1
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Shan L, Azagba S. Longitudinal associations of tobacco-related social media involvement with cigarette and e-cigarette initiation among US adolescents. Eur J Pediatr 2022; 181:189-196. [PMID: 34240227 DOI: 10.1007/s00431-021-04166-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 11/29/2022]
Abstract
Tobacco is the leading cause of preventable morbidity and mortality in the USA. Evidence suggests adolescents are particularly vulnerable to online tobacco marketing. This study examined longitudinal associations of following or liking of tobacco brands with subsequent cigarette and e-cigarette initiation among US adolescents. We used Wave 1-Wave 4 Population Assessment of Tobacco and Health study data (n = 6997) and discrete-time survival regression models to examine associations of past-year tobacco-related social media interactions with the initiation of cigarettes and e-cigarettes among US adolescents. About 4.8% (n = 280) of adolescent never cigarette users and 4.9% (n = 288) of never e-cigarette users followed or liked tobacco brands on social media between Wave 1 and Wave 2. By Wave 4, 8.8% of all cigarettes never users had initiated cigarette use, and 18.7% of never e-cigarette users initiated e-cigarette use. The following or liking tobacco brands on social media was significantly associated with increased odds of cigarette initiation (adjusted odds ratio (aOR) 2.12, 95% CI 1.56-2.88) and e-cigarette initiation (aOR 2.11, 95% CI 1.66-2.69). Also, the initiation of cigarettes and e-cigarettes differed significantly among race/ethnicity, school performance, and other tobacco and substance use.Conclusion: Adolescents who followed or liked tobacco products on social media were more likely to initiate cigarette or e-cigarette use subsequently. Increasing anti-tobacco efforts on social media sites could be beneficial. What is Known: • Evidence suggests adolescents are particularly vulnerable to online tobacco marketing. What is New: • The following or liking tobacco brands on social media was significantly associated with the odds of cigarette and e-cigarette initiation.
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Affiliation(s)
- Lingpeng Shan
- Department of Family and Preventive Medicine, Division of Public Health, University of Utah School of Medicine, 375 Chipeta Way, Salt Lake City, UT, 84108, USA
| | - Sunday Azagba
- Department of Family and Preventive Medicine, Division of Public Health, University of Utah School of Medicine, 375 Chipeta Way, Salt Lake City, UT, 84108, USA.
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2
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Murphy MD, Pinheiro D, Iyengar R, Lim G, Menezes R, Cadeiras M. A Data-Driven Social Network Intervention for Improving Organ Donation Awareness Among Minorities: Analysis and Optimization of a Cross-Sectional Study. J Med Internet Res 2020; 22:e14605. [PMID: 31934867 PMCID: PMC6996769 DOI: 10.2196/14605] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 10/24/2019] [Accepted: 11/12/2019] [Indexed: 12/29/2022] Open
Abstract
Background Increasing the number of organ donors may enhance organ transplantation, and past health interventions have shown the potential to generate both large-scale and sustainable changes, particularly among minorities. Objective This study aimed to propose a conceptual data-driven framework that tracks digital markers of public organ donation awareness using Twitter and delivers an optimized social network intervention (SNI) to targeted audiences using Facebook. Methods We monitored digital markers of organ donation awareness across the United States over a 1-year period using Twitter and examined their association with organ donation registration. We delivered this SNI on Facebook with and without optimized awareness content (ie, educational content with a weblink to an online donor registration website) to low-income Hispanics in Los Angeles over a 1-month period and measured the daily number of impressions (ie, exposure to information) and clicks (ie, engagement) among the target audience. Results Digital markers of organ donation awareness on Twitter are associated with donation registration (beta=.0032; P<.001) such that 10 additional organ-related tweets are associated with a 3.20% (33,933/1,060,403) increase in the number of organ donor registrations at the city level. In addition, our SNI on Facebook effectively reached 1 million users, and the use of optimization significantly increased the rate of clicks per impression (beta=.0213; P<.004). Conclusions Our framework can provide a real-time characterization of organ donation awareness while effectively delivering tailored interventions to minority communities. It can complement past approaches to create large-scale, sustainable interventions that are capable of raising awareness and effectively mitigate disparities in organ donation.
