nursing, Baltimore, MD, United States
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11
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Weitzman PF, Zhou Y, Kogelman L, Mack S, Sharir JY, Vicente SR, Levkoff SE. A Web-Based HIV/STD Prevention Intervention for Divorced or Separated Older Women. THE GERONTOLOGIST 2021; 60:1159-1168. [PMID: 31403668 DOI: 10.1093/geront/gnz098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Sexually transmitted diseases (STDs) are increasing among older adults concomitant with a rise in divorce after the age of 50 years. The objective of this study was to examine the effectiveness of a web-based human immunodeficiency virus (HIV)/STD risk reduction intervention for divorced and separated women aged more than 50 years. RESEARCH DESIGN AND METHODS Two hundred nineteen divorced or separated women, aged 50 years and older, participated in 60-day randomized pre-post control group study. Recruitment occurred via health agencies in Boston and Columbia, SC, and Craigslist advertisements placed in Boston, Columbia, Charleston, New York City, Washington DC, Baltimore, Chicago, Atlanta, Orlando, and Miami. RESULTS Intervention group reported greater intention to practice safe sex compared to the control group (B = .55, p = .03). Intention to practice safe sex differed by perceived stress (B = .15, p = .005), with no difference between control and intervention groups for those with low levels of stress. For high levels of stress, intervention group reported greater intention to practice safe sex compared to controls. Sexual risk was reduced by 6.10 points (SD: 1.10), and self-efficacy for sexual discussion was increased by 2.65 points (SD: 0.56) in the intervention group. DISCUSSION AND IMPLICATIONS A web-based intervention represents a promising tool to reduce HIV/STD risk among older women. Offering HIV/STD education in the context of other topics of interest to at-risk older women, such as divorce, may solve the problem of at-risk older women not seeking out prevention information due to lack of awareness of their heightened risk.
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Affiliation(s)
| | - Yi Zhou
- Environment and Health Group, Cambridge, Massachusetts
| | - Laura Kogelman
- Infectious Diseases Clinic, Traveler's Health Service, Tufts University School of Medicine, Boston, Massachusetts
| | - Sarah Mack
- Environment and Health Group, Cambridge, Massachusetts
| | | | | | - Sue E Levkoff
- Environment and Health Group, Cambridge, Massachusetts.,College of Social Work, University of South Carolina, Columbia
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O'Brien T, Russell CL, AlKahlout N, Rosenthal A, Meyer T, Tan A, Daloul R, Hathaway D. Recruitment of Older Kidney Transplant Recipients to a Longitudinal Study. Nurs Res 2020; 69:233-237. [PMID: 31688340 PMCID: PMC7313092 DOI: 10.1097/nnr.0000000000000406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Currently, limited information is available regarding selection of the most successful strategies for recruitment of older adult kidney transplant recipients as research participants. OBJECTIVE The aim of this study was to explore multiple modes of recruitment strategies to enroll older kidney transplant recipients in a 1-year longitudinal study. METHODS We used a feasibility design to explore the following recruitment methods: face-to-face contact in the transplant clinic, paper flyers placed in the transplant clinic, Facebook, an online transplant newsletter, and a university website listing of research studies. RESULTS Enrollment was open for 9 months, during which time websites and the Facebook portal were active, 142 newsletters were e-mailed, and 424 patients were approached in the transplant clinic. Among patients approached in the clinic, 12 did not own a smartphone required for the study. The sample consisted of 60 participants (39 men, 21 women), with a mean age of 64.5 ± 4.7 years. Of the participants who enrolled in the study, the largest number (75%, n = 45) was recruited using the face-to-face method in the transplant clinic. The online transplant newsletter was the second-best recruitment source (18%, n = 11). DISCUSSION Recruitment strategies using face-to-face contact and the online newsletter associated with the transplant clinic organization appeared to be more effective than strategies not associated with the transplant clinic (Facebook and university website). Findings suggest that using a familiar organization communication method to recruit older chronic disease population may be the most beneficial.
