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Chang A, Huang SD, Benjamin DJ, Schmidt JL, Palmer CGS, Garrison NA. Exploring the role of digital tools in rare disease management: An interview-based study. J Genet Couns 2024. [PMID: 38741243 DOI: 10.1002/jgc4.1908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 03/09/2024] [Accepted: 04/25/2024] [Indexed: 05/16/2024]
Abstract
While digital tools, such as the Internet, smartphones, and social media, are an important part of modern society, little is known about the specific role they play in the healthcare management of individuals and caregivers affected by rare disease. Collectively, rare diseases directly affect up to 10% of the global population, suggesting that a significant number of individuals might benefit from the use of digital tools. The purpose of this qualitative interview-based study was to explore: (a) the ways in which digital tools help the rare disease community; (b) the healthcare gaps not addressed by current digital tools; and (c) recommended digital tool features. Individuals and caregivers affected by rare disease who were comfortable using a smartphone and at least 18 years old were eligible to participate. We recruited from rare disease organizations using purposive sampling in order to achieve a diverse and information rich sample. Interviews took place over Zoom and reflexive thematic analysis was utilized to conceptualize themes. Eight semistructured interviews took place with four individuals and four caregivers. Three themes were conceptualized which elucidated key aspects of how digital tools were utilized in disease management: (1) digital tools should lessen the burden of managing a rare disease condition; (2) digital tools should foster community building and promote trust; and (3) digital tools should provide trusted and personalized information to understand the condition and what the future may hold. These results suggest that digital tools play a central role in the lives of individuals with rare disease and their caregivers. Digital tools that centralize trustworthy information, and that bring the relevant community together to interact and promote trust are needed. Genetic counselors can consider these ideal attributes of digital tools when providing resources to individuals and caretakers of rare disease.
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Affiliation(s)
- Andrea Chang
- Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Sarah D Huang
- Institute for Society and Genetics, University of California, Los Angeles, Los Angeles, California, USA
| | - Daniel J Benjamin
- Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
- Behavioral Decision Making Group, Anderson School of Management, University of California, Los Angeles, Los Angeles, California, USA
- National Bureau of Economic Research, Cambridge, Massachusetts, USA
| | | | - Christina G S Palmer
- Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
- Institute for Society and Genetics, University of California, Los Angeles, Los Angeles, California, USA
- Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, USA
| | - Nanibaa' A Garrison
- Institute for Society and Genetics, University of California, Los Angeles, Los Angeles, California, USA
- Institute for Precision Health, University of California, Los Angeles, Los Angeles, California, USA
- Division of General Internal Medicine and Health Services Research, University of California, Los Angeles, Los Angeles, California, USA
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Buhr RG, Huynh A, Lee C, Nair VP, Romero R, Wisk LE. Health Professional vs Layperson Values and Preferences on Scarce Resource Allocation. JAMA Netw Open 2024; 7:e241958. [PMID: 38470416 PMCID: PMC10933708 DOI: 10.1001/jamanetworkopen.2024.1958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/21/2024] [Indexed: 03/13/2024] Open
Abstract
Importance COVID-19 prompted rapid development of scarce resource allocation (SRA) policies to be implemented if demand eclipsed health systems' ability to provide critical care. While SRA policies follow general ethical frameworks, understanding priorities of those affected by policies and/or tasked with implementing them is critical. Objective To evaluate whether community members and health care profesionals (HCP) agree with SRA protocols at the University of California (UC). Design, Setting, and Participants This survey study used social media and community-partnered engagement to recruit participants to a web-based survey open to all participants aged older than 18 years who wished to enroll. This study was fielded between May and September 2020 and queried participants' values and preferences on draft SRA policy tenets. Participants were also encouraged to forward the survey to their networks for snowball sampling. Data were analyzed from July 2020 to January 2024. Main Outcomes and Measures Survey items assessed values and preferences, graded on Likert scales. Agreement was tabulated as difference in Likert points between expressed opinion and policy tenets. Descriptive statistics were tested for significance by HCP status. Free text responses were analyzed using applied rapid qualitative analysis. Results A total of 1545 participants aged older than 18 years (mean [SD] age 49 [16] years; 1149 female participants [74%], 478 health care practitioners [30%]) provided data on SRA values and preferences. Agreement with UC SRA policy as drafted was moderately high among respondents, ranging from 67% to 83% across domains. Higher agreement with the interim policy was observed for laypersons across all domains except health-related factors. HCPs agreed more strongly on average that resources should not be allocated to those less likely to survive (HCP mean, 3.70; 95% CI, 3.16-3.59; vs layperson mean, 3.38; 95% CI, 3.17-3.59; P = .002), and were more in favor of reallocating life support from patients less likely to those more likely to survive (HCP mean, 6.41; 95% CI, 6.15-6.67; vs layperson mean, 5.40; 95% CI, 5.23-5.58; P < .001). Transparency and trust building themes were common in free text responses and highly rated on scaled items. Conclusions and Relevance This survey of SRA policy values found moderate agreement with fundamental principles of such policies. Engagement with communities affected by SRA policy should continue in iterative refinement in preparation for future crises.
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Affiliation(s)
- Russell G. Buhr
- Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at the University of California, Los Angeles
- Center for the Study of Healthcare Innovation, Implementation, and Policy, Health Services Research and Development, Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, California
- Department of Health Policy and Management, Fielding School of Public Health at the University of California, Los Angeles
| | - Ashley Huynh
- Clinical and Translational Science Institute Research Associates Program, University of California, Los Angeles
- University of California Irvine School of Medicine, Irvine
| | - Connie Lee
- Clinical and Translational Science Institute Research Associates Program, University of California, Los Angeles
- Keck Graduate Institute School of Pharmacy and Health Sciences, Claremont, California
| | - Vishnu P. Nair
- David Geffen School of Medicine, University of California, Los Angeles
- Department of Medicine, Stanford University, Stanford, California
| | - Ruby Romero
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at the University of California, Los Angeles
| | - Lauren E. Wisk
- Department of Health Policy and Management, Fielding School of Public Health at the University of California, Los Angeles
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at the University of California, Los Angeles
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Weisblum M, Trussell E, Schwinn T, Pacheco AR, Nurkin P. Screening and Retaining Adolescents Recruited Through Social Media: Secondary Analysis from a Longitudinal Clinical Trial. JMIR Pediatr Parent 2024; 7:e47984. [PMID: 38416559 PMCID: PMC10938224 DOI: 10.2196/47984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 11/26/2023] [Accepted: 12/29/2023] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Social media has become a popular method to recruit participants, particularly for studies with hard-to-reach populations. These studies still face challenges in data quality and, for longitudinal studies, sample retention. However, in addition to aiding in recruitment, social media platforms can help researchers with participant verification and tracking procedures during the study. There is limited previous research describing how longitudinal studies can use social media to screen and retain participants. OBJECTIVE This paper describes strategies implemented to screen and retain a nationwide sample of sexual minority youth who were recruited through social media platforms for a longitudinal study testing a drug abuse prevention program. METHODS Our screening strategies for participants included collecting necessary demographic information (name, phone, email, and social media accounts), verifying this information using publicly available web-based records, and sending confirmation emails to ensure working email addresses and correct dates of birth. Retention strategies included communications designed to develop positive participant relationships, incentives for survey completion, regular updating of participant contact information, targeting hard-to-reach participants, and using social media as an alternative means of contacting participants. RESULTS During enrollment, although the only demographic data required were a phone number and an email address, 87.58% (1065/1216) of participants provided their Instagram as an alternative means of contact. This form of alternative communication remains the most preferred with 87.40% (1047/1198) of participants continuing to provide an Instagram username as of January 2023, about 3 years after recruitment began. In comparison, other alternative means of contact (eg, Facebook and alternative email) were provided by only 6.43% (77/1198) to 56.18% (673/1198) of participants. Direct messaging on Instagram was used to successfully confirm participant identity, remind participants to take annual follow-up surveys, and update lost participant contact information. Screening and retention strategies used in the study have helped achieve 96.30% (1171/1216) to 96.79% (1177/1216) sample retention across 3 waves of data collection. CONCLUSIONS Though social media can be a helpful tool to recruit participants, attrition and participant authenticity difficulties may be associated with this method. Screening and retention strategies can be implemented to improve retention. Internet searches are effective for screening youth to ensure they meet eligibility requirements. Additionally, social media-Instagram in this study-can help to track and locate participants who do not respond to traditional contact methods. TRIAL REGISTRATION ClinicalTrials.gov NCT03954535; https://clinicaltrials.gov/study/NCT03954535.