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Affiliation(s)
- Michael Douglas Murphy
- Department of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Diego Pinheiro
- Department of Internal Medicine, University of California, Davis, Sacramento, CA, United States
| | - Rahul Iyengar
- Department of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Gene Lim
- Mav12 Inc, Santa Monica, CA, United States
| | - Ronaldo Menezes
- Department of Computer Science, University of Exeter, Exeter, United Kingdom
| | - Martin Cadeiras
- Department of Internal Medicine, University of California, Davis, Sacramento, CA, United States
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3
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Blok AC, Sadasivam RS, Hogan TP, Patterson A, Day N, Houston TK. Nurse-Driven mHealth Implementation Using the Technology Inpatient Program for Smokers (TIPS): Mixed Methods Study. JMIR Mhealth Uhealth 2019; 7:e14331. [PMID: 31588908 PMCID: PMC6818438 DOI: 10.2196/14331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 07/19/2019] [Accepted: 07/21/2019] [Indexed: 12/20/2022] Open
Abstract
Background Smoking is the leading cause of preventable death and disease, yet implementation of smoking cessation in inpatient settings is inconsistent. The Technology Inpatient Program for Smokers (TIPS) is an implementation program designed to reach smokers with a mobile health (mHealth) intervention using stakeholder-supported strategies. Objective The purpose of this study was to determine the impact of the TIPS implementation strategies on smoker-level engagement of the mHealth intervention during care transition. Methods We examined varying intensities (passive motivational posters only and posters + active nurse-led facilitation) of TIPS strategies on four hospital units located in two sites. Unit-level and smoker-level adoption was monitored during active implementation (30 weeks) and sustainability follow-up (30 weeks). Process measures reflecting the reach, effectiveness, adoption, implementation, maintenance (RE-AIM) framework, stakeholder reported adaptations of strategies, and formative evaluation data were collected and analyzed. Results For our smoker-level reach, 103 smokers signed up for the mHealth intervention in-hospital, with minimal decline during sustainability follow-up. While posters + nurse facilitation did not lead to higher reach than posters alone during active implementation (27 vs 30 signed up), it did lead to higher engagement of smokers (85.2% vs 73.3% completion of the full 2-week intervention). TIPS strategy adoption and fidelity varied by unit, including adoption of motivational posters (range: weeks 1 and 5), fidelity of posters (0.4% to 16.2% of posters missing per unit weekly) and internal facilitation of nurse training sessions (average of 2 vs 7.5 by site). Variable maintenance costs of the program totaled US $6.63 (US $683.28/103) per smoker reached. Reported family-member facilitation of mHealth sign-up was an observation of unintended behavior. Conclusions TIPS is a feasible and low-cost implementation program that successfully engages smokers in an mHealth intervention and sustains engagement after discharge. Further testing of nurse facilitation and expanding reach to patient family and friends as an implementation strategy is needed.
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Affiliation(s)
- Amanda C Blok
- Veterans Affairs Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, United States Department of Veterans Affairs, Ann Arbor, MI, United States.,Systems, Populations and Leadership Department, School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | - Rajani S Sadasivam
- Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Timothy P Hogan
- Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States.,Veterans Affairs Center for Healthcare Organization and Implementation Research, Veterans Affairs Bedford Medical Center, United States Department of Veterans Affairs, Bedford, MA, United States
| | - Angela Patterson
- Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Nicole Day
- University of Massachusetts Memorial Health Center, Worcester, MA, United States
| | - Thomas K Houston
- Learning Health Systems, Department of Medicine, Wake Forest University, Winston-Salem, NC, United States
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4
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Li W, Ding W, Sadasivam R, Cui X, Chen P. His-GAN: A histogram-based GAN model to improve data generation quality. Neural Netw 2019; 119:31-45. [PMID: 31376636 DOI: 10.1016/j.neunet.2019.07.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 06/22/2019] [Accepted: 07/03/2019] [Indexed: 11/16/2022]
Abstract
Generative Adversarial Network (GAN) has become an active research field due to its capability to generate quality simulation data. However, two consistent distributions (generated data distribution and original data distribution) produced by GAN cannot guarantee that generated data are always close to real data. Traditionally GAN is mainly applied to images, and it becomes more challenging for numeric datasets. In this paper, we propose a histogram-based GAN model (His-GAN). The purpose of our proposed model is to help GAN produce generated data with high quality. Specifically, we map generated data and original data into a histogram, then we count probability percentile on each bin and calculate dissimilarity with traditional f-divergence measures (e.g., Hellinger distance, Jensen-Shannon divergence) and Histogram Intersection Kernel. After that, we incorporate this dissimilarity score into training of the GAN model to update the generator's parameters to improve generated data quality. This is because the parameters have an influence on the generated data quality. Moreover, we revised GAN training process by feeding GAN model with one group of samples (these samples can come from one class or one cluster that hold similar characteristics) each time, so the final generated data could contain the characteristics from a single group to overcome the challenge of figuring out complex characteristics from mixed groups/clusters of data. In this way, we can generate data that is more indistinguishable from original data. We conduct extensive experiments to validate our idea with MNIST, CIFAR-10, and a real-world numeric dataset, and the results clearly show the effectiveness of our approach.
