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Johnson LC, Stevens G, Cantrell M, Little NR, Holahan TJ, Saunders CH, Thomeer RP, Sheppard R, Elwyn G, Durand MA. Engaging Long-Term Care Workers in Research: Recruitment Approaches and Participant Characteristics From a Randomized Controlled Trial to Improve COVID-19 Vaccine Confidence. J Am Med Dir Assoc 2024:S1525-8610(24)00175-0. [PMID: 38588798 DOI: 10.1016/j.jamda.2024.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/21/2024] [Accepted: 02/28/2024] [Indexed: 04/10/2024]
Abstract
OBJECTIVE To describe and compare the recruitment methods employed in a randomized controlled trial targeting long-term care workers, and resulting participant baseline characteristics. DESIGN We used a multifaceted recruitment process to enroll long-term care workers in our 3-arm randomized controlled trial comparing 2 interventions to enhanced usual practice, for improving COVID-19 vaccine confidence and other outcomes. SETTING AND PARTICIPANTS Adult long-term care workers living in the United States employed within the last 2 years were invited to join the study. Participants also had to meet specific screening criteria related to their degree of worry about the vaccine and/or their vaccination status. METHODS We used a participatory approach to engage our long-term care stakeholders in codesigning and executing a combination of recruitment methods, including targeted e-recruitment, paid e-recruitment, and in-person recruitment. Participants were screened, consented, and enrolled online. We implemented a participant verification process to ensure the integrity of our study data, and used a tailored participant management platform to manage enrollment. RESULTS We enrolled 1930 long-term care workers between May 2022 and January 2023. We met our enrollment target, despite each recruitment method having limitations. Total variable costs of approximately $102,700 were incurred and differed on a per-enrolled participant basis across methods: $25.72 for targeted e-recruitment, $57.12 for paid e-recruitment, and $64.92 for in-person methods. Our sample differed from the national population in age, gender, race/ethnicity, education, and role in long-term care. Differences were also observed between online and in-person recruitment methods. CONCLUSIONS AND IMPLICATIONS Our results support the feasibility of enrolling a large number of long-term care workers in a randomized controlled trial to increase COVID-19 vaccine confidence. Findings build upon the evidence base for engaging this important population in research, a critical step to improving long-term care resident health and well-being. Results from our trial are anticipated in 2024.
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Affiliation(s)
- Lisa C Johnson
- The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA.
| | - Gabrielle Stevens
- The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
| | | | - N Ruth Little
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC, USA
| | - Timothy J Holahan
- Department of Geriatric Medicine, University of Rochester, Rochester, NY, USA
| | | | - Rachael P Thomeer
- The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
| | | | - Glyn Elwyn
- The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
| | - Marie-Anne Durand
- Unisanté Center for Primary Care and Public Health Department of Occupational and Environmental Medicine, Lausanne, Switzerland
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2
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Gurung S, Jones SS, Mehta K, Budhwani H, MacDonell K, Belzer M, Naar S. Examining Recruitment Strategies in the Enrollment Cascade of Youth Living With HIV: Descriptive Findings From a Nationwide Web-Based Adherence Protocol. JMIR Form Res 2023; 7:e40077. [PMID: 36745773 PMCID: PMC10131637 DOI: 10.2196/40077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 01/05/2023] [Accepted: 01/05/2023] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Digital strategies and broadened eligibility criteria may optimize the enrollment of youth living with HIV in mobile health adaptive interventions. Prior research suggests that digital recruitment strategies are more efficient than traditional methods for overcoming enrollment challenges of youth living with HIV in the United States. OBJECTIVE This study highlights the challenges and strategies that explain screening and enrollment milestones in a national web-based adherence protocol for youth living with HIV. METHODS Baseline data from a national web-based HIV adherence protocol for youth living with HIV, collected from July 2018 to February 2021, were