Recruitment and retention of mothers of preschoolers and school-aged children in a social media-delivered healthy eating intervention: lessons learned from a randomized controlled trial

Social Media Influences on Dietary Awareness in Children

BACKGROUND

Social media platforms have become increasingly influential channels for discussing various aspects of children's health, including dietary habits and food choices. This research explores the impact of social media on childhood dietary habits regarding the foods children consume by analyzing published findings about online videos and other social media platforms.

METHODS

From a pool of 9646 articles available on Google Scholar, Science Direct, Web of Science, and ProQuest, 25 were selected for inclusion in this systematic literature review after meeting the qualifying criteria. The screened papers contained clinical studies, cross-sectional studies, and editorials published in English.

RESULTS

A review of these articles revealed that individuals' communication with friends via social media significantly enhanced their comprehension of conversations related to weight management. The results of this research inform efforts to combat poor diets and promote overall well-being among children at an earlier stage when personal interactions are likely limited. To promote the healthy growth of children, it is essential that the videos they engage with offer them appropriate guidance on maintaining a nutritious diet. Ultimately, this research provides insights into how social media creates environments conducive to the well-being of children.

CONCLUSIONS

As a result, social media can serve as a valuable resource to help mitigate the prevalence of obesity in this vulnerable population.

A Randomized Pilot Trial of the Donor Conception Tool to Empower Parental Telling and Talking (TELL Tool) with Their Children About Their Genetic Origins

INTRODUCTION

Parents who use donated gametes or embryos to form their families struggle with telling their children about their genetic origins. We developed the Tool to Empower Parental Telling and Talking (TELL Tool) to support parents in disclosure to their children and an eBook attention control.

METHOD

A randomized parallel, two-group, attention-controlled clinical pilot trial was conducted online during COVID-19. Feasibility, acceptability, and preliminary effects among parents with children aged 1-16 years were examined.

RESULTS

Over 10 months, our target of 75 parents were enrolled (85% of eligible [95% confidence interval (CI), 76% to 91%]), and 68% (95% CI: 57% to 78%) were retained at 12 weeks. At 4 and 12 weeks, positive trends were found for parental disclosure, telling confidence, and anxiety compared with attention controls.

DISCUSSION

The study protocol is feasible, and the TELL Tool is acceptable to parents and demonstrates a positive effect on parents' ability to tell their children. The results support the implementation of a large efficacy trial.

Recruitment Barriers of an mHealth Pediatric Asthma Pilot Study

Successful participant recruitment for pediatric studies can be challenging and even result in study discontinuation. In conducting a 2-year pilot study for a pediatric mobile health (mHealth) asthma intervention, a group of researchers experienced multiple barriers and failures in all 4 areas of recruitment: generating initial contacts, screening, consenting, and enrollment and retention. The main failures that resulted in minimal participant enrollment were poor participation, communication issues, and difficulties related to recruiting in an emergency department during a pandemic. The following is a report on this study's recruitment efforts, including preliminary and adapted strategies, the results of these strategies, and considerations for researchers who conduct studies with children. The research team concluded that frequent and clear communication, flexibility, and a willingness to alter initial recruitment plans are essential elements for recruitment success in pediatric studies.

Social Networking Services as a Tool for Support of Mothers: A Literature Review

BACKGROUND

Difficulties experienced by mothers in raising their children can be resolved using social networking services (SNSs). Being aware of issues associated with SNSs in such situations may be useful for supporting mothers. We herein review the issues associated with using SNSs to support mothers.

METHODS

This review was conducted using an electronic search engine to search for articles that described issues associated with using SNSs to support mothers, and which were published up to August 2022.

RESULTS

After screening, a total of 19 articles were included. We thematically categorized the contents into three major issues associated with using SNSs for support of mothers: (1) issues on the management side, (2) issues on the user side, and (3) social and environmental issues. The mainly discussed issues were the safety of using SNSs and/or securing and training human resources on the management side, busyness of mothers on the user side, as well as sociocultural and communication environment-related limitations as social and environmental issues.

CONCLUSIONS

The issues we detected would aid in developing the use of SNSs as a tool to support mothers. Further research on these issues is needed.

Active vs Traditional Methods of Recruiting Children for a Clinical Trial in Rural Primary Care Clinics: A Cluster-Randomized Clinical Trial

IMPORTANCE

To our knowledge, there are no published randomized clinical trials of recruitment strategies. Rigorously evaluated successful recruitment strategies for children are needed.

OBJECTIVE

To evaluate the feasibility of 2 recruitment methods for enrolling rural children through primary care clinics to assess whether either or both methods are sufficiently effective for enrolling participants into a clinical trial of a behavioral telehealth intervention for children with overweight or obesity.

DESIGN, SETTING, AND PARTICIPANTS

This cluster-randomized clinical trial of 2 recruitment methods was conducted at 4 primary care clinics in 4 separate states. Each clinic used both recruitment methods in random order. Clinic eligibility criteria included at least 40% pediatric patients with Medicaid coverage and at least 100 potential participants. Eligibility criteria for children included a rural home address, age 6 to 11 years, and body mass index at or above the 85th percentile. Recruitment began February 3, 2020, and randomization of participants occurred on August 17, 2020. Data were analyzed from October 3, 2021, to April 21, 2022.