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Affiliation(s)
- Wei Li
- School of Cyber Science and Engineering, Wuhan University, China.
| | - Wei Ding
- Mathematics and Science computer, University of Massachusetts Boston, USA.
| | - Rajani Sadasivam
- Quantitative Health Sciences and Medicine Division of Health Informatics and Implementation Science, University of Massachusetts Medical School, USA.
| | - Xiaohui Cui
- School of Cyber Science and Engineering, Wuhan University, China.
| | - Ping Chen
- Department of Engineering, University of Massachusetts Boston, USA.
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5
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Faro JM, Orvek EA, Blok AC, Nagawa CS, McDonald AJ, Seward G, Houston TK, Kamberi A, Allison JJ, Person SD, Smith BM, Brady K, Grosowsky T, Jacobsen LL, Paine J, Welch JM, Sadasivam RS. Dissemination and Effectiveness of the Peer Marketing and Messaging of a Web-Assisted Tobacco Intervention: Protocol for a Hybrid Effectiveness Trial. JMIR Res Protoc 2019; 8:e14814. [PMID: 31339104 PMCID: PMC6683651 DOI: 10.2196/14814] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 06/27/2019] [Accepted: 06/27/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Smoking continues to be the leading preventable cause of death. Digital Interventions for Smoking Cessation (DISCs) are health communication programs accessible via the internet and smartphones and allow for greater reach and effectiveness of tobacco cessation programs. DISCs have led to increased 6-month cessation rates while also reaching vulnerable populations. Despite this, the impact of DISCs has been limited and new ways to increase access and effectiveness are needed. OBJECTIVE We are conducting a hybrid effectiveness-dissemination study. We aim to evaluate the effectiveness of a machine learning-based approach (recommender system) for computer-tailored health communication (CTHC) over a standard CTHC system based on quit rates and risk reduction. In addition, this study will assess the dissemination of providing access to a peer recruitment toolset on recruitment rate and variability of the sample. METHODS The Smoker-to-Smoker (S2S) study is a 6-month hybrid effectiveness dissemination trial conducted nationally among English-speaking, current smokers aged ≥18 years. All eligible participants will register for the DISC (Decide2quit) and be randomized to the recommender system CTHC or the standard CTHC, followed by allocation to a peer recruitment toolset group or control group. Primary outcomes will be 7-day point prevalence and risk reduction at the 6-month follow-up. Secondary outcomes include recruitment rate, website engagement, and patient-reported outcomes collected via the 6-month follow-up questionnaire. All primary analyses will be conducted on an intent-to-treat basis. RESULTS The project is funded from 2017 to 2020 by the Patient Centered Outcomes Research Institute. Enrollment was completed in early 2019, and 6-month follow-ups will be completed by late 2019. Preliminary data analysis is currently underway. CONCLUSIONS Conducting a hybrid study with both effectiveness and dissemination hypotheses raises some unique challenges in the study design and analysis. Our study addresses these challenges to test new innovations and increase the effectiveness and reach of DISCs. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/14814.