analyzed. A centralized recruitment procedure was developed, which used web-based recruitment via Online Master Screener; paid targeted advertisements on social media platforms (eg, Facebook and Reddit) and geosocial networking dating apps (eg, Grindr and Jack'd); and site and provider referrals from Subject Recruitment Venues and other AIDS service organizations, website referrals, and text-in recruitment. RESULTS A total of 3 distinct cohorts of youth living with HIV were identified, marked by changes in recruitment strategies. Overall, 3270 individuals consented to screening, 2721 completed screening, 581 were eligible, and 83 completed enrollment. We examined sociodemographic and behavioral differences in completing milestones from eligibility to full enrollment (ie, submitting antiretroviral therapy and viral load data and completing the baseline web-based survey). Those with the most recent viral load tests >6 months ago were half as likely to enroll (odds ratio 0.45, 95% CI 0.21-0.94). Moreover, eligible participants with self-reported antiretroviral therapy adherence (SRA) between 50% and 80% were statistically significant (P<.001 to P=.03) and more likely to enroll than those with SRA >80%. CONCLUSIONS The findings add to our knowledge on the use of digital technologies for youth living with HIV before and during the COVID-19 pandemic and provide insight into the impact of expanding eligibility criteria on enrollment. As the COVID-19 pandemic continues and the use of and engagement with social media and dating apps among youth living with HIV changes, these platforms should continue to be investigated as potential recruitment tools. Using a wide variety of recruitment strategies such as using social media and dating apps as well as provider referral mechanisms, increasing compensation amounts, and including SRA in enrollment criteria should continue to be studied with respect to their ability to successfully recruit and enroll eligible participants. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/11183.
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Affiliation(s)
- Sitaji Gurung
- Department of Health Sciences, New York City College of Technology, The City University of New York, Brooklyn, NY, United States
| | - Stephen Scott Jones
- Department of Psychology, Hunter College, The City University of New York, New York, NY, United States
| | - Kripa Mehta
- Department of Psychology, Hunter College, The City University of New York, New York, NY, United States
| | - Henna Budhwani
- College of Nursing, Florida State University, Tallahassee, FL, United States
| | - Karen MacDonell
- Department of Behavioral Sciences and Social Medicine, Center for Translational Behavorial Science, College of Medicine, Florida State University, Tallahassee, FL, United States
| | - Marvin Belzer
- Children's Hospital Los Angeles, Los Angeles, CA, United States
| | - Sylvie Naar
- Department of Behavioral Sciences and Social Medicine, Center for Translational Behavorial Science, College of Medicine, Florida State University, Tallahassee, FL, United States
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3
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Karasik J. Door-to-door recruitment during the COVID-19 pandemic: Lessons learned from a population-based, longitudinal cohort study in North Carolina, USA. Res Sq 2022:rs.3.rs-1234834. [PMID: 35194600 PMCID: PMC8863159 DOI: 10.21203/rs.3.rs-1234834/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Background The COVID-19 pandemic has disproportionately impacted many of the same communities that have been historically harmed by or underrepresented in public health research. In a prospective cohort study on COVID-19 in North Carolina, USA, we employed a door-to-door recruitment strategy on a randomly selected sample of households to maximize inclusivity and improve study diversity. Discussion Rapidly shifting current events and an evolving pandemic required continuous updating of our approach. Using a variety of recruitment strategies and participation methods allowed us to quickly adapt and to reach a broad range of people with diverse needs and circumstances. Door-to-door recruitment had many unexpected benefits, allowing us to easily reach people that were working from home and leaving people with positive impressions of public health research. However, even when we were able to elicit a response from prospective participants, follow-up has remained a substantial challenge. Conclusions It is paramount for public health practitioners to employ creative strategies and to invest time and resources to include hard-to-reach communities in research.
