The Use of Web-Based Technologies in Health Research Participation: Qualitative Study of Consumer and Researcher Experiences

Participatory Design and Evaluation of the "Stem Cells Australia" Website for Delivering Complex Health Knowledge: Mixed Methods Study

BACKGROUND

The internet has become a commonly used information source for people seeking to understand their health care options. However, inconsistent representation about what stem cell treatments are available and from whom, coupled with the lack of transparency about what has been shown to work or is even safe, can distract and mislead users. Given these challenges, there is a need to develop effective evidence-based tools for delivering information about health care options involving stem cells.

OBJECTIVE

A need to redesign an existing website in Australia was identified to provide trustworthy information about stem cell research and to counter misinformation. Using a participatory design approach to generate an understanding of what information users need for stem cell treatments, the Stem Cells Australia website serves as a case study for the development and evaluation of websites delivering complex messages about science and health.

METHODS

This study comprised 3 steps. First, a focus group and several one-on-one interviews with a purposive sample of users (n=12) were conducted to identify their needs and requirements. Second, we designed a new version of the website based on findings from the focus group and interviews. Finally, for evaluating the participatory design process, we collected 180 days of Google Analytics data for both the original and redesigned versions (90 days for each) and compared their differences using 2-sample z tests.

RESULTS

The feedback from participants was grouped into 3 themes-needed and unwanted information, how and where to obtain information, and their information preferences. These were translated into requirements for rebuilding the website. The redesigned version reached users in other continents, despite the daily numbers of users (-61.2%; P<.001) and sessions (-61.7%; P<.001) decreasing. The redesigned version also showed substantial decrease in daily bounce rate (-97.2%; P<.001), significant increase in the daily average of page reads per session (+110.8%; P<.001), and long daily average for session duration (+22.9%; P=.045). Navigation flow analysis showed more traffic toward web pages related to health conditions in the redesigned version.

CONCLUSIONS

Websites about stem cell research need to provide content for vulnerable global audiences. Participatory design that addresses knowledge gaps and information needs can produce better performance and engagement, which can be evaluated using Google Analytics, a common web analytics tool used by many websites. Learnings for improving the metrics regarding website identity, research updates, and clinical trials are concluded, which can inform the future design of websites seeking to engage users and provide reliable and accessible science and health information including but not limited to stem cell research and therapies.

Testing Multiple Methods to Effectively Promote Use of a Knowledge Portal to Health Policy Makers: Quasi-Experimental Evaluation

BACKGROUND

Health policy makers and advocates increasingly utilize online resources for policy-relevant knowledge. Knowledge brokering is one potential mechanism to encourage the use of research evidence in policy making, but the mechanisms of knowledge brokerage in online spaces are understudied. This work looks at knowledge brokerage through the launch of Project ASPEN, an online knowledge portal developed in response to a New Jersey legislative act that established a pilot program for adolescent depression screening for young adults in grades 7-12.

OBJECTIVE

This study compares the ability to drive policy brief downloads by policy makers and advocates from the Project ASPEN knowledge portal using a variety of online methods to promote the knowledge portal.

METHODS

The knowledge portal was launched on February 1, 2022, and a Google Ad campaign was run between February 27, 2022, and March 26, 2022. Subsequently, a targeted social media campaign, an email campaign, and tailored research presentations were used to promote the website. Promotional activities ended on May 31, 2022. Website analytics were used to track a variety of actions including new users coming to the website, page views, and policy brief downloads. Statistical analysis was used to assess the efficacy of different approaches.

RESULTS

The campaign generated 2837 unique user visits to the knowledge portal and 4713 page views. In addition, the campaign generated 6.5 policy web page views/day and 0.7 policy brief downloads/day compared with 1.8 views/day and 0.5 downloads/day in the month following the campaign. The rate of policy brief page view conversions was significantly higher for Google Ads compared with other channels such as email (16.0 vs 5.4; P<.001) and tailored research presentations (16.0 vs 0.8; P<.001). The download conversion rate for Google Ads was significantly higher compared with social media (1.2 vs 0.1; P<.001) and knowledge brokering activities (1.2 vs 0.2; P<.001). By contrast, the download conversion rate for the email campaign was significantly higher than that for social media (1.0 vs 0.1; P<.001) and tailored research presentations (1.0 vs 0.2; P<.001). While Google Ads for this campaign cost an average of US $2.09 per click, the cost per conversion was US $11 per conversion to drive targeted policy web page views and US $147 per conversion to drive policy brief downloads. While other approaches drove less traffic, those approaches were more targeted and cost-effective.

CONCLUSIONS

Four tactics were tested to drive user engagement with policy briefs on the Project ASPEN knowledge portal. Google Ads was shown to be effective in driving a high volume of policy web page views but was ineffective in terms of relative costs. More targeted approaches such as email campaigns and tailored research presentations given to policy makers and advocates to promote the use of research evidence on the knowledge portal website are likely to be more effective when balancing goals and cost-effectiveness.

Sickle Cell Transplantation Evaluation of Long-term and Late Effects Registry (STELLAR) to Compare Long-term Outcomes After Hematopoietic Cell Transplantation to Those in Siblings Without Sickle Cell Disease and in Nontransplanted Individuals With Sickle Cell Disease: Design and Feasibility Study

BACKGROUND

There are sparse data on the long-term and late effects of hematopoietic cell transplantation (HCT) for sickle cell disease (SCD).

OBJECTIVE

This study aims to establish an international registry of long-term outcomes post-HCT for SCD and demonstrate the feasibility of recruitment at a single site in the United States.