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Affiliation(s)
- Jamie M Faro
- Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Elizabeth A Orvek
- Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Amanda C Blok
- Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
- Center for Healthcare Organization and Implementation Research, Bedford Veterans Affairs Medical Center, Bedford, MA, United States
| | - Catherine S Nagawa
- Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Annalise J McDonald
- Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Gregory Seward
- Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Thomas K Houston
- Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Ariana Kamberi
- Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Jeroan J Allison
- Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Sharina D Person
- Division of Biostatistics And Health Services Research, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Bridget M Smith
- Center of Innovation for Complex Chronic Healthcare, Spinal Cord Injury Quality Enhancement Research Initiative, Hines VA Medical Center, Chicago, IL, United States
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Evanston, IL, United States
| | | | - Tina Grosowsky
- S2S Patient Panel, Worcester, MA, United States
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, United States
| | | | | | | | - Rajani S Sadasivam
- Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
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6
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Bunge EL, Taylor LA, Bond M, Stephens TN, Nishimuta K, Barrera AZ, Wickham R, Muñoz RF. Facebook for recruiting Spanish- and English-speaking smokers. Internet Interv 2019; 17:100238. [PMID: 30886827 PMCID: PMC6403078 DOI: 10.1016/j.invent.2019.02.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 02/09/2019] [Accepted: 02/13/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Recruitment for research is usually expensive and time consuming. Facebook (FB) recruitment has become widely utilized in recent years. The main aim of this study was to assess FB as a recruitment tool in a study for Spanish- and English-speaking smokers. Additionally, the study set out to compare performance of ads by language (Spanish vs. English), location (U.S. vs. San Francisco) and content (self-efficacy ad vs. fear appeal ad). METHODS Participants of a one-condition smoking cessation webapp study were recruited utilizing FB ads and posts through two phases: a recruitment-focused phase and an experimental phase comparing language, location and content. RESULTS During the recruitment phase 581 participants in total (U.S. = 540, San Francisco = 41) provided consent. Of the U.S. participants 275 were Spanish-speakers and 265 English-speakers. The cost-per-consent was $25.81 for Spanish-speakers, and $15.49 for English-speakers. During the experimental phase U.S. users performed better (i.e. more clicks, engagement and social reach) than San Francisco users, Spanish-speakers engaged more than English-speakers, and the self-efficacy ad performed better than the fear appeal ad. CONCLUSIONS This study showed that although there were differences in cost-per-consent for Spanish- and English-speakers, recruitment of Spanish-speakers through Facebook is feasible. Furthermore, comparing performance of ads by location, language, and ad content may contribute to developing more efficient campaigns.
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Affiliation(s)
| | | | | | | | | | | | | | - Ricardo F. Muñoz
- Corresponding author at: Palo Alto University, 1791 Arastradero Rd., Palo Alto, CA 94304, United States of America.
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7
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Lim MSC, Wright CJC, Carrotte ER, Pedrana AE. Reach, engagement, and effectiveness: a systematic review of evaluation methodologies used in health promotion via social networking sites. Health Promot J Austr 2018; 27:187-197. [PMID: 27719734 DOI: 10.1071/he16057] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 09/04/2016] [Indexed: 11/23/2022] Open
Abstract
Issue addressed Social networking sites (SNS) are increasingly popular platforms for health promotion. Advancements in SNS health promotion require quality evidence; however, interventions are often not formally evaluated. This study aims to describe evaluation practices used in SNS health promotion. Methods A systematic review was undertaken of Medline, PsycINFO, Scopus, EMBASE, CINAHL Plus, Communication and Mass Media Complete, and Cochrane Library databases. Articles published between 2006 and 2013 describing any health promotion intervention delivered using SNS were included. Results Forty-seven studies were included. There were two main evaluation approaches: closed designs (n=23), which used traditional research designs and formal recruitment procedures; and open designs (n=19), which evaluated the intervention in a real-world setting, allowing unknown SNS users to interact with the content without enrolling in research. Closed designs were unable to assess reach and engagement beyond their research sample. Open designs often relied on weaker study designs with no use of objective outcome measures and yielded low response rates. Conclusions Barriers to evaluation included low participation rates, high attrition, unknown representativeness and lack of comparison groups. Acceptability was typically assessed among those engaged with the intervention, with limited population data available to accurately assess intervention reach. Few studies were able to assess uptake of the intervention in a real-life setting while simultaneously assessing effectiveness of interventions with research rigour. So what? Through use of quasi-experimental or well designed before-after evaluations, in combination with detailed engagement metrics, it is possible to balance assessment of effectiveness and reach to evaluate SNS health promotion.