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Affiliation(s)
- Tara O'Brien
- Tara O'Brien, PhD, RN, CNE, is an Assistant Professor; Noor AlKahlout, BS, Anna Rosenthal, SN, and Tess Meyer SN, are Research Team Members; and Alai Tan, PhD, is a Research Associate Professor at The Ohio State University College of Nursing, Columbus. Cynthia Russell PhD, RN, FAAN, is a Professor at the School of Nursing and Health Studies, University of Missouri-Kansas City. Reem Daloul, MD, is an Assistant Professor at The Ohio State University College of Medicine, Columbus. Donna Hathaway PhD, RN, FAAN, is a Distinguished Professor at the University of Tennessee Health Science Center, Memphis
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13
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Ash GI, Robledo DS, Ishii M, Pittman B, DeMartini KS, O'Malley SS, Redeker NS, Fucito LM. Using Web-Based Social Media to Recruit Heavy-Drinking Young Adults for Sleep Intervention: Prospective Observational Study. J Med Internet Res 2020; 22:e17449. [PMID: 32780027 PMCID: PMC7448185 DOI: 10.2196/17449] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 04/12/2020] [Accepted: 06/15/2020] [Indexed: 01/06/2023] Open
Abstract
Background Novel alcohol prevention strategies are needed for heavy-drinking young adults. Sleep problems are common among young adults who drink heavily and are a risk factor for developing an alcohol use disorder (AUD). Young adults, interested in the connection between sleep and alcohol, are open to getting help with their sleep. Therefore, sleep interventions may offer an innovative solution. This study evaluates social media advertising for reaching young adults and recruiting them for a new alcohol prevention program focused on sleep. Objective This study aims to evaluate the effectiveness and cost of using Facebook, Instagram, and Snapchat advertising to reach young adults who drink heavily for a sleep intervention; characterize responders’ sleep, alcohol use, and related concerns and interests; and identify the most appealing advertising content. Methods In study 1, advertisements targeting young adults with sleep concerns, heavy alcohol use, or interest in participating in a sleep program ran over 3 months. Advertisements directed volunteers to a brief web-based survey to determine initial sleep program eligibility and characterize the concerns or interests that attracted them to click the advertisement. In study 2, three advertisements ran simultaneously for 2 days to enable us to compare the effectiveness of specific advertising themes. Results In study 1, advertisements generated 13,638 clicks, 909 surveys, and 27 enrolled volunteers in 3 months across the social media platforms. Fees averaged US $0.27 per click, US $3.99 per completed survey, US $11.43 per volunteer meeting initial screening eligibility, and US $106.59 per study enrollee. On average, those who completed the web-based survey were 21.1 (SD 2.3) years of age, and 69.4% (631/909) were female. Most reported sleep concerns (725/909, 79.8%) and an interest in the connection between sleep and alcohol use (547/909, 60.2%), but few had drinking concerns (49/909, 5.4%). About one-third (317/909, 34.9%) were identified as being at risk for developing an AUD based on a validated alcohol screener. Among this subsample, 8.5% (27/317) met the final criteria and were enrolled in the trial. Some volunteers also referred additional volunteers by word of mouth. In study 2, advertisements targeting sleep yielded a higher response rate than advertisements targeting alcohol use (0.91% vs 0.56% click rate, respectively; P<.001). Conclusions Social media advertisements designed to target young adults with sleep concerns reached those who also drank alcohol heavily, despite few being concerned about their drinking. Moreover, advertisements focused on sleep were more effective than those focused on drinking. Compared with previous studies, cost-effectiveness was moderate for engagement (impressions to clicks), excellent for conversion (clicks to survey completion), and reasonable for enrollment. These data demonstrate the utility of social media advertising focused on sleep to reach young adults who drink heavily and recruit them for intervention.