METHODS

The Sickle Cell Transplantation Evaluation of Long-Term and Late Effects Registry (STELLAR) was designed to enroll patients with SCD ≥1 year post-HCT, their siblings without SCD, and nontransplanted controls with SCD to collect web-based participant self-reports of health status and practices by using the Bone Marrow Transplant Survivor Study (BMTSS) surveys, health-related quality of life (HRQOL) using the Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Profile-25 or Pediatric Profile-29 survey, chronic graft-versus-host disease (cGVHD) using the symptom scale survey, daily pain using an electronic pain diary, the economic impact of HCT using the financial hardship survey, sexual function using the PROMIS Sexual Function SexFSv2.0 survey, and economic productivity using the American Time Use Survey (ATUS). We also piloted retrieval of clinical data previously submitted to the Center for International Blood and Marrow Transplant Research (CIBMTR); recorded demographics, height, weight, blood pressure, waist and hip circumferences, timed up and go (TUG) test, and handgrip test; and obtained blood for metabolic screening, gonadal function, fertility potential, and biorepository of plasma, serum, RNA, and DNA.

RESULTS

Of 100 eligible post-HCT patients, we enrolled 72 (72%) participants aged 9-38 (median 17) years. We also enrolled 19 siblings aged 5-32 (median 10) years and 28 nontransplanted controls with SCD aged 4-46 (median 22) years. Of the total 119 participants, 73 (61%) completed 85 sets of surveys and 41 (35%) contributed samples to the biorepository. We completed ATUS interviews of 28 (24%) participants. We successfully piloted retrieval of data submitted to the CIBMTR and expanded recruitment to multiple sites in the United States, Canada, the United Kingdom, and Nigeria.

CONCLUSIONS

It is feasible to recruit subjects and conduct study procedures for STELLAR in order to determine the long-term and late effects of HCT for SCD.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/36780.

Engagement of Government Social Media on Facebook during the COVID-19 Pandemic in Macao

Government social media is widely used for providing updates to and engaging with the public in the COVID-19 pandemic. While Facebook is one of the popular social media used by governments, there is only a scant of research on this platform. This paper aims to understand how government social media should be used and how its engagement changes in prodromal, acute and chronic stages of the pandemic. We collected 1664 posts and 10,805 comments from the Facebook pages of the Macao government from 1 January to 31 October 2020. Using word frequency and content analysis, the results suggest that the engagement was relatively low at the beginning and then surged in the acute stage, with a decreasing trend in the chronic stage. Information about public health measures maintained their engagement in all stages, whereas the engagement of other information was dropping over time. Government social media can be used for increasing vigilance and awareness in the prodromal stage; disseminating information and increasing transparency in the acute stage; and focusing on mental health support and recovery policies in the chronic stage. Additionally, it can be a tool for controlling rumors, providing regular updates and fostering community cohesion in public health crises.

Participant Reactions to a Literacy-Focused, Web-Based Informed Consent Approach for a Genomic Implementation Study

BACKGROUND

Clinical genomic implementation studies pose challenges for informed consent. Consent forms often include complex language and concepts, which can be a barrier to diverse enrollment, and these studies often blur traditional research-clinical boundaries. There is a move toward self-directed, web-based research enrollment, but more evidence is needed about how these enrollment approaches work in practice. In this study, we developed and evaluated a literacy-focused, web-based consent approach to support enrollment of diverse participants in an ongoing clinical genomic implementation study. Methods: As part of the Cancer Health Assessments Reaching Many (CHARM) study, we developed a web-based consent approach that featured plain language, multimedia, and separate descriptions of clinical care and research activities. CHARM offered clinical exome sequencing to individuals at high risk of hereditary cancer. We interviewed CHARM participants about their reactions to the consent approach. We audio recorded, transcribed, and coded interviews using a deductively and inductively derived codebook. We reviewed coded excerpts as a team to identify overarching themes. Results: We conducted 32 interviews, including 12 (38%) in Spanish. Most (69%) enrolled without assistance from study staff, usually on a mobile phone. Those who completed enrollment in one day spent an average of 12 minutes on the consent portion. Interviewees found the information simple to read but comprehensive, were neutral to positive about the multimedia support, and identified increased access to testing in the study as the key difference from clinical care. Conclusions: This study showed that interviewees found our literacy-focused, web-based consent approach acceptable; did not distinguish the consent materials from other online study processes; and valued getting access to testing in the study. Overall, conducting empirical bioethics research in an ongoing clinical trial was useful to demonstrate the acceptability of our novel consent approach but posed practical challenges.

Advancing the Science of Recruitment for Family Caregivers: Focus Group and Delphi Methods

Background

Successful recruitment of participants is imperative to a rigorous study, and recruitment challenges are not new to researchers. Many researchers have used social media successfully to recruit study participants. However, challenges remain for effective online social media recruitment for some populations.

Objective

Using a multistep approach that included a focus group and Delphi method, researchers performed this study to gain expert advice regarding material development for social media recruitment and to test the recruitment material with the target population.

Methods

In the first phase, we conducted a focus group with 5 social media experts to identify critical elements for effective social media recruitment material. Utilizing the Delphi method with 5 family caregivers, we conducted the second phase to reach consensus regarding effective recruitment videos.

Results

Phase I utilized a focus group that resulted in identification of three barriers related to social media recruitment, including lack of staff and resources, issues with restrictive algorithms, and not standing out in the crowd. Phase II used the Delphi method. At the completion of Delphi Round 1, 5 Delphi participants received a summary of the analysis for feedback and agreement with our summary. Using data and recommendations from Round 1, researchers created two new recruitment videos with additions to improve trustworthiness and transparency, such as the university's logo. In Round 2 of the Delphi method, consensus regarding the quality and trustworthiness of the recruitment videos reached 100%.

Conclusions

One of the primary challenges for family caregiver research is recruitment. Despite the broad adoption of social media marketing approaches, the effectiveness of online recruitment strategies needs further investigation.