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Affiliation(s)
- Megan S C Lim
- Centre for Population Health, Burnet Institute, 85 Commercial Road, Melbourne, Vic. 3004, Australia
| | - Cassandra J C Wright
- Centre for Population Health, Burnet Institute, 85 Commercial Road, Melbourne, Vic. 3004, Australia
| | - Elise R Carrotte
- Centre for Population Health, Burnet Institute, 85 Commercial Road, Melbourne, Vic. 3004, Australia
| | - Alisa E Pedrana
- Centre for Population Health, Burnet Institute, 85 Commercial Road, Melbourne, Vic. 3004, Australia
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8
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Sadasivam RS, Cutrona SL, Luger TM, Volz E, Kinney R, Rao SR, Allison JJ, Houston TK. Share2Quit: Online Social Network Peer Marketing of Tobacco Cessation Systems. Nicotine Tob Res 2017; 19:314-323. [PMID: 27613918 DOI: 10.1093/ntr/ntw187] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 07/18/2016] [Indexed: 11/13/2022]
Abstract
Introduction Although technology-assisted tobacco interventions (TATIs) are effective, they are underused due to recruitment challenges. We tested whether we could successfully recruit smokers to a TATI using peer marketing through a social network (Facebook). Methods We recruited smokers on Facebook using online advertisements. These recruited smokers (seeds) and subsequent waves of smokers (peer recruits) were provided the Share2Quit peer recruitment Facebook app and other tools. Smokers were incentivized for up to seven successful peer recruitments and had 30 days to recruit from date of registration. Successful peer recruitment was defined as a peer recruited smoker completing the registration on the TATI following a referral. Our primary questions were (1) whether smokers would recruit other smokers and (2) whether peer recruitment would extend the reach of the intervention to harder-to-reach groups, including those not ready to quit and minority smokers. Results Overall, 759 smokers were recruited (seeds: 190; peer recruits: 569). Fifteen percent (n = 117) of smokers successfully recruited their peers (seeds: 24.7%; peer recruits: 7.7%) leading to four recruitment waves. Compared to seeds, peer recruits were less likely to be ready to quit (peer recruits 74.2% vs. seeds 95.1%), more likely to be male (67.1% vs. 32.9%), and more likely to be African American (23.8% vs. 10.8%) (p < .01 for all comparisons). Conclusions Peer marketing quadrupled our engaged smokers and enriched the sample with not-ready-to-quit and African American smokers. Peer recruitment is promising, and our study uncovered several important challenges for future research. Implications This study demonstrates the successful recruitment of smokers to a TATI using a Facebook-based peer marketing strategy. Smokers on Facebook were willing and able to recruit other smokers to a TATI, yielding a large and diverse population of smokers.
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Affiliation(s)
- Rajani S Sadasivam
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
| | - Sarah L Cutrona
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA.,Meyers Primary Care Institute, Worcester, MA
| | - Tana M Luger
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA.,Center for Healthcare Organization and Implementation Research, Department of Veterans Affairs, Bedford, MA
| | | | - Rebecca Kinney
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
| | - Sowmya R Rao
- Department of Surgery, Boston University, Boston, MA
| | - Jeroan J Allison
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
| | - Thomas K Houston
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA.,Center for Healthcare Organization and Implementation Research, Department of Veterans Affairs, Bedford, MA
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9
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StopApp: Using the Behaviour Change Wheel to Develop an App to Increase Uptake and Attendance at NHS Stop Smoking Services. Healthcare (Basel) 2016; 4:healthcare4020031. [PMID: 27417619 PMCID: PMC4934584 DOI: 10.3390/healthcare4020031] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 05/26/2016] [Accepted: 05/31/2016] [Indexed: 11/17/2022] Open
Abstract
Smokers who attend NHS Stop Smoking Services (SSS) are four times more likely to stop smoking; however, uptake has been in decline. We report the development of an intervention designed to increase uptake of SSS, from a more motivated self-selected sample of smokers. In Phase 1 we collected data to explore the barriers and facilitators to people using SSS. In Phase 2, data from extant literature and Phase 1 were subject to behavioural analysis, as outlined by the Behaviour Change Wheel (BCW) framework. Relevant Behaviour Change Techniques (BCTs) were identified in order to address these, informing the content of the StopApp intervention. In Phase 3 we assessed the acceptability of the StopApp. Smokers and ex-smokers identified a number of barriers to attending SSS, including a lack of knowledge about what happens at SSS (Capability); the belief that SSS is not easy to access (Opportunity); that there would be ’scare tactics’ or ‘nagging’; and not knowing anyone who had been and successfully quit (Motivation). The ‘StopApp’ is in development and will link in with the commissioned SSS booking system. Examples of the content and functionality of the app are outlined. The next phase will involve a full trial to test effectiveness.