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Affiliation(s)
- Garrett I Ash
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.,Pain, Research, Informatics, Medical Comorbidities and Education Center (PRIME), Veterans Affairs Connecticut Healthcare System, West Haven, CT, United States
| | - David S Robledo
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | - Momoko Ishii
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.,Yale School of Public Health, New Haven, CT, United States
| | - Brian Pittman
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | - Kelly S DeMartini
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | | | | | - Lisa M Fucito
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.,Yale Cancer Center, New Haven, CT, United States.,Smilow Cancer Hospital, Yale-New Haven Hospital, New Haven, CT, United States
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14
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Frampton GK, Shepherd J, Pickett K, Griffiths G, Wyatt JC. Digital tools for the recruitment and retention of participants in randomised controlled trials: a systematic map. Trials 2020; 21:478. [PMID: 32498690 PMCID: PMC7273688 DOI: 10.1186/s13063-020-04358-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 04/28/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Recruiting and retaining participants in randomised controlled trials (RCTs) is challenging. Digital tools, such as social media, data mining, email or text-messaging, could improve recruitment or retention, but an overview of this research area is lacking. We aimed to systematically map the characteristics of digital recruitment and retention tools for RCTs, and the features of the comparative studies that have evaluated the effectiveness of these tools during the past 10 years. METHODS We searched Medline, Embase, other databases, the Internet, and relevant web sites in July 2018 to identify comparative studies of digital tools for recruiting and/or retaining participants in health RCTs. Two reviewers independently screened references against protocol-specified eligibility criteria. Included studies were coded by one reviewer with 20% checked by a second reviewer, using pre-defined keywords to describe characteristics of the studies, populations and digital tools evaluated. RESULTS We identified 9163 potentially relevant references, of which 104 articles reporting 105 comparative studies were included in the systematic map. The number of published studies on digital tools has doubled in the past decade, but most studies evaluated digital tools for recruitment rather than retention. The key health areas investigated were health promotion, cancers, circulatory system diseases and mental health. Few studies focussed on minority or under-served populations, and most studies were observational. The most frequently-studied digital tools were social media, Internet sites, email and tv/radio for recruitment; and email and text-messaging for retention. One quarter of the studies measured efficiency (cost per recruited or retained participant) but few studies have evaluated people's attitudes towards the use of digital tools. CONCLUSIONS This systematic map highlights a number of evidence gaps and may help stakeholders to identify and prioritise further research needs. In particular, there is a need for rigorous research on the efficiency of the digital tools and their impact on RCT participants and investigators, perhaps as studies-within-a-trial (SWAT) research. There is also a need for research into how digital tools may improve participant retention in RCTs which is currently underrepresented relative to recruitment research. REGISTRATION Not registered; based on a pre-specified protocol, peer-reviewed by the project's Advisory Board.