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Affiliation(s)
- Margaret Weisblum
- School of Social Work, Columbia University, New York, NY, United States
- Department of Psychology, Georgetown University, Washington, DC, United States
| | - Emma Trussell
- School of Social Work, Columbia University, New York, NY, United States
- School of Medicine, University of Queensland, Brisbane, Australia
- School of Medicine, Ochsner Health, New Orleans, LA, United States
| | - Traci Schwinn
- School of Social Work, Columbia University, New York, NY, United States
| | - Andrea R Pacheco
- School of Social Work, Columbia University, New York, NY, United States
- National Institute of Allergy and Infectious Diseases, International Center of Excellence in Research, Phnom Penh, Cambodia
| | - Paige Nurkin
- School of Social Work, Columbia University, New York, NY, United States
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Griggs S, Ash GI, Pignatiello G, Papik A, Huynh J, Leuchtag M, Hickman RL. Internet-Based Recruitment and Retention of Young Adults With Type 1 Diabetes: Cross-Sectional Study. JMIR Form Res 2023; 7:e46415. [PMID: 37606985 PMCID: PMC10481220 DOI: 10.2196/46415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 06/23/2023] [Accepted: 07/31/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Multiple research strategies are required to recruit and engage a representative cohort of young adults in diabetes research. In this report, we describe an approach for internet-based recruitment for a repeated-measures descriptive study. OBJECTIVE The objective of this cross-sectional study was to determine whether internet-based recruitment through multiple social media platforms, a clinical research platform, and cooperation with community partnerships-College Diabetes Network and Beyond Type 1-would serve as an effective way to recruit a representative sample of young adults aged 18-25 years with type 1 diabetes (T1D). METHODS We conducted a repeated-measures descriptive study. We captured enrollment rates and participant characteristics acquired from each social media platform through survey data and Facebook analytics. This study was advertised via paid postings across a combination of different social media platforms (eg, Facebook, Instagram, Twitter, and Reddit). We used quarterly application postings, quarterly newsletters, and participation in the ResearchMatch registry to identify potentially eligible participants from February 3, 2021, to June 6, 2022. RESULTS ResearchMatch proved to be the most cost-effective strategy overall, yielding the highest gender and racial diversity compared to other internet platforms (eg, Facebook, Instagram, Twitter, and Reddit), application postings (eg, Beyond Type 1), and newsletters (eg, College Diabetes Network and a local area college). However, we propose that the combination of these approaches yielded a larger, more diverse sample compared to any individual strategy. Our recruitment cost was US $16.69 per eligible participant, with a 1.27% conversion rate and a 30% eligibility rate. CONCLUSIONS Recruiting young adults with T1D across multiple internet-based platforms was an effective strategy to yield a moderately diverse sample. Leveraging various recruitment strategies is necessary to produce a representative sample of young adults with T1D. As the internet becomes a larger forum for study recruitment, participants from underrepresented backgrounds may continue engaging in research through advertisements on the internet and other internet-based recruitment platforms.
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Affiliation(s)
- Stephanie Griggs
- Case Western Reserve University Frances Payne Bolton School of Nursing, Cleveland, OH, United States
| | - Garrett I Ash
- Yale School of Medicine, New Haven, CT, United States
| | - Grant Pignatiello
- Case Western Reserve University Frances Payne Bolton School of Nursing, Cleveland, OH, United States
| | - AnnMarie Papik
- Case Western Reserve University Frances Payne Bolton School of Nursing, Cleveland, OH, United States
| | - Johnathan Huynh
- Case Western Reserve University Frances Payne Bolton School of Nursing, Cleveland, OH, United States
| | - Mary Leuchtag
- Case Western Reserve University Frances Payne Bolton School of Nursing, Cleveland, OH, United States
| | - Ronald L Hickman
- Case Western Reserve University Frances Payne Bolton School of Nursing, Cleveland, OH, United States
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Loui HF, Li J, Jackson NJ, Wisk LE, Buhr RG. Tobacco consumption behavior change during the COVID-19 pandemic is associated with perceived COVID threat. RESEARCH SQUARE 2023:rs.3.rs-3143401. [PMID: 37461647 PMCID: PMC10350210 DOI: 10.21203/rs.3.rs-3143401/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Rationale Tobacco use is a risk factor for COVID-19 adverse outcomes. Despite health implications, data conflict regarding COVID-19 and tobacco consumption. We present results from a survey of health behaviors during the pandemic to identify how COVID-19 influenced tobacco use. Methods A national internet-based survey was deployed between May-September 2020. We analyzed participants who reported current or former smoking. We tabulated change in tobacco use, whether changes related to COVID-19, and measures of anxiety, depression, and novel perceived COVID-19 threat scale. We employed multinomial logistic regression to determine associations between these items and tobacco consumption. Results We identified 500 respondents who reported ever smoking previously, 150 of which were currently smoking. Of 220 participants who reported any use of vapes, 110 were currently vaping. Increased perceived threat of COVID-19 was associated with both increased (aRRincrease 1.75, 95% CI [1.07-2.86], P = 0.03) and decreased (aRRdecrease 1.72 [1.04-2.85], P = 0.03) tobacco consumption relative to no change. There were no significant relationships found between perceived threat of COVID-19 and vaping behavior. Conclusions As perceived COVID-19 threat increased, people were more likely to increase or decrease their smoking than stay the same, even after controlling for anxiety and depression, both of which can affect smoking in either direction. Further study into motivators of increasing or decreasing affected tobacco consumption, and how barriers to care from safer-at-home policies and changes in care delivery moderate change in tobacco use will aid planning tobacco reduction interventions during the ongoing and future respiratory viral pandemics.