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10
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Arayasirikul S, Chen YH, Jin H, Wilson E. A Web 2.0 and Epidemiology Mash-Up: Using Respondent-Driven Sampling in Combination with Social Network Site Recruitment to Reach Young Transwomen. AIDS Behav 2016; 20:1265-74. [PMID: 26499337 DOI: 10.1007/s10461-015-1234-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Respondent-driven sampling (RDS) peer referral has been proven to be an effective recruitment method for hard-to-reach populations; however, its application in diverse populations is limited. Recruitment occurred in two phases: RDS-only followed by development and implementation of an online social network strategy in combination with RDS peer referral (RDS + SNS). Compared to RDS-only, RDS + SNS reached a sample that was younger (χ(2) = 9.19, P = .03), more likely to identify with a non-binary gender identity (χ(2) = 10.4247, P = .03), with less housing instability (50.5 vs. 68.6 %, χ(2) = 9.0038, P = .002) and less sex work (19.7 vs. 31.4 %, χ(2) = 5.0798, P = .02). Additionally, we describe lessons learned as a result of implementing our online social network strategy. Our findings underscore the importance of integrating Internet-driven strategies to meet challenges in sample diversity and recruitment of young transwomen.
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Affiliation(s)
- Sean Arayasirikul
- Center for Public Health Research, San Francisco Department of Public Health, 25 Van Ness Ave, Floor 5, San Francisco, CA, 94102, USA.
- Medical Sociology, Department of Social and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA.
| | - Yea-Hung Chen
- Center for Public Health Research, San Francisco Department of Public Health, 25 Van Ness Ave, Floor 5, San Francisco, CA, 94102, USA
| | - Harry Jin
- Center for Public Health Research, San Francisco Department of Public Health, 25 Van Ness Ave, Floor 5, San Francisco, CA, 94102, USA
- Medical Sociology, Department of Social and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Erin Wilson
- Center for Public Health Research, San Francisco Department of Public Health, 25 Van Ness Ave, Floor 5, San Francisco, CA, 94102, USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
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11
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Pedersen ER, Kurz J. Using Facebook for Health-related Research Study Recruitment and Program Delivery. Curr Opin Psychol 2016; 9:38-43. [PMID: 26726313 DOI: 10.1016/j.copsyc.2015.09.011] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Facebook has become an important tool for recruiting research participants and for program delivery. Given the wide use of Facebook, there is much potential for the site to help with recruitment efforts in both physical and behavioral health care arenas; reaching groups typically difficult to recruit and providing outreach to individuals that may not have received services elsewhere. Health studies using Facebook have generally reported success, including cost-effectiveness, recruitment of samples in brief periods of time, and ability to locate participants for follow-up research. Still, the use of Facebook for research and program delivery is a relatively new area that warrants more research attention and guidance around issues like validity of data, representativeness of samples, and protections of human subjects.
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12
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Thornton L, Batterham PJ, Fassnacht DB, Kay-Lambkin F, Calear AL, Hunt S. Recruiting for health, medical or psychosocial research using Facebook: Systematic review. Internet Interv 2016; 4:72-81. [PMID: 30135792 PMCID: PMC6096238 DOI: 10.1016/j.invent.2016.02.001] [Citation(s) in RCA: 197] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 01/12/2016] [Accepted: 02/04/2016] [Indexed: 11/24/2022] Open
Abstract
Recruiting participants is a challenge for many health, medical and psychosocial research projects. One tool more frequently being used to improve recruitment is the social networking website Facebook. A systematic review was conducted to identify studies that have used Facebook to recruit participants of all ages, to any psychosocial, health or medical research. 110 unique studies that used Facebook as a recruitment source were included in the review. The majority of studies used a cross-sectional design (80%) and addressed a physical health or disease issue (57%). Half (49%) of the included studies reported specific details of the Facebook recruitment process. Researchers paid between $1.36 and $110 per completing participants (Mean = $17.48, SD = $23.06). Among studies that examined the representativeness of their sample, the majority concluded (86%) their Facebook-recruited samples were similarly representative of samples recruited via traditional methods. These results indicate that Facebook is an effective and cost-efficient recruitment method. Researchers should consider their target group, advertisement wording, offering incentives and no-cost methods of recruitment when considering Facebook as a recruitment source. It is hoped this review will assist researchers to make decisions regarding the use of Facebook as a recruitment tool in future research.