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Affiliation(s)
- Geoff K. Frampton
- Southampton Health Technology Assessments Centre (SHTAC), Wessex Institute, Faculty of Medicine, University of Southampton, Alpha House, Southampton Science Park, Southampton, SO16 7NS UK
- Wessex Institute, Faculty of Medicine, University of Southampton, Alpha House, Southampton Science Park, Southampton, SO16 7NS UK
| | - Jonathan Shepherd
- Southampton Health Technology Assessments Centre (SHTAC), Wessex Institute, Faculty of Medicine, University of Southampton, Alpha House, Southampton Science Park, Southampton, SO16 7NS UK
- Wessex Institute, Faculty of Medicine, University of Southampton, Alpha House, Southampton Science Park, Southampton, SO16 7NS UK
| | - Karen Pickett
- Southampton Health Technology Assessments Centre (SHTAC), Wessex Institute, Faculty of Medicine, University of Southampton, Alpha House, Southampton Science Park, Southampton, SO16 7NS UK
- Wessex Institute, Faculty of Medicine, University of Southampton, Alpha House, Southampton Science Park, Southampton, SO16 7NS UK
| | - Gareth Griffiths
- Southampton Clinical Trials Unit, University of Southampton and Southampton University Hospital NHS Foundation Trust, Southampton General Hospital, Southampton, SO16 6YD UK
| | - Jeremy C. Wyatt
- Wessex Institute, Faculty of Medicine, University of Southampton, Alpha House, Southampton Science Park, Southampton, SO16 7NS UK
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15
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Bejtkovsky J. Social Media Platforms as HR Marketing Tool in Selected Healthcare Service Providers. MARKETING AND MANAGEMENT OF INNOVATIONS 2020. [DOI: 10.21272/mmi.2020.1-25] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The research paper summarizes the arguments and counterarguments within the scientific discussion on the issue of social media platforms, HR marketing, E-recruitment and human capital management. The primary purpose of the research is to determine whether the size of the selected healthcare providers influences (1) the active use of social media platforms and (2) the creation of the recruitment videos to address potential employees on the internal or external labour market. Systematization literary sources and approaches for solving the problems of the social media platforms, HR marketing, E-recruitment and human capital management indicate that the implementation of IT technologies in the field of human resources management is becoming a necessity in today’s world. Regarding methodological tools of the research methods, this research study used quantitative and qualitative marketing research as the essential primary sources of information and data. For the precise questionnaire survey and understanding of the individual questions in the questionnaire, a pretest questionnaire survey was also carried out. The pretest was conducted in the fourth quarter of 2018 on a sample of eight respondents. A significant marketing quantitative research followed after the removal of minor shortcomings, from October 2018 to January 2019. The object of the study was selected healthcare service providers in the Czech Republic. Fifty-eight healthcare service providers were thus analysed. Besides other things, two research hypotheses and one research question were formulated. In the research study, the Pearson’s chi-square test, Microsoft Excel 2013 and IBM SPSS Statistics 23 were used to verify the research hypotheses. The research paper presents the results of an empirical analysis showing that (1) there is no statistically significant relationship between the size of the selected healthcare service provider and the active use of the social media platforms as an HR marketing tool; (2) there is a statistically significant relationship between the size of the selected healthcare service provider and the creation of recruiting videos to address potential employees on the internal or external labour market; (3) social media platforms are used for the communication with the patients, clients, public and further for PR or promotion of selected healthcare service provider and the recruitment purposes of human resources and HR marketing. The research also empirically confirms and theoretically proves the need for IT knowledge and the active use of IT technology in the area of human resources management, today in the 21st century. The results of the research can be useful for the domestic and foreign healthcare service providers such as hospitals, maternity hospitals, children’s hospitals, hospital wards, field hospitals, nursing homes, asylums, clinics, sanatoriums of long term disease, health resorts, thermal baths, healing spas and other health and medical institutions or for academicians that are interested in human resource management.
Keywords
E-recruitment, healthcare service provider, human capital management, HR marketing, social media platforms.