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Affiliation(s)
| | - Joshua Li
- David Geffen School of Medicine at UCLA
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Goldman N, Willem T, Buyx A, Zimmermann BM. Practical Benefits, Challenges, and Recommendations on Social Media Recruitment: Multi-Stakeholder Interview Study. J Med Internet Res 2023; 25:e44587. [PMID: 37213177 DOI: 10.2196/44587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/12/2023] [Accepted: 03/25/2023] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND The increasing use of social media opens new opportunities for recruiting patients for research studies. However, systematic evaluations indicate that the success of social media recruitment in terms of cost-effectiveness and representativeness depends on the type of study and its purpose. OBJECTIVE This study aims to explore the practical benefits and challenges of recruiting study participants with social media in the context of clinical and nonclinical studies and provide a summary of expert advice on how to conduct social media-based recruitment. METHODS We conducted semistructured interviews with 6 patients with hepatitis B who use social media and 30 experts from the following disciplines: (1) social media researchers or social scientists, (2) practical experts for social media recruitment, (3) legal experts, (4) ethics committee members, and (5) clinical researchers. The interview transcripts were analyzed using thematic analysis. RESULTS We found diverging expert opinions regarding the challenges and benefits of social media recruitment for research studies in four domains: (1) resources needed, (2) representativeness, (3) web-based community building, and (4) privacy considerations. Moreover, the interviewed experts provided practical advice on how to promote a research study via social media. CONCLUSIONS Even though recruitment strategies should always be sensitive to individual study contexts, a multiplatform approach (recruiting via several different social media platforms) with mixed-methods recruitment (web-based and offline recruitment channels) is the most beneficial recruitment strategy for many research studies. The different recruitment methods complement each other and may contribute to improving the reach of the study, the recruitment accrual, and the representativeness of the sample. However, it is important to assess the context- and project-specific appropriateness and usefulness of social media recruitment before designing the recruitment strategy.
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Affiliation(s)
- Nina Goldman
- Institute of History and Ethics in Medicine, Technical University of Munich, Munich, Germany
- Institute for Molecular Immunology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Theresa Willem
- Institute of History and Ethics in Medicine, Technical University of Munich, Munich, Germany
- Institute for Molecular Immunology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Science, Technology and Society, Technical University of Munich, Munich, Germany
| | - Alena Buyx
- Institute of History and Ethics in Medicine, Technical University of Munich, Munich, Germany
- Institute for Molecular Immunology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Science, Technology and Society, Technical University of Munich, Munich, Germany
| | - Bettina M Zimmermann
- Institute of History and Ethics in Medicine, Technical University of Munich, Munich, Germany
- Institute for Molecular Immunology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Science, Technology and Society, Technical University of Munich, Munich, Germany
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
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Tsevat RK, Weitzman ER, Wisk LE. Indicators of Healthcare Transition Progress Among College Youth With Type 1 Diabetes. Acad Pediatr 2023; 23:737-746. [PMID: 36067922 DOI: 10.1016/j.acap.2022.08.012] [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] [Received: 12/06/2021] [Revised: 08/23/2022] [Accepted: 08/27/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Adolescents with chronic diseases must navigate changing healthcare needs in college and beyond. This study examined the ability of college youth with type 1 diabetes (T1D) to achieve transition milestones and ascertained sociodemographic predictors of a successful healthcare transition (HCT). METHODS College youth with T1D were recruited via social media and direct outreach to participate in a web-based study, during which they answered questions about the HCT process. Descriptive statistics and multivariable regression were used to evaluate HCT measures as a function of sociodemographic variables. RESULTS Nearly two-thirds of participants (N = 138) had discussions with their providers about changing healthcare needs (65.9%) and transferring care to adult physicians (64.5%); less than one-third (27.9%) discussed obtaining health insurance as an adult. Females were more likely than males to discuss transitioning to adult providers (70.3% vs 40.7%, P < .01). Those covered on a parent's insurance (vs other) plan were more likely to receive help with finding adult providers (79.3% vs 44.4%, P = .04) but less likely to discuss how to obtain health insurance (25.0% vs 61.1%, P < .01). These differences persisted after adjustment. CONCLUSIONS Improvement is needed with regard to college youth with T1D becoming autonomous managers of their own care. Gaps were found in their experiences of discussing changing healthcare needs, locating adult providers, and obtaining health insurance-especially among those who were younger, male, and not covered under parental insurance. Efforts to improve the HCT process should focus particularly on these subgroups to advance healthcare delivery in this population.
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Affiliation(s)
- Rebecca K Tsevat
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at the University of California, Los Angeles (UCLA) (RK Tsevat and LE Wisk)
| | - Elissa R Weitzman
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital (ER Weitzman and LE Wisk), Boston, Mass; Department of Pediatrics, Harvard Medical School (ER Weitzman and LE Wisk), Boston, Mass; Computational Health Informatics Program, Boston Children's Hospital (ER Weitzman), Boston, Mass
| | - Lauren E Wisk
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital (ER Weitzman and LE Wisk), Boston, Mass; Department of Pediatrics, Harvard Medical School (ER Weitzman and LE Wisk), Boston, Mass; Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at the University of California, Los Angeles (UCLA) (RK Tsevat and LE Wisk); Department of Health Policy and Management, Fielding School of Public Health at the University of California, Los Angeles (UCLA) (LE Wisk).
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Weitzman ER, Wisk LE, Minegishi M, Cox R, Lunstead J, Brogna M, Levy S. Effects of a Patient-Centered Intervention to Reduce Alcohol Use Among Youth With Chronic Medical Conditions. J Adolesc Health 2022; 71:S24-S33. [PMID: 36122966 DOI: 10.1016/j.jadohealth.2021.10.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/13/2021] [Accepted: 10/15/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE Alcohol poses unique risks for youth with chronic medical conditions (YCMC) yet many drink. Preventive interventions targeting YCMC are scarce. METHODS YCMC with type 1 diabetes, juvenile idiopathic arthritis, systemic lupus erythematosus, or inflammatory bowel disease were recruited and randomized to trial the effects of a self-administered condition-tailored psychoeducational intervention on frequency in days of past 3-month alcohol use, alcohol-related risk perceptions, and knowledge. Changes in outcomes over time were measured and compared by treatment arm using multivariate mixed effects models. RESULTS Among N = 418 participants (average age 16.0 years, 52.2% female, 84.7% white, 90.7% non-Hispanic), 24.2% reported past-year alcohol use at baseline. Alcohol-related knowledge increased overall and was greater for the intervention group (adjusted improvement in knowledge score +7.70, 95% confidence interval [CI] 2.92-12.48). By 6-month follow-up, the percentage of youth reporting any alcohol use is risky/dangerous increased among intervention arm participants from 41.5% to 45.4% at baseline and decreased from 38.9% to 37.4% among controls (adjusted intervention effect odds ratio 1.79, 95% confidence interval 1.02-3.13). Overall, frequency of drinking increased over time from 3.72 to 4.52 days on average, with no differences by treatment group. Among female drinkers, the predicted mean frequency of drinking days declined in the intervention group (4.11-3.33) and increased among controls (2.82-4.55) (adjusted intervention effect rate ratio .50, 95% confidence interval .25-.99). CONCLUSIONS Exposure to a chronic illness-tailored psychoeducational intervention targeting alcohol use increased knowledge and perceived risk and, among females, reduced alcohol use. Promising results merit future work to optimize the model for both males and females.