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Affiliation(s)
- Louise Thornton
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Philip J. Batterham
- National Institute for Mental Health Research, The Australian National University, Canberra, Australia
| | - Daniel B. Fassnacht
- Research School of Psychology, The Australian National University, Canberra, Australia
| | - Frances Kay-Lambkin
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
- Centre for Translational Neuroscience and Mental Health, The University of Newcastle, Newcastle, Australia
- Corresponding author at: National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
| | - Alison L. Calear
- National Institute for Mental Health Research, The Australian National University, Canberra, Australia
| | - Sally Hunt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
- Centre for Translational Neuroscience and Mental Health, The University of Newcastle, Newcastle, Australia
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Arayasirikul S, Cai X, Wilson EC. A Qualitative Examination of Respondent-Driven Sampling (RDS) Peer Referral Challenges Among Young Transwomen in the San Francisco Bay Area. JMIR Public Health Surveill 2015; 1:e9. [PMID: 27227143 PMCID: PMC4869213 DOI: 10.2196/publichealth.4573] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 07/13/2015] [Accepted: 07/21/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Efforts have focused on developing innovative recruitment strategies to engage the most marginalized of populations in public health research. Respondent-driven sampling (RDS) has been found to be an effective sampling strategy for hard-to-reach, hidden populations. Though studies have documented RDS peer referral as challenging, literature contextualizing these challenges is scant and rarely do they discuss the role of Internet technologies. OBJECTIVE The objective of the study was to explore reasons for peer referral challenges in a human immunodeficiency virus (HIV) risk and resilience study among a hidden population of youth, specifically, young transwomen. These findings amplify the unique opportunities Internet technologies bring to public health research and methodology. METHODS We conducted focused, semistructured, qualitative interviews with 16 young transwomen to investigate the reasons why youth did or did not refer peers to an RDS study for transwomen ages 16-24 in the San Francisco Bay Area. Qualitative interview data were coded and analyzed using grounded theory. RESULTS Participants discussed specific barriers and facilitators related to four factors that include study design, study implementation, community characteristics, and individual characteristics, which contributed to RDS peer referral challenges. CONCLUSIONS Our grounded theory analysis identifies important considerations for future RDS studies with hidden youth populations. Exploring research participants' experiences is integral in strengthening future epidemiologic research efforts that plan to use RDS to sample and estimate the hidden epidemics among at-risk youth and transgender women. Additionally, Internet technologies and Web-based adaptations offer solutions to traditional RDS peer referral challenges, having the potential to increase accessibility and use among hidden youth populations.
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Affiliation(s)
- Sean Arayasirikul
- Center for Public HealthPopulation Health DivisionSan Francisco Department of Public HealthSan Francisco, CAUnited States.,Medical SociologyDepartment of Social and Behavioral SciencesUniversity of California San FranciscoSan Francisco, CAUnited States
| | - Xiang Cai
- Yale UniversityNew Haven, CTUnited States
| | - Erin C Wilson
- Center for Public HealthPopulation Health DivisionSan Francisco Department of Public HealthSan Francisco, CAUnited States.,Department of Epidemiology and BiostatisticsUniversity of California San FranciscoSan Francisco, CAUnited States
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Borrelli B, Bartlett YK, Tooley E, Armitage CJ, Wearden A. Prevalence and Frequency of mHealth and eHealth Use Among US and UK Smokers and Differences by Motivation to Quit. J Med Internet Res 2015; 17:e164. [PMID: 26149323 PMCID: PMC4526978 DOI: 10.2196/jmir.4420] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 04/16/2015] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Both mHealth and eHealth interventions for smoking cessation are rapidly being developed and tested. There are no data on use of mHealth and eHealth technologies by smokers in general or by smokers who are not motivated to quit smoking. OBJECTIVE The aims of our study were to (1) assess technology use (eg, texting, social media, Internet) among smokers in the United States and United Kingdom, (2) examine whether technology use differs between smokers who are motivated to quit and smokers who are not motivated to quit, (3) examine previous use of technology to assist with smoking cessation, and (4) examine future intentions to use technology to assist with smoking cessation. METHODS Participants were 1000 adult smokers (54.90%, 549/1000 female; mean age 43.9, SD 15.5 years; US: n=500, UK: n=500) who were recruited via online representative sampling strategies. Data were collected online and included demographics, smoking history, and frequency and patterns of technology use. RESULTS Among smokers in general, there was a high prevalence of mobile and smartphone ownership, sending and receiving texts, downloading and using apps, using Facebook, and visiting health-related websites. Smokers who were unmotivated to quit were significantly less likely to own a smartphone or handheld device that connects to the Internet than smokers motivated to quit. There was a significantly lower prevalence of sending text messages among US smokers unmotivated to quit (78.2%, 179/229) versus smokers motivated to quit (95.0%, 229/241), but no significant differences between the UK groups (motivated: 96.4%, 239/248; unmotivated: 94.9%, 223/235). Smokers unmotivated to quit in both countries were significantly less likely to use a handheld device to read email, play games, browse the Web, or visit health-related websites versus smokers motivated to quit. US smokers had a high prevalence of app downloads regardless of motivation to quit, but UK smokers who were motivated to quit had greater prevalence of app downloads than smokers unmotivated to quit. US smokers were significantly more likely to have a Facebook account (87.0%, 435/500) than UK smokers (76.4%, 382/500), but smokers unmotivated to quit in both countries used Facebook less frequently than smokers motivated to quit. Smokers who were unmotivated to quit were less likely to have used eHealth or mHealth platforms to help them quit smoking in the past and less likely to say that they would use them for smoking cessation in the future. CONCLUSIONS Although smokers unmotivated to quit make less use of technology than smokers motivated to quit, there is sufficient prevalence to make it worthwhile to develop eHealth and mHealth interventions to encourage cessation. Short and low-effort communications, such as text messaging, might be better for smokers who are less motivated to quit. Multiple channels may be required to reach unmotivated smokers.