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16
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Han P, Nicholson W, Norton A, Graffeo K, Singerman R, King S, Sundaresan A, Bennett W. DiabetesSistersVoices: Virtual Patient Community to Identify Research Priorities for Women Living With Diabetes. J Med Internet Res 2019; 21:e13312. [PMID: 31094360 PMCID: PMC6533875 DOI: 10.2196/13312] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 03/29/2019] [Accepted: 03/30/2019] [Indexed: 01/16/2023] Open
Abstract
Background Women with or at high risk of diabetes have unique health concerns across their life course. Effective methods are needed to engage women living with diabetes to develop and carry out a patient-centered research agenda. Objective This study aimed to (1) describe the creation of DiabetesSistersVoices, a virtual patient community for women living with and at risk for diabetes and (2) assess the feasibility and acceptability of DiabetesSistersVoices for engaging women in talking about their experiences, health care, and research priorities. Methods We partnered with a national advocacy organization to create DiabetesSistersVoices and to develop recruitment strategies, which included use of social media, Web-based newsletters, and weblinks through partnering organizations. Study inclusion criteria were as follows: Being a woman aged ≥18 years, residing in the United States, and self-reporting a diagnosis of diabetes or risk of diabetes. Eligible participants were given access to DiabetesSistersVoices and completed online surveys at enrollment and 6 months. We assessed trends in participants’ activities, including posting questions, sharing experiences about living with diabetes, and searching for posted resources. Results We enrolled 332 women (white: 86.5%; type 1 diabetes: 76.2%; median age: 51 years [interquartile range: 31 to 59 years]) over 8 months. Most (41.6%, 138/332) were classified as being active users (ie, posting) of the virtual community, 36.1% (120/332) as observers (ie, logged in but no posts), and 22.3% (74/332) as never users (ie, completed baseline surveys but then never logged in). Online activities were constant during the study, although participants had the highest website usage during the first 10 weeks after their enrollment. Conclusions We demonstrated the feasibility and acceptability of an online patient community for women living with diabetes by showing durability of recruitment and online usage over 6 months of testing. Next steps are to address barriers to joining a virtual patient community for women of color and women with type 2 diabetes to enhance inclusiveness and gain diverse perspectives to inform diabetes research.
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Affiliation(s)
- Peijin Han
- The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Wanda Nicholson
- Center for Women's Health Research, Department of Obstetrics and Gynecology, Chapel Hill, NC, United States.,Public Health Leadership Program, The University of North Carolina School of Medicine and, Gillings Global School of Public Health, Chapel Hill, NC, United States
| | - Anna Norton
- DiabetesSisters, #180, 1112 W Boughton Road, Bolingbrook, IL, United States
| | - Karen Graffeo
- DiabetesSisters, #180, 1112 W Boughton Road, Bolingbrook, IL, United States
| | | | | | - Aditi Sundaresan
- Center for Women's Health Research, Department of Obstetrics and Gynecology, Chapel Hill, NC, United States
| | - Wendy Bennett
- The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.,Johns Hopkins University School of Medicin, Division of General Internal Medicine, Baltimore, MD, United States
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17
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Wozney L, Turner K, Rose-Davis B, McGrath PJ. Facebook ads to the rescue? Recruiting a hard to reach population into an Internet-based behavioral health intervention trial. Internet Interv 2019; 17:100246. [PMID: 31080751 PMCID: PMC6500917 DOI: 10.1016/j.invent.2019.100246] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 03/20/2019] [Accepted: 03/24/2019] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE Facebook (FB) ads are touted as a way to facilitate recruitment of hard to reach participants into digital health research but the evidence has been mixed. This study aimed to empirically evaluate the impact and cost-effectiveness of paid ads for recruitment into a national trial testing an Internet-based, coached intervention for parents of children with Fetal Alcohol Spectrum Disorders. METHODS Post hoc analysis of FB ad data and Google analytics on the online trial consent site (myStudies) were conducted on 11 campaigns employing static image/text ads. Standard metrics (e.g., click through rate, cost per 1000 impressions, cost per consent) were calculated and descriptive statistics comparing FB ad engagement and enrolled participants over time were conducted. RESULTS Ad campaigns were active for a combined 115 days over 58 weeks resulting in 1533 links to the online recruitment site. During the ad campaigns, the mean rate of enrolment was 1 participant every 2 days. The first 3 ad campaigns were the most cost-effective. Mean cost per enrolment was $19.27 (Canadian dollars). CONCLUSIONS FB ads were efficient and cost-effective in broad dissemination of trial information, but more research is needed to explore the impact of saturation (how often ads are posted), design (what is in the ad), and individual determinants (who is likely to respond to an ad) on converting FB ad engagement into enrolment. Avoiding a reductionist approach to analytics will help ensure appropriate and targeted strategies remain the priority for digital health research recruitment through social media.