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Wasfi R, Poirier Stephens Z, Sones M, Laberee K, Pugh C, Fuller D, Winters M, Kestens Y. Recruiting Participants for Population Health Intervention Research: Effectiveness and Costs of Recruitment Methods for a Cohort Study. J Med Internet Res 2021; 23:e21142. [PMID: 34587586 PMCID: PMC8663714 DOI: 10.2196/21142] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 12/26/2020] [Accepted: 09/29/2021] [Indexed: 01/24/2023] Open
Abstract
Background Public health research studies often rely on population-based participation and draw on various recruitment methods to establish samples. Increasingly, researchers are turning to web-based recruitment tools. However, few studies detail traditional and web-based recruitment efforts in terms of costs and potential biases. Objective This study aims to report on and evaluate the cost-effectiveness, time effectiveness, and sociodemographic representation of diverse recruitment methods used to enroll participants in 3 cities of the Interventions, Research, and Action in Cities Team (INTERACT) study, a cohort study conducted in Canadian cities. Methods Over 2017 and 2018 in Vancouver, Saskatoon, and Montreal, the INTERACT study used the following recruitment methods: mailed letters, social media (including sponsored Facebook advertisements), news media, partner communications, snowball recruitment, in-person recruitment, and posters. Participation in the study involved answering web-based questionnaires (at minimum), activating a smartphone app to share sensor data, and wearing a device for mobility and physical activity monitoring. We describe sociodemographic characteristics by the recruitment method and analyze performance indicators, including cost, completion rate, and time effectiveness. Effectiveness included calculating cost per completer (ie, a participant who completed at least one questionnaire), the completion rate of a health questionnaire, and the delay between completion of eligibility and health questionnaires. Cost included producing materials (ie, printing costs), transmitting recruitment messages (ie, mailing list rental, postage, and sponsored Facebook posts charges), and staff time. In Montreal, the largest INTERACT sample, we modeled the number of daily recruits through generalized linear models accounting for the distributed lagged effects of recruitment campaigns. Results Overall, 1791 participants were recruited from 3 cities and completed at least one questionnaire: 318 in Vancouver, 315 in Saskatoon, and 1158 in Montreal. In all cities, most participants chose to participate fully (questionnaires, apps, and devices). The costs associated with a completed participant varied across recruitment methods and by city. Facebook advertisements generated the most recruits (n=687), at a cost of CAD $15.04 (US $11.57; including staff time) per completer. Mailed letters were the costliest, at CAD $108.30 (US $83.3) per completer but served to reach older participants. All methods resulted in a gender imbalance, with women participating more, specifically with social media. Partner newsletters resulted in the participation of younger adults and were cost-efficient (CAD $5.16 [US $3.97] per completer). A generalized linear model for daily Montreal recruitment identified 2-day lag effects on most recruitment methods, except for the snowball campaign (4 days), letters (15 days), and reminder cards (5 days). Conclusions This study presents comprehensive data on the costs, effectiveness, and bias of population recruitment in a cohort study in 3 Canadian cities. More comprehensive documentation and reporting of recruitment efforts across studies are needed to improve our capacity to conduct inclusive intervention research.
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Affiliation(s)
- Rania Wasfi
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, Canada.,Centre de recherche du CHUM, Université de Montréal, Montréal, QC, Canada.,École de Santé Publique, Université de Montréal, Montreal, QC, Canada
| | | | - Meridith Sones
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Karen Laberee
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Caitlin Pugh
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Daniel Fuller
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St John's, NL, Canada
| | - Meghan Winters
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Yan Kestens
- Centre de recherche du CHUM, Université de Montréal, Montréal, QC, Canada.,École de Santé Publique, Université de Montréal, Montreal, QC, Canada
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5
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Lanier Y, Goldstein A, Lavarin C, Choi E, Bond K, Riascos K. A Qualitative Investigation of Facilitators to Black and Latino Adolescent and Young Adults' Participation in a Couple-Based HIV Prevention Study. Am J Health Promot 2021; 35:809-817. [PMID: 33641448 PMCID: PMC10878312 DOI: 10.1177/0890117121997040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE Recruitment and retention of adolescents and young adults (AYAs) in couple-based HIV prevention research can be difficult. This study's primary objective is to identify factors that influenced Black and Latino AYAs to participate in couple-based HIV/STI prevention research. DESIGN In-depth, semi-structured qualitative interviews. SETTING Face-to-face interviews with couples recruited from the South Bronx, New York. PARTICIPANTS Twenty-three heterosexual couples (46 individuals) aged 16-28 (M = 20.1, SD = 3.01). METHODS Participants completed 60 to 90-minute individual and dyadic interviews. All interviews were audio-recorded and transcribed. Thematic analysis was conducted to identify key themes. RESULTS Two levels of influence emerged from participants' interviews regarding their reasons for study participation: 1) individual factors (interest in the study topic, study incentives, opportunity to help their community, and opportunity to learn something new), 2) interpersonal factors (positive interactions with the research team, partner's desire to participate and relationship strengthening). There were key differences by gender and recruitment order. CONCLUSION Black and Latino AYAs report multiple reasons for participating in couple-based research. Highlighting the benefits of study participation to themselves, their relationships, and their communities may be an important strategy for engaging AYAs in couple-based research.