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Affiliation(s)
- Belinda Borrelli
- Boston University, Henry M Goldman School of Dental Medicine, Boston, MA, United States.
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Yuan P, Bare MG, Johnson MO, Saberi P. Using online social media for recruitment of human immunodeficiency virus-positive participants: a cross-sectional survey. J Med Internet Res 2014; 16:e117. [PMID: 24784982 PMCID: PMC4026571 DOI: 10.2196/jmir.3229] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 03/11/2014] [Accepted: 03/30/2014] [Indexed: 11/13/2022] Open
Abstract
Background There are many challenges in recruiting and engaging participants when conducting research, especially with HIV-positive individuals. Some of these challenges include geographical barriers, insufficient time and financial resources, and perceived HIV-related stigma. Objective This paper describes the methodology of a recruitment approach that capitalized on existing online social media venues and other Internet resources in an attempt to overcome some of these barriers to research recruitment and retention. Methods From May through August 2013, a campaign approach using a combination of online social media, non-financial incentives, and Web-based survey software was implemented to advertise, recruit, and retain participants, and collect data for a survey study with a limited budget. Results Approximately US $5,000 was spent with a research staff designated at 20% of full-time effort, yielding 2034 survey clicks, 1404 of which met the inclusion criteria and initiated the survey, for an average cost of US $3.56 per survey initiation. A total of 1221 individuals completed the survey, yielding 86.97% retention. Conclusions These data indicate that online recruitment is a feasible and efficient tool that can be further enhanced by sophisticated online data collection software and the addition of non-financial incentives.
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Affiliation(s)
- Patrick Yuan
- Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
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Abstract
Further understanding is needed of the functionalities and efficiency of social media for health intervention research recruitment. Facebook was examined as a mechanism to recruit young adults for a smoking cessation intervention. An ad campaign targeting young adult smokers tested specific messaging based on market theory and successful strategies used to recruit smokers in previous clinical trials (i.e. informative, call to action, scarcity, social norms), previously successful ads, and general messaging. Images were selected to target smokers (e.g., lit cigarette), appeal to the target age, vary demographically, and vary graphically (cartoon, photo, logo). Facebook's Ads Manager was used over 7 weeks (6/10/13 - 7/29/13), targeted by age (18-25), location (U.S.), and language (English), and employed multiple ad types (newsfeed, standard, promoted posts, sponsored stories) and keywords. Ads linked to the online screening survey or study Facebook page. The 36 different ads generated 3,198,373 impressions, 5,895 unique clicks, at an overall cost of $2,024 ($0.34/click). Images of smoking and newsfeed ads had the greatest reach and clicks at the lowest cost. Of 5,895 unique clicks, 586 (10%) were study eligible and 230 (39%) consented. Advertising costs averaged $8.80 per eligible, consented participant. The final study sample (n=79) was largely Caucasian (77%) and male (69%), averaging 11 cigarettes/day (SD=8.3) and 2.7 years smoking (SD=0.7). Facebook is a useful, cost-effective recruitment source for young adult smokers. Ads posted via newsfeed posts were particularly successful, likely because they were viewable via mobile phone. Efforts to engage more ethnic minorities, young women, and smokers motivated to quit are needed.
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