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Affiliation(s)
- Lori Wozney
- Nova Scotia Health Authority, Mental Health and Addictions Policy and Planning, E.C. Purdy Building, 302 Pleasant Street, Dartmouth, Nova Scotia B2Y 3Z9, Canada,Corresponding author.
| | - Karen Turner
- Centre for Research in Family Health, IWK Health Centre, 5850—5980 University Avenue, Halifax, Nova Scotia, Halifax B3K 6R8, Canada
| | - Benjamin Rose-Davis
- Centre for Research in Family Health, IWK Health Centre, 5850—5980 University Avenue, Halifax, Nova Scotia, Halifax B3K 6R8, Canada
| | - Patrick J. McGrath
- Dalhousie University, Department of Psychiatry, 5909 Veterans' Memorial Lane, Halifax, Nova Scotia B3H 2E2, Canada
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18
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Mejova Y, Weber I, Fernandez-Luque L. Online Health Monitoring using Facebook Advertisement Audience Estimates in the United States: Evaluation Study. JMIR Public Health Surveill 2018; 4:e30. [PMID: 29592849 PMCID: PMC5895920 DOI: 10.2196/publichealth.7217] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 04/25/2017] [Accepted: 10/08/2017] [Indexed: 01/08/2023] Open
Abstract
Background Facebook, the most popular social network with over one billion daily users, provides rich opportunities for its use in the health domain. Though much of Facebook’s data are not available to outsiders, the company provides a tool for estimating the audience of Facebook advertisements, which includes aggregated information on the demographics and interests, such as weight loss or dieting, of Facebook users. This paper explores the potential uses of Facebook ad audience estimates for eHealth by studying the following: (1) for what type of health conditions prevalence estimates can be obtained via social media and (2) what type of marker interests are useful in obtaining such estimates, which can then be used for recruitment within online health interventions. Objective The objective of this study was to understand the limitations and capabilities of using Facebook ad audience estimates for public health monitoring and as a recruitment tool for eHealth interventions. Methods We use the Facebook Marketing application programming interface to correlate estimated sizes of audiences having health-related interests with public health data. Using several study cases, we identify both potential benefits and challenges in using this tool. Results We find several limitations in using Facebook ad audience estimates, for example, using placebo interest estimates to control for background level of user activity on the platform. Some Facebook interests such as plus-size clothing show encouraging levels of correlation (r=.74) across the 50 US states; however, we also sometimes find substantial correlations with the placebo interests such as r=.68 between interest in Technology and Obesity prevalence. Furthermore, we find demographic-specific peculiarities in the interests on health-related topics. Conclusions Facebook’s advertising platform provides aggregate data for more than 190 million US adults. We show how disease-specific marker interests can be used to model prevalence rates in a simple and intuitive manner. However, we also illustrate that building effective marker interests involves some trial-and-error, as many details about Facebook’s black box remain opaque.