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Affiliation(s)
- Yzette Lanier
- New York University, Rory Meyers College of Nursing, New York, NY, USA
| | | | | | - Elizabeth Choi
- New York University, Steinhardt School of Culture, Education, and Human Development, New York, NY, USA
| | - Keosha Bond
- New York Medical College, School of Health Sciences & Practice, Hawthorne, New York, NY, USA
| | - Katerin Riascos
- New York University, Steinhardt School of Culture, Education, and Human Development, New York, NY, USA
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6
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Palamar JJ, Fitzgerald ND, Keyes KM, Cottler LB. Drug checking at dance festivals: A review with recommendations to increase generalizability of findings. Exp Clin Psychopharmacol 2021; 29:229-235. [PMID: 33600199 PMCID: PMC8282667 DOI: 10.1037/pha0000452] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Dance festival attendees are at high risk for consuming adulterated drugs. In recent years, drug checking studies have been conducted at various dance festivals to provide valuable harm reduction information to attendees regarding drug content. We conducted a review of the literature to determine the generalizability of findings to the target population of interest-festival attendees at risk for using adulterated drugs. Six published studies involving drug checking at festivals were reviewed. All relied on self-selected samples and male attendees were overrepresented based on previous research. Test methods, drugs tested, definitions of adulteration, and prevalence of adulteration varied across studies. Prevalence of detection of adulterants ranged from 11% to 55%. While the drug checking services described appear to have been beneficial for participants, results have limited generalizability to the target population. We recommend that researchers expand beyond the self-selection model in future studies and utilize recruitment methods that involve random sampling techniques such as systematic random sampling, stratified random sampling, or time-space sampling within festivals. We also recommend that individuals approached are surveyed for demographic characteristics, planned drug use at the festival, and willingness to test their drugs. These methods would help determine how representative the sample is compared to the target population and allow for more generalizable estimates. In conclusion, as these valuable harm reduction services expand, it may be possible to reach a wider portion of the population at risk and to obtain more generalizable estimates of engagement, adulteration, and reactions to learning one possesses adulterated drugs. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Joseph J. Palamar
- Department of Population Health, New York University Grossman School of Medicine
| | - Nicole D. Fitzgerald
- Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida
| | - Katherine M. Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University
| | - Linda B. Cottler
- Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida
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7
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Bennett WL, Bramante CT, Rothenberger SD, Kraschnewski JL, Herring SJ, Lent MR, Clark JM, Conroy MB, Lehmann H, Cappella N, Gauvey-Kern M, McCullough J, McTigue KM. Patient Recruitment Into a Multicenter Clinical Cohort Linking Electronic Health Records From 5 Health Systems: Cross-sectional Analysis. J Med Internet Res 2021; 23:e24003. [PMID: 34042604 PMCID: PMC8193474 DOI: 10.2196/24003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 02/04/2021] [Accepted: 04/04/2021] [Indexed: 12/02/2022] Open
Abstract
Background There is growing interest in identifying and recruiting research participants from health systems using electronic health records (EHRs). However, few studies have described the practical aspects of the recruitment process or compared electronic recruitment methods to in-person recruitment, particularly