INTERVENTIONS

Two recruitment methods were assessed: the active method, for which a list of potential participants seen within the past year at each clinic was generated through the electronic health record and consecutively approached by research staff based on visit date to the clinic, and the traditional method, for which recruitment included posters, flyers, social media, and press release. Clinics were randomized to the order in which the 2 methods were implemented in 4-week periods, followed by a 4-week catch-up period using the method found most effective in previous periods.

MAIN OUTCOMES AND MEASURES

For each recruitment method, the number and proportion of randomized children among those who were approached was calculated.

RESULTS

A total of 104 participants were randomized (58 girls [55.8%]; mean age, 9.3 [95% CI, 9.0-9.6] years). Using the active method, 535 child-parent dyads were approached and 99 (18.5% [95% CI, 15.3%-22.1%]) were randomized. Using the traditional method, 23 caregivers expressed interest, and 5 (21.7% [95% CI, 7.5%-43.7%]) were randomized. All sites reached full enrollment using the active method and no sites achieved full enrollment using the traditional method. Mean time to full enrollment was 26.3 (range, 21.0-31.0) days.

CONCLUSIONS AND RELEVANCE

This study supports the use of the active approach with local primary care clinics to recruit children with overweight and obesity from rural communities into clinical trials.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT04142034.

Strategies to improve uptake and adherence of non-pharmacologic interventions for orthostatic hypotension in older people: a qualitative study

Aim

To identify specific behavioural change techniques to promote uptake and adherence with non-pharmacologic interventions for older adults with OH.

Findings

Specific behaviour change strategies, derived from older people with orthostatic hypotension, include biofeedback, rehearsal, embedding into daily routine and patient education.

Message

Evidence-based behaviour change strategies may be used to improve uptake and adherence to non-drug therapies for older people with orthostatic hypotension.

Purpose

Non-pharmacologic therapies are a safe and effective treatment for orthostatic hypotension (OH) in older adults. However, adherence to non-drug therapies is challenging and may require specific behaviour change approaches to promote uptake and adherence. The study aim is to identify specific behavioural change techniques to promote uptake and adherence with non-pharmacologic interventions for older adults with OH.

Methods

Forty semi-structured, qualitative interviews were performed in 25 older adults with OH. Each participant experienced bolus-water drinking, physical counter-manoeuvres and compression garments during two efficacy studies. Emergent themes were identified through framework analysis, based on The Behaviour Change Technique Taxonomy.

Results

Several themes to encourage uptake and adherence arose. Motivation to adhere with an intervention may be improved by demonstrating its effectiveness, either through symptom monitoring or biofeedback. Practising or rehearsing how to use an intervention may improve self-efficacy and promote habit formation. Embedding therapies into daily life so that they become second nature was felt to be a useful strategy. Educating older adults about why they are being asked to use a therapy and demonstrating how to use it is important. More specific barriers may be overcome by encouraging a personal problem-solving approach.

Conclusion

These specific behaviour change techniques, derived by older people with OH and based on evidence-based approaches, provide useful strategies to improve the uptake and adherence of non-drug therapies in the treatment of OH.

Trial registration

ISRCTN15084870.

A Long-Term Evaluation of Facebook for Recruitment and Retention in the ENDIA Type 1 Diabetes Pregnancy-Birth Cohort Study

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.

Use of Facebook, Instagram, and Twitter for recruiting healthy participants in nutrition-, physical activity-, or obesity-related studies: a systematic review

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.

Factors influencing engagement and dietary behaviour change of mothers and their children in a blog-delivered healthy eating intervention: a process evaluation of a randomised controlled trial

OBJECTIVE

A randomised controlled trial found no evidence of an impact of a blog written by a registered dietitian (RD) on vegetables and fruit and milk and alternatives (e.g. soya-based beverages, yogurt and cheese) consumption - two food groups included in the 2007 version of the Canadian Food Guide - in mothers and their children compared with a control condition. To investigate these null findings, the current study explored participants' perceptions of engagement with the blog and its influence on their dietary behaviours.

DESIGN

Mixed methods process evaluation using a post-intervention satisfaction questionnaire and a content analysis of mothers' comments on the blog (n 213 comments).

SETTING

French-speaking adult mothers living in Quebec City, Quebec, Canada (n 26; response rate = 61·9 % of the total sample randomised to exposure to the blog).

RESULTS

Most mothers (n 20/26; 76·9 %) perceived the blog useful to improve their dietary habits - with the most appreciated blog features being nutritional information and healthy recipes and interactions with fellow participants and the RD. Mothers reported several facilitators (e.g. meal planning and involving children in household food activities) and few barriers (e.g. lack of time and children's food preferences) to maternal and child consumption of vegetables and fruit and milk and alternatives. Lack of time was the principal reported barrier affecting blog engagement.

CONCLUSIONS

The findings from the current study suggest that blogs written by an RD may be an acceptable format of intervention delivery among mothers, but may not alleviate all the barriers to healthy eating and engagement in a dietary intervention.