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Affiliation(s)
- Yelena Mejova
- Qatar Computing Research Institute, Hamad Bin Khalifa University, Doha, Qatar
| | - Ingmar Weber
- Qatar Computing Research Institute, Hamad Bin Khalifa University, Doha, Qatar
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Whitaker C, Stevelink S, Fear N. The Use of Facebook in Recruiting Participants for Health Research Purposes: A Systematic Review. J Med Internet Res 2017; 19:e290. [PMID: 28851679 PMCID: PMC5594255 DOI: 10.2196/jmir.7071] [Citation(s) in RCA: 437] [Impact Index Per Article: 62.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 04/06/2017] [Accepted: 05/09/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Social media is a popular online tool that allows users to communicate and exchange information. It allows digital content such as pictures, videos and websites to be shared, discussed, republished and endorsed by its users, their friends and businesses. Adverts can be posted and promoted to specific target audiences by demographics such as region, age or gender. Recruiting for health research is complex with strict requirement criteria imposed on the participants. Traditional research recruitment relies on flyers, newspaper adverts, radio and television broadcasts, letters, emails, website listings, and word of mouth. These methods are potentially poor at recruiting hard to reach demographics, can be slow and expensive. Recruitment via social media, in particular Facebook, may be faster and cheaper. OBJECTIVE The aim of this study was to systematically review the literature regarding the current use and success of Facebook to recruit participants for health research purposes. METHODS A literature review was completed in March 2017 in the English language using MEDLINE, EMBASE, Web of Science, PubMed, PsycInfo, Google Scholar, and a hand search of article references. Papers from the past 12 years were included and number of participants, recruitment period, number of impressions, cost per click or participant, and conversion rate extracted. RESULTS A total of 35 studies were identified from the United States (n=22), Australia (n=9), Canada (n=2), Japan (n=1), and Germany (n=1) and appraised using the Critical Appraisal Skills Programme (CASP) checklist. All focused on the feasibility of recruitment via Facebook, with some (n=10) also testing interventions, such as smoking cessation and depression reduction. Most recruited young age groups (16-24 years), with the remaining targeting specific demographics, for example, military veterans. Information from the 35 studies was analyzed with median values being 264 recruited participants, a 3-month recruitment period, 3.3 million impressions, cost per click of US $0.51, conversion rate of 4% (range 0.06-29.50), eligibility of 61% (range 17-100), and cost per participant of US $14.41. The studies showed success in penetrating hard to reach populations, finding the results representative of their control or comparison demographic, except for an over representation of young white women. CONCLUSIONS There is growing evidence to suggest that Facebook is a useful recruitment tool and its use, therefore, should be considered when implementing future health research. When compared with traditional recruitment methods (print, radio, television, and email), benefits include reduced costs, shorter recruitment periods, better representation, and improved participant selection in young and hard to reach demographics. It however, remains limited by Internet access and the over representation of young white women. Future studies should recruit across all ages and explore recruitment via other forms of social media.
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Affiliation(s)
- Christopher Whitaker
- Kings Centre for Military Health Research, Department of Psychological Medicine, Kings College London, London, United Kingdom
| | - Sharon Stevelink
- Kings Centre for Military Health Research, Department of Psychological Medicine, Kings College London, London, United Kingdom
| | - Nicola Fear
- Kings Centre for Military Health Research, Department of Psychological Medicine, Kings College London, London, United Kingdom
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20
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Reiter PL, Katz ML, Bauermeister JA, Shoben AB, Paskett ED, McRee AL. Recruiting Young Gay and Bisexual Men for a Human Papillomavirus Vaccination Intervention Through Social Media: The Effects of Advertisement Content. JMIR Public Health Surveill 2017; 3:e33. [PMID: 28576758 PMCID: PMC5473946 DOI: 10.2196/publichealth.7545] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 04/20/2017] [Accepted: 04/25/2017] [Indexed: 11/16/2022] Open
Abstract
Background Web-based approaches, specifically social media sites, represent a promising approach for recruiting young gay and bisexual men for research studies. Little is known, however, about how the performance of social media advertisements (ads) used to recruit this population is affected by ad content (ie, image and text). Objective The aim of this study was to evaluate the effects of different images and text included in social media ads used to recruit young gay and bisexual men for the pilot test of a Web-based human papillomavirus (HPV) vaccination intervention. Methods In July and September 2016, we used paid Facebook advertisements to recruit men who were aged 18-25 years, self-identified as gay or bisexual, US resident, and had not received HPV vaccine. A 4x2x2 factorial experiment varied ad image (a single young adult male, a young adult male couple, a group of young adult men, or a young adult male talking to a doctor), content focus (text mentioning HPV or HPV vaccine), and disease framing (text mentioning cancer or a sexually transmitted disease [STD]). Poisson regression determined whether these experimental factors affected ad performance. Results The recruitment campaign reached a total of 35,646 users who viewed ads for 36,395 times. This resulted in an overall unique click-through rate of 2.01% (717/35,646) and an overall conversion rate of 0.66% (241/36,395). Reach was higher for ads that included an image of a couple (incidence rate ratio, IRR=4.91, 95% CI 2.68-8.97, P<.001) or a group (IRR=2.65, 95% CI 1.08-6.50, P=.03) compared with those that included an image of a single person. Ads that included an image of a couple also had a higher conversion rate (IRR=2.56, 95% CI 1.13-5.77, P=.02) than ads that included an image of a single person. Ads with text mentioning an STD had a higher unique click-through rate compared with ads with text mentioning cancer (IRR=1.34, 95% CI 1.06-1.69, P=.01). The campaign cost a total of US $413.72 and resulted in 150 eligible and enrolled individuals (US $2.76 per enrolled participant). Conclusions Facebook ads are a convenient and cost-efficient strategy for reaching and recruiting young gay and bisexual men for a Web-based HPV vaccination intervention. To help optimize ad performance among this population, researchers should consider the importance of the text and image included in the social media recruitment ads.
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Affiliation(s)
- Paul L Reiter
- College of Medicine, Ohio State University, Columbus, OH, United States
| | - Mira L Katz
- College of Public Health, Ohio State University, Columbus, OH, United States
| | - Jose A Bauermeister
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, United States
| | - Abigail B Shoben
- College of Public Health, Ohio State University, Columbus, OH, United States
| | - Electra D Paskett
- College of Medicine, Ohio State University, Columbus, OH, United States
| | - Annie-Laurie McRee
- Division of General Pediatrics and Adolescent Health, University of Minnesota Medical School, Minneapolis, MN, United States
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21
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Abshire M, Dinglas VD, Cajita MIA, Eakin MN, Needham DM, Himmelfarb CD. Participant retention practices in longitudinal clinical research studies with high retention rates. BMC Med Res Methodol 2017; 17:30. [PMID: 28219336 PMCID: PMC5319074 DOI: 10.1186/s12874-017-0310-z] [Citation(s) in RCA: 148] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 02/11/2017] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND There is a need for improving cohort retention in longitudinal studies. Our objective was to identify cohort retention strategies and implementation approaches used in studies with high retention rates. METHODS Longitudinal studies with ≥200 participants, ≥80% retention rates over ≥1 year of follow-up were queried from an Institutional Review Board database at a large research-intensive U.S. university; additional studies were identified through networking. Nineteen (86%) of 22 eligible studies agreed to participate. Through in-depth semi-structured interviews, participants provided retention strategies based on themes identified from previous literature reviews. Synthesis of data was completed by a multidisciplinary team. RESULTS The most commonly used retention strategies were: study reminders, study visit characteristics, emphasizing study benefits, and contact/scheduling strategies. The research teams were well-functioning, organized, and persistent. Additionally, teams tailored their strategies to their participants, often adapting and innovating their approaches. CONCLUSIONS These studies included specialized and persistent teams and utilized tailored strategies specific to their cohort and individual participants. Studies' written protocols and published manuscripts often did not reflect the varied strategies employed and adapted through the duration of study. Appropriate retention strategy use requires cultural sensitivity and more research is needed to identify how strategy use varies globally.
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Affiliation(s)
- Martha Abshire
- Johns Hopkins University School of Nursing, 525 North Wolfe Street, Suite 527, 21287, Baltimore, MD, USA.
| | - Victor D Dinglas
- Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD, USA
- Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Maan Isabella A Cajita
- Johns Hopkins University School of Nursing, 525 North Wolfe Street, Suite 527, 21287, Baltimore, MD, USA
| | - Michelle N Eakin
- Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD, USA
- Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Dale M Needham
- Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD, USA
- Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
- Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Cheryl Dennison Himmelfarb
- Johns Hopkins University School of Nursing, 525 North Wolfe Street, Suite 527, 21287, Baltimore, MD, USA
- Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD, USA
- Johns Hopkins Institute for Clinical and Translational Sciences, Johns Hopkins University, Baltimore, MD, USA
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