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Affiliation(s)
- Elissa R Weitzman
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Computational Health Informatics Program, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
| | - Lauren E Wisk
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Division of General Internal Medicine and Health Services Research, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, California
| | - Machiko Minegishi
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Rachele Cox
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Julie Lunstead
- Division of Developmental Medicine, Boston Children's Hospital, Boston, Massachusetts; Adolescent Substance Use and Addiction Program, Boston Children's Hospital, Boston, Massachusetts
| | - Melissa Brogna
- Division of Developmental Medicine, Boston Children's Hospital, Boston, Massachusetts; Adolescent Substance Use and Addiction Program, Boston Children's Hospital, Boston, Massachusetts
| | - Sharon Levy
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Division of Developmental Medicine, Boston Children's Hospital, Boston, Massachusetts; Adolescent Substance Use and Addiction Program, Boston Children's Hospital, Boston, Massachusetts
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Zimmermann BM, Willem T, Bredthauer CJ, Buyx A. Ethical Issues in Social Media Recruitment for Clinical Studies: Ethical Analysis and Framework. J Med Internet Res 2022; 24:e31231. [PMID: 35503247 PMCID: PMC9115665 DOI: 10.2196/31231] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 11/11/2021] [Accepted: 12/02/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Social media recruitment for clinical studies holds the promise of being a cost-effective way of attracting traditionally marginalized populations and promoting patient engagement with researchers and a particular study. However, using social media for recruiting clinical study participants also poses a range of ethical issues. OBJECTIVE This study aims to provide a comprehensive overview of the ethical benefits and risks to be considered for social media recruitment in clinical studies and develop practical recommendations on how to implement these considerations. METHODS On the basis of established principles of clinical ethics and research ethics, we reviewed the conceptual and empirical literature for ethical benefits and challenges related to social media recruitment. From these, we derived a conceptual framework to evaluate the eligibility of social media use for recruitment for a specific clinical study. RESULTS We identified three eligibility criteria for social media recruitment for clinical studies: information and consent, risks for target groups, and recruitment effectiveness. These criteria can be used to evaluate the implementation of a social media recruitment strategy at its planning stage. We have discussed the practical implications of these criteria for researchers. CONCLUSIONS The ethical challenges related to social media recruitment are context sensitive. Therefore, social media recruitment should be planned rigorously, taking into account the target group, the appropriateness of social media as a recruitment channel, and the resources available to execute the strategy.
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Affiliation(s)
- Bettina M Zimmermann
- Institute of History and Ethics in Medicine, School of Medicine, Technical University of Munich, Munich, Germany.,Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Theresa Willem
- Institute of History and Ethics in Medicine, School of Medicine, Technical University of Munich, Munich, Germany.,Department of Science, Technology and Society, School of Social Sciences and Technology, Technical University of Munich, Munich, Germany
| | - Carl Justus Bredthauer
- Institute of History and Ethics in Medicine, School of Medicine, Technical University of Munich, Munich, Germany
| | - Alena Buyx
- Institute of History and Ethics in Medicine, School of Medicine, Technical University of Munich, Munich, Germany
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10
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McGorm KJ, Brown JD, Thomson RL, Oakey H, Moore B, Hendry A, Colman PG, Craig ME, Davis EA, Harris M, Harrison LC, Haynes A, Soldatos G, Vuillermin P, Wentworth JM, Couper JJ, Penno MAS. A Long-Term Evaluation of Facebook for Recruitment and Retention in the ENDIA Type 1 Diabetes Pregnancy-Birth Cohort Study. J Diabetes Sci Technol 2022; 17:696-704. [PMID: 35193430 DOI: 10.1177/19322968221079867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The Environmental Determinants of Islet Autoimmunity (ENDIA) study is an Australia-wide pregnancy-birth cohort study following children who have a first-degree relative with type 1 diabetes (ACTRN1261300794707). A dedicated ENDIA Facebook page was established in 2013 with the aim of enhancing recruitment and supporting participant retention through dissemination of study information. To measure the impact of Facebook, we evaluated the sources of referral to the study, cohort demographics, and withdrawal rates. We also investigated whether engagement with Facebook content was associated with specific post themes. METHODS Characteristics of Facebook versus conventional recruits were compared using linear, logistic, and multinomial logistic regression models. Logistic regression was used to determine the risk of study withdrawal. Data pertaining to 794 Facebook posts over 7.5 years were included in the analysis. RESULTS Facebook was the third largest source of referral (300/1511; 19.9%). Facebook recruits were more frequently Australian-born (P < .001) enrolling postnatally (P = .01) and withdrew from the study at a significantly lower rate compared with conventional recruits (4.7% vs 12.3%; P < .001) after a median of follow-up of 3.3 years. Facebook content featuring stories and images of participants received the highest engagement even though <20% of the 2337 Facebook followers were enrolled in the study. CONCLUSIONS Facebook was a valuable recruitment tool for ENDIA. Compared with conventional recruits, Facebook recruits were three times less likely to withdraw during long-term follow-up and had different sociodemographic characteristics. Facebook content featuring participants was the most engaging. These findings inform social media strategies for future cohort and type 1 diabetes studies. TRIAL REGISTRATION Australia New Zealand Clinical Trials Registry: ACTRN1261300794707.
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Affiliation(s)
- Kelly J McGorm
- Robinson Research Institute, Adelaide Medical School, The University of Adelaide, North Adelaide, SA, Australia
| | - James D Brown
- Robinson Research Institute, Adelaide Medical School, The University of Adelaide, North Adelaide, SA, Australia
| | - Rebecca L Thomson
- Robinson Research Institute, Adelaide Medical School, The University of Adelaide, North Adelaide, SA, Australia
| | - Helena Oakey
- Robinson Research Institute, Adelaide Medical School, The University of Adelaide, North Adelaide, SA, Australia
| | - Belinda Moore
- Department of Diabetes & Endocrinology, The Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Alexandra Hendry
- Robinson Research Institute, Adelaide Medical School, The University of Adelaide, North Adelaide, SA, Australia
| | - Peter G Colman
- Department of Diabetes & Endocrinology, The Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Maria E Craig
- School of Women's and Children's Health, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Elizabeth A Davis
- Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, WA, Australia
| | - Mark Harris
- Queensland Children's Hospital, South Brisbane, QLD, Australia
| | - Leonard C Harrison
- Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia
| | - Aveni Haynes
- Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, WA, Australia
| | - Georgia Soldatos
- Diabetes and Vascular Medicine Unit, Monash Health, Melbourne, VIC, Australia
| | - Peter Vuillermin
- Child Health Research Unit, Barwon Health, Geelong, VIC, Australia
| | - John M Wentworth
- Department of Diabetes & Endocrinology, The Royal Melbourne Hospital, Melbourne, VIC, Australia
- Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia
| | - Jennifer J Couper
- Robinson Research Institute, Adelaide Medical School, The University of Adelaide, North Adelaide, SA, Australia
- Women's and Children's Hospital, Adelaide, SA, Australia
| | - Megan A S Penno
- Robinson Research Institute, Adelaide Medical School, The University of Adelaide, North Adelaide, SA, Australia
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11
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Hausmann JS, Vizcaino-Riveros J, Marin AC, Minegishi M, Cox R, Chang ML, Schanberg LE, Natter M, Weitzman ER. Feasibility and Efficacy of Online Strategies to Recruit Parents of Children With Rheumatic Diseases for Research. ACR Open Rheumatol 2022; 4:410-416. [PMID: 35150085 PMCID: PMC9096518 DOI: 10.1002/acr2.11360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 09/14/2021] [Accepted: 09/20/2021] [Indexed: 12/23/2022] Open
Abstract
Objective We aimed to determine the feasibility and efficacy of online strategies to recruit parents of children with pediatric rheumatic diseases (PRDs) for research and to evaluate the degree to which known features of various rheumatic disease groups were present in the online cohort. Methods We studied two cohorts; the first was composed of respondents from a cross‐sectional parental survey of children with PRDs contacted through patient support groups and social media platforms, and the second cohort was composed of participants from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) legacy clinical registry. Results In the social media cohort, 712 complete surveys were analyzed. Most (65.9%) were referred from Facebook. The most common rheumatic disease was juvenile idiopathic arthritis (JIA) (27.1%), followed by juvenile dermatomyositis (22.1%). In the CARRA registry cohort, 7985 records were included. JIA was the largest disease group (70.3%), followed by systemic lupus erythematosus (12.0%). The age at disease onset for most PRDs was similar between those in the social media and CARRA registry cohorts (mean difference = 1.3 years). Conclusion Recruitment through Facebook was the most fruitful. The clinical characteristics of the social media cohort were similar to those of patients recruited through a clinical registry, suggesting the utility of online recruitment for engaging disease‐relevant cohorts. Parents of children with rare PRDs were overrepresented in the social media cohort, perhaps reflecting the increased need of those parents to find online information and receive emotional support. Social media recruitment for research studies may help expand the number and diversity of participants in clinical research, especially by including those with rare diseases.
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Affiliation(s)
- Jonathan S Hausmann
- Boston Children's Hospital, Program in Rheumatology, Division of Immunology, Boston, Massachusetts.,Beth Israel Deaconess Medical Center, Division of Rheumatology and Clinical Immunology, Boston, Massachusetts
| | - Jorge Vizcaino-Riveros
- Boston University School of Public Health, Boston, Massachusetts.,Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Alexandra C Marin
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Machiko Minegishi
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Rachele Cox
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Min-Lee Chang
- Computational Health Informatics Program, Boston Children's Hospital, Boston, Massachusetts
| | - Laura E Schanberg
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina
| | - Marc Natter
- Computational Health Informatics Program, Boston Children's Hospital, Boston, Massachusetts
| | - Elissa R Weitzman
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.,Computational Health Informatics Program, Boston Children's Hospital, Boston, Massachusetts
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12
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Bodicoat DH, Routen AC, Willis A, Ekezie W, Gillies C, Lawson C, Yates T, Zaccardi F, Davies MJ, Khunti K. Promoting inclusion in clinical trials-a rapid review of the literature and recommendations for action. Trials 2021; 22:880. [PMID: 34863265 PMCID: PMC8643184 DOI: 10.1186/s13063-021-05849-7] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/20/2021] [Indexed: 11/18/2022] Open
Abstract
Background Without inclusion of diverse research participants, it is challenging to understand how study findings will translate into the real world. Despite this, a lack of inclusion of those from under-served groups in research is a prevailing problem due to multi-faceted barriers acting at multiple levels. Therefore, we rapidly reviewed international published literature, in relation to clinical trials, on barriers relating to inclusion, and evidence of approaches that are effective in overcoming these. Methods A rapid literature review was conducted searching PubMed for peer-reviewed articles that discussed barriers to inclusion or strategies to improve inclusion in clinical trial research published between 2010 and 2021. Grey literature articles were excluded. Results Seventy-two eligible articles were included. The main barriers identified were language and communication, lack of trust, access to trials, eligibility criteria, attitudes and beliefs, lack of knowledge around clinical trials, and logistical and practical issues. In relation to evidence-based strategies and enablers, two key themes arose: [1] a multi-faceted approach is essential [2]; no single strategy was universally effective either within or between trials. The key evidence-based strategies identified were cultural competency training, community partnerships, personalised approach, multilingual materials and staff, communication-specific strategies, increasing understanding and trust, and tackling logistical barriers. Conclusions Many of the barriers relating to inclusion are the same as those that impact trial design and healthcare delivery generally. However, the presentation of these barriers among different under-served groups may be unique to each population’s particular circumstances, background, and needs. Based on the literature, we make 15 recommendations that, if implemented, may help improve inclusion within clinical trials and clinical research more generally. The three main recommendations include improving cultural competency and sensitivity of all clinical trial staff through training and ongoing personal development, the need to establish a diverse community advisory panel for ongoing input into the research process, and increasing recruitment of staff from under-served groups. Implementation of these recommendations may help improve representation of under-served groups in clinical trials which would improve the external validity of associated findings. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05849-7.
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Affiliation(s)
| | - Ash C Routen
- Centre for Ethnic Health Research, University of Leicester, Leicester General Hospital, Leicester, UK.,Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - Andrew Willis
- Centre for Ethnic Health Research, University of Leicester, Leicester General Hospital, Leicester, UK.,Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - Winifred Ekezie
- Centre for Ethnic Health Research, University of Leicester, Leicester General Hospital, Leicester, UK.,Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - Clare Gillies
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - Claire Lawson
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK.,NIHR Leicester Biomedical Research Centre, Leicester General Hospital, Leicester, UK
| | - Francesco Zaccardi
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK.,NIHR Leicester Biomedical Research Centre, Leicester General Hospital, Leicester, UK.,Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Kamlesh Khunti
- Centre for Ethnic Health Research, University of Leicester, Leicester General Hospital, Leicester, UK. .,Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK. .,NIHR Leicester Biomedical Research Centre, Leicester General Hospital, Leicester, UK. .,Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK.
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13
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Heckman CJ, Riley M, Khavjou O, Ohman-Strickland P, Manne SL, Yaroch AL, Bhurosy T, Coups EJ, Glanz K. Cost, reach, and representativeness of recruitment efforts for an online skin cancer risk reduction intervention trial for young adults. Transl Behav Med 2021; 11:1875-1884. [PMID: 34160622 PMCID: PMC8541696 DOI: 10.1093/tbm/ibab047] [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: 11/13/2022] Open
Abstract
Despite its increasing use, few studies have reported on demographic representativeness and costs of research recruitment via social media. It was hypothesized that cost, reach, enrollment, and demographic representativeness would differ by social media recruitment approach. Participants were 18-25 year-olds at moderate to high risk of skin cancer based on phenotypic and behavioral characteristics. Paid Instagram, Facebook, and Twitter ads, unpaid social media posts by study staff, and unpaid referrals were used to recruit participants. Demographic and other characteristics of the sample were compared with the 2015 National Health Interview Survey (NHIS) sample. Analyses demonstrated significant differences among recruitment approaches regarding cost efficiency, study participation, and representativeness. Costs were compared across 4,274 individuals who completed eligibility screeners over a 7-month period from: Instagram, 44.6% (of the sample) = 1,907, $9 (per individual screened); Facebook, 31.5% = 1,345, $8; Twitter, 1% = 42, $178; unpaid posts by study staff, 10.6% and referred, 6.5%, $1. The lowest rates of study enrollment among individuals screened was for Twitter. Most demographic and skin cancer risk factors of study participants differed from those of the 2015 NHIS sample and across social media recruitment approaches. Considering recruitment costs and number of participants enrolled, Facebook and Instagram appeared to be the most useful approaches for recruiting 18-25 year-olds. Findings suggest that project budget, target population and representativeness, and participation goals should inform selection and/or combination of existing and emerging online recruitment approaches.
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Affiliation(s)
| | - Mary Riley
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Olga Khavjou
- RTI International, Research Triangle Park, NC, USA
| | | | - Sharon L Manne
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Amy L Yaroch
- Gretchen Swanson Center for Nutrition, Omaha, NE, USA
| | | | | | - Karen Glanz
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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14
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Wisk LE, Magane KM, Nelson EB, Tsevat RK, Levy S, Weitzman ER. Psychoeducational Messaging to Reduce Alcohol Use for College Students With Type 1 Diabetes: Internet-Delivered Pilot Trial. J Med Internet Res 2021; 23:e26418. [PMID: 34591022 PMCID: PMC8517820 DOI: 10.2196/26418] [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: 12/10/2020] [Revised: 04/15/2021] [Accepted: 05/06/2021] [Indexed: 01/24/2023] Open
Abstract
Background College environments promote high-volume or binge alcohol consumption among youth, which may be especially harmful to those with type 1 diabetes (T1D). Little is known about the acceptability and effectiveness of interventions targeting reduced alcohol use by college students with T1D, and it is unclear whether intervention framing (specifically, the narrator of intervention messages) matters with respect to affecting behavior change. Interventions promoted by peer educators may be highly relatable and socially persuasive, whereas those delivered by clinical providers may be highly credible and motivating. Objective The aim of this study is to determine the acceptability and impacts of an alcohol use psychoeducational intervention delivered asynchronously through web-based channels to college students with T1D. The secondary aim is to compare the impacts of two competing versions of the intervention that differed by narrator (peer vs clinician). Methods We recruited 138 college students (aged 17-25 years) with T1D through web-based channels and delivered a brief intervention to participants randomly assigned to 1 of 2 versions that differed only with respect to the audiovisually recorded narrator. We assessed the impacts of the exposure to the intervention overall and by group, comparing the levels of alcohol- and diabetes-related knowledge, perceptions, and use among baseline, immediately after the intervention, and 2 weeks after intervention delivery. Results Of the 138 enrolled participants, 122 (88.4%) completed all follow-up assessments; the participants were predominantly women (98/122, 80.3%), were White non-Hispanic (102/122, 83.6%), and had consumed alcohol in the past year (101/122, 82.8%). Both arms saw significant postintervention gains in the knowledge of alcohol’s impacts on diabetes-related factors, health-protecting attitudes toward drinking, and concerns about drinking. All participants reported significant decreases in binge drinking 2 weeks after the intervention (21.3%; odds ratio 0.48, 95% CI 0.31-0.75) compared with the 2 weeks before the intervention (43/122, 35.2%). Changes in binge drinking after the intervention were affected by changes in concerns about alcohol use and T1D. Those who viewed the provider narrator were significantly more likely to rate their narrator as knowledgeable and trustworthy; there were no other significant differences in intervention effects by the narrator. Conclusions The intervention model was highly acceptable and effective at reducing self-reported binge drinking at follow-up, offering the potential for broad dissemination and reach given the web-based format and contactless, on-demand content. Both intervention narrators increased knowledge, improved health-protecting attitudes, and increased concerns regarding alcohol use. The participants’ perceptions of expertise and credibility differed by narrator. Trial Registration ClinicalTrials.gov NCT02883829; https://clinicaltrials.gov/ct2/show/NCT02883829 International Registered Report Identifier (IRRID) RR2-10.1177/1932296819839503
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Affiliation(s)
- Lauren E Wisk
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States.,Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States.,Department of Pediatrics, Harvard Medical School, Boston, MA, United States
| | - Kara M Magane
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Eliza B Nelson
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Rebecca K Tsevat
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Sharon Levy
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States.,Division of Developmental Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Elissa R Weitzman
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States.,Department of Pediatrics, Harvard Medical School, Boston, MA, United States.,Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, United States
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15
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Wisk LE, Buhr RG. Rapid deployment of a community engagement study and educational trial via social media: implementation of the UC-COVID study. Trials 2021; 22:513. [PMID: 34340693 PMCID: PMC8327053 DOI: 10.1186/s13063-021-05467-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 07/17/2021] [Indexed: 11/25/2022] Open
Abstract
Background In response to the COVID-19 pandemic and associated adoption of scarce resource allocation (SRA) policies, we sought to rapidly deploy a novel survey to ascertain community values and preferences for SRA and to test the utility of a brief intervention to improve knowledge of and values alignment with a new SRA policy. Given social distancing and precipitous evolution of the pandemic, Internet-enabled recruitment was deemed the best method to engage a community-based sample. We quantify the efficiency and acceptability of this Internet-based recruitment for engaging a trial cohort and describe the approach used for implementing a health-related trial entirely online using off-the-shelf tools. Methods We recruited 1971 adult participants (≥ 18 years) via engagement with community partners and organizations and outreach through direct and social media messaging. We quantified response rate and participant characteristics of our sample, examine sample representativeness, and evaluate potential non-response bias. Results Recruitment was similarly derived from direct referral from partner organizations and broader social media based outreach, with extremely low study entry from organic (non-invited) search activity. Of social media platforms, Facebook was the highest yield recruitment source. Bot activity was present but minimal and identifiable through meta-data and engagement behavior. Recruited participants differed from broader populations in terms of sex, ethnicity, and education, but had similar prevalence of chronic conditions. Retention was satisfactory, with entrance into the first follow-up survey for 61% of those invited. Conclusions We demonstrate that rapid recruitment into a longitudinal intervention trial via social media is feasible, efficient, and acceptable. Recruitment in conjunction with community partners representing target populations, and with outreach across multiple platforms, is recommended to optimize sample size and diversity. Trial implementation, engagement tracking, and retention are feasible with off-the-shelf tools using preexisting platforms. Trial registration ClinicalTrials.gov NCT04373135. Registered on May 4, 2020
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Affiliation(s)
- Lauren E Wisk
- Division of General Internal Medicine & Health Services Research, David Geffen School of Medicine at the University of California, Los Angeles, 1100 Glendon Ave, Ste 850, Los Angeles, CA, 90024, USA.
| | - Russell G Buhr
- Division of Pulmonary & Critical Care Medicine, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA.,Center for the Study of Healthcare Innovation, Implementation, and Policy, Health Services Research & Development, Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA, USA
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16
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Ash GI, Griggs S, Nally LM, Stults-Kolehmainen M, Jeon S, Brandt C, Gulanski BI, Spanakis EK, Baker JS, Whittemore R, Weinzimer SA, Fucito LM. Evaluation of Web-Based and In-Person Methods to Recruit Adults With Type 1 Diabetes for a Mobile Exercise Intervention: Prospective Observational Study. JMIR Diabetes 2021; 6:e28309. [PMID: 34047700 PMCID: PMC8299346 DOI: 10.2196/28309] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/12/2021] [Accepted: 05/08/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Our clinical trial of a mobile exercise intervention for adults 18 to 65 years old with type 1 diabetes (T1D) occurred during COVID-19 social distancing restrictions, prompting us to test web-based recruitment methods previously underexplored for this demographic. OBJECTIVE Our objectives for this study were to (1) evaluate the effectiveness and cost of using social media news feed advertisements, a clinic-based approach method, and web-based snowball sampling to reach inadequately active adults with T1D and (2) compare characteristics of enrollees against normative data. METHODS Participants were recruited between November 2019 and August 2020. In method #1, Facebook and Instagram news feed advertisements ran for five 1-to-8-day windows targeting adults (18 to 64 years old) in the greater New Haven and Hartford, Connecticut, areas with one or more diabetes-related profile interest. If interested, participants completed a webform so that the research team could contact them for eligibility screening. In method #2, patients 18 to 24 years old with T1D were approached in person at clinical visits in November and December 2019. Those who were interested immediately completed eligibility screening. Older patients could not be approached due to clinic restrictions. In method #3, snowball sampling was conducted by physically active individuals with T1D contacting their peers on Facebook and via email for 48 days, with details to contact the research staff to express interest and complete eligibility screening. Other methods referred participants to the study similarly to snowball sampling. RESULTS In method #1, advertisements were displayed to 11,738 unique viewers and attracted 274 clickers (2.33%); 20 participants from this group (7.3%) volunteered, of whom 8 (40%) were eligible. Costs averaged US $1.20 per click and US $95.88 per eligible volunteer. Men had lower click rates than women (1.71% vs 3.17%; P<.001), but their responsiveness and eligibility rates did not differ. In method #2, we approached 40 patients; 32 of these patients (80%) inquired about the study, of whom 20 (63%) volunteered, and 2 of these volunteers (10%) were eligible. Costs including personnel for in-person approaches averaged US $21.01 per inquirer and US $479.79 per eligible volunteer. In method #3, snowball sampling generated 13 inquirers; 12 of these inquirers (92%) volunteered, of whom 8 (67%) were eligible. Incremental costs to attract inquirers were negligible, and total costs averaged US $20.59 per eligible volunteer. Other methods yielded 7 inquirers; 5 of these inquirers (71%) volunteered, of whom 2 (40%) were eligible. Incremental costs to attract inquirers were negligible, and total costs averaged US $34.94 per eligible volunteer. Demographic overrepresentations emerged in the overall cohort (ie, optimal glycemic control, obesity, and low exercise), among those recruited by news feed advertisements (ie, obesity and older age), and among those recruited by snowball sampling (ie, optimal glycemic control and low exercise). CONCLUSIONS Web-based advertising and recruitment strategies are a promising means to attract adults with T1D to clinical trials and exercise interventions, with costs comparing favorably to prior trials despite targeting an uncommon condition (ie, T1D) and commitment to an intervention. These strategies should be tailored in future studies to increase access to higher-risk participants. TRIAL REGISTRATION ClinicalTrials.gov NCT04204733; https://clinicaltrials.gov/ct2/show/NCT04204733.
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Affiliation(s)
- Garrett I Ash
- Pain, Research, Informatics, Medical Comorbidities and Education Center, Veterans Affairs Connecticut Healthcare System, West Haven, CT, United States.,Center for Medical Informatics, Yale University School of Medicine, New Haven, CT, United States
| | - Stephanie Griggs
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, United States
| | - Laura M Nally
- Section of Pediatric Endocrinology & Diabetes, Yale University School of Medicine, New Haven, CT, United States
| | - Matthew Stults-Kolehmainen
- Digestive Health Multispecialty Clinic, Yale-New Haven Hospital, New Haven, CT, United States.,Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, United States
| | - Sangchoon Jeon
- School of Nursing, Yale University, Orange, CT, United States
| | - Cynthia Brandt
- Pain, Research, Informatics, Medical Comorbidities and Education Center, Veterans Affairs Connecticut Healthcare System, West Haven, CT, United States.,Center for Medical Informatics, Yale University School of Medicine, New Haven, CT, United States
| | - Barbara I Gulanski
- Section of Endocrinology, Veterans Affairs Connecticut Healthcare System, West Haven, CT, United States.,Section of Endocrinology, Yale University School of Medicine, New Haven, CT, United States
| | - Elias K Spanakis
- Division of Endocrinology, Baltimore Veterans Administrative Medical Center, Baltimore, MD, United States.,Division of Endocrinology, Diabetes, and Nutrition, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Julien S Baker
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, China (Hong Kong)
| | | | - Stuart A Weinzimer
- Section of Pediatric Endocrinology & Diabetes, Yale University School of Medicine, New Haven, CT, United States
| | - Lisa M Fucito
- Department of Psychiatry, Yale University 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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17
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Bour C, Ahne A, Schmitz S, Perchoux C, Dessenne C, Fagherazzi G. The Use of Social Media for Health Research Purposes: Scoping Review. J Med Internet Res 2021; 23:e25736. [PMID: 34042593 PMCID: PMC8193478 DOI: 10.2196/25736] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/15/2021] [Accepted: 03/18/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND As social media are increasingly used worldwide, more and more scientists are relying on them for their health-related projects. However, social media features, methodologies, and ethical issues are unclear so far because, to our knowledge, there has been no overview of this relatively young field of research. OBJECTIVE This scoping review aimed to provide an evidence map of the different uses of social media for health research purposes, their fields of application, and their analysis methods. METHODS We followed the scoping review methodologies developed by Arksey and O'Malley and the Joanna Briggs Institute. After developing search strategies based on keywords (eg, social media, health research), comprehensive searches were conducted in the PubMed/MEDLINE and Web of Science databases. We limited the search strategies to documents written in English and published between January 1, 2005, and April 9, 2020. After removing duplicates, articles were screened at the title and abstract level and at the full text level by two independent reviewers. One reviewer extracted data, which were descriptively analyzed to map the available evidence. RESULTS After screening 1237 titles and abstracts and 407 full texts, 268 unique papers were included, dating from 2009 to 2020 with an average annual growth rate of 32.71% for the 2009-2019 period. Studies mainly came from the Americas (173/268, 64.6%, including 151 from the United States). Articles used machine learning or data mining techniques (60/268) to analyze the data, discussed opportunities and limitations of the use of social media for research (59/268), assessed the feasibility of recruitment strategies (45/268), or discussed ethical issues (16/268). Communicable (eg, influenza, 40/268) and then chronic (eg, cancer, 24/268) diseases were the two main areas of interest. CONCLUSIONS Since their early days, social media have been recognized as resources with high potential for health research purposes, yet the field is still suffering from strong heterogeneity in the methodologies used, which prevents the research from being compared and generalized. For the field to be fully recognized as a valid, complementary approach to more traditional health research study designs, there is now a need for more guidance by types of applications of social media for health research, both from a methodological and an ethical perspective. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1136/bmjopen-2020-040671.
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Affiliation(s)
- Charline Bour
- Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Adrian Ahne
- Inserm U1018, Center for Research in Epidemiology and Population Health (CESP), Paris Saclay University, Villejuif, France.,Epiconcept, Paris, France
| | - Susanne Schmitz
- Competence Centre for Methodology and Statistics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Camille Perchoux
- Luxembourg Institute of Socio-Economic Research, Esch/Alzette, Luxembourg
| | - Coralie Dessenne
- Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Guy Fagherazzi
- Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
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18
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Wisk LE, Buhr RG. Rapid Deployment of A Community Engagement Study And Educational Trial Via Social Media: Implementation of The UC-COVID Study. RESEARCH SQUARE 2021. [PMID: 34013254 PMCID: PMC8132248 DOI: 10.21203/rs.3.rs-359099/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Background: In response to the COVID-19 pandemic and associated adoption of scarce resource allocation (SRA) policies, we sought to rapidly deploy a novel survey to ascertain community values and preferences for SRA, and to test the utility of a brief intervention to improve knowledge of and values alignment with a new SRA policy. Given social distancing and precipitous evolution of the pandemic, Internet enabled recruitment was deemed the best method to engage a community-based sample. We quantify the efficiency and acceptability of this Internet-based recruitment for engaging a trial cohort and describe the approach used for implementing a health-related trial entirely online using off-the-shelf tools. Methods: We recruited 1,971 adult participants (≥18 years) via engagement with community partners and organizations and outreach through direct and social media messaging. We quantified response rate and participant characteristics of our sample, examine sample representativeness, and evaluate potential non-response bias. Results: Recruitment was similarly derived from direct referral from partner organizations and broader social media based outreach, with extremely low study entry from organic (non-invited) search activity. Of social media platforms, Facebook was the highest yield recruitment source. Bot activity was present but minimal and identifiable through meta-data and engagement behavior. Recruited participants differed from broader populations in terms of sex, ethnicity, and education, but had similar prevalence of chronic conditions. Retention was satisfactory, with entrance into the first follow-up survey for 61% of those invited. Conclusions: We demonstrate that rapid recruitment into a longitudinal intervention trial via social media is feasible, efficient, and acceptable. Recruitment in conjunction with community partners representing target populations, and with outreach across multiple platforms, is recommended to optimize sample size and diversity. Trial implementation, engagement tracking, engagement and retention are feasible with off-the-shelf tools using preexisting platforms. Trial Registration: ClinicalTrials.gov registration NCT04373135.
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Affiliation(s)
- Lauren E Wisk
- David Geffen School of Medicine at the University of California
| | - Russell G Buhr
- David Geffen School of Medicine at the University of California
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19
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Luo X, Luo L, Liu H, Xiao Y, Yu X, Hou X, Zeng H, Zhang F, Zhang Y, Sharm M, Zhao Y. Needs Assessment Survey for a Food Safety Education through We-Media: A Cross-Sectional Survey among Junior Students of an Education and a Medical University in Chongqing, China. J Nutr Sci Vitaminol (Tokyo) 2021; 66:S267-S274. [PMID: 33612609 DOI: 10.3177/jnsv.66.s267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Many studies on food safety cognition and practice intervention among university students exist, but only few conduct needs assessment surveys. In recent years, We-media has been applied in the field of health education and promotion, but its application in food safety intervention is limited at home and abroad. This study aimed to explore the current situation of We-media use and assess the needs for food safety information through We-media among junior students of an education and a medical university. A cross-sectional survey was conducted among junior students of an education and a medical university in Chongqing, China in 2016. A total of 1,250 education students and 1,434 medical students participated in the questionnaire survey. Findings revealed that 71.4% and 64.8% of the education and medical students were willing to accept food safety educational information by We-media, respectively. In addition, 47.6% and 48.8% of the education and medical students were willing to accept food safety information through WeChat official accounts, respectively. Among the education students, 83.8%, 63.9%, 59.6%, and 13.0% wanted to acquire food safety knowledge by picture, text, video, and voice, respectively. Of the medical students, 84.7%, 67.7%, 62.3%, and 11.9% wanted to acquire food safety knowledge by picture, text, video, and voice, respectively. Gender, school category, and whether food safety information is given attention were the influencing factors of participants' willingness to accept such information through We-media (p<0.05). This study indicated that We-media could be an appropriate intervention approach for the junior students of an education and a medical university to accept food safety intervention. WeChat was also revealed as the best platform. Pictures, text messages, and videos were observed the most popular means for students to acquire food safety knowledge.
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Affiliation(s)
- Xinmiao Luo
- School of Public Health and Management, Chongqing Medical University.,Department of Disease Control, Songzi Department of Health
| | - Li Luo
- Chengdu Center for Disease Control and Prevention
| | - Hongyan Liu
- School of Public Health and Management, Chongqing Medical University.,Research Center for Medicine and Social Development, Chongqing Medical University.,Innovation Center for Social Risk Governance in Health, Chongqing Medical University
| | - Yangxue Xiao
- School of Public Health and Management, Chongqing Medical University.,Research Center for Medicine and Social Development, Chongqing Medical University.,Innovation Center for Social Risk Governance in Health, Chongqing Medical University
| | - Xinyang Yu
- School of Public Health and Management, Chongqing Medical University.,Research Center for Medicine and Social Development, Chongqing Medical University.,Innovation Center for Social Risk Governance in Health, Chongqing Medical University
| | - Xiaorong Hou
- College of Medical Informatics, Chongqing Medical University
| | - Huan Zeng
- School of Public Health and Management, Chongqing Medical University.,Research Center for Medicine and Social Development, Chongqing Medical University.,Innovation Center for Social Risk Governance in Health, Chongqing Medical University
| | - Fan Zhang
- School of Public Health and Management, Chongqing Medical University.,Research Center for Medicine and Social Development, Chongqing Medical University.,Innovation Center for Social Risk Governance in Health, Chongqing Medical University
| | - Yong Zhang
- School of Public Health and Management, Chongqing Medical University.,Research Center for Medicine and Social Development, Chongqing Medical University.,Innovation Center for Social Risk Governance in Health, Chongqing Medical University
| | - Manoj Sharm
- Department of Behavioral and Environmental Health, Jackson State University
| | - Yong Zhao
- School of Public Health and Management, Chongqing Medical University.,Research Center for Medicine and Social Development, Chongqing Medical University.,Innovation Center for Social Risk Governance in Health, Chongqing Medical University
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20
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Affiliation(s)
- Neal Kaufman
- Fielding School of Public Health, Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
- Canary Health, Inc., Los Angeles, CA
| | - Eran Mel
- The Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Centre for Childhood Diabetes, Schneider's Children's Medical Center of Israel, Petah Tikva, Israel
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21
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Wilson BT, Hughes J. Joining the hidden revolution in rare diseases: working with family support groups. Arch Dis Child 2020; 105:107-108. [PMID: 31196911 DOI: 10.1136/archdischild-2019-317227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 05/13/2019] [Accepted: 05/14/2019] [Indexed: 11/04/2022]
Affiliation(s)
- Brian T Wilson
- Clinical Genetics, Great Ormond Street Hospital for Children, London, UK.,Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Jayne Hughes
- Amy and Friends Cockayne Syndrome Support, Wirral, UK
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22
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Mayen S, De Clifford-Faugère G, Colson S. Letter to the Editor Regarding "Clinical Trial Recruitment and Retention of College Students with Type 1 Diabetes via Social Media: An Implementation Case Study": A Commentary on Wisk et al (2019). J Diabetes Sci Technol 2020; 14:185-186. [PMID: 31596131 PMCID: PMC7189149 DOI: 10.1177/1932296819879909] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Sandrine Mayen
- Faculté des sciences médicales et
paramédicales, Aix Marseille Université, EA3279-CEReSS, France
- Sandrine Mayen, Faculté des sciences
médicales et paramédicales, Aix Marseille Université, EA3279-CEReSS, Ecole des
Sciences Infirmières, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 5,
Marseille, France.
| | | | - Sébastien Colson
- Faculté des sciences médicales et
paramédicales, Aix Marseille Université, EA3279-CEReSS, France
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23
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Wisk LE, Magane KM, Nelson EB, Weitzman ER. Response to the Letter to the Editor From Mayen et al Regarding "Clinical Trial Recruitment and Retention of College Students With Type 1 Diabetes via Social Media: An Implementation Case Study". J Diabetes Sci Technol 2020; 14:187-188. [PMID: 31617408 PMCID: PMC7189160 DOI: 10.1177/1932296819882052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Lauren E. Wisk
- Division of General Internal Medicine
and Health Services Research, David Geffen School of Medicine at the University of
California, Los Angeles, CA, USA
- Division of Adolescent/Young Adult
Medicine, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard
Medical School, Boston, MA, USA
- Lauren E. Wisk, PhD, Division of General
Internal Medicine and Health Services Research, David Geffen School of Medicine
at the University of California, 1100 Glendon Ave, Suite 850, Los Angeles, CA
90024, USA.
| | - Kara M. Magane
- Division of Adolescent/Young Adult
Medicine, Boston Children’s Hospital, Boston, MA, USA
| | - Eliza B. Nelson
- Division of Adolescent/Young Adult
Medicine, Boston Children’s Hospital, Boston, MA, USA
| | - Elissa R. Weitzman
- Division of Adolescent/Young Adult
Medicine, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard
Medical School, Boston, MA, USA
- Computational Health Informatics
Program, Boston Children’s Hospital, Boston, MA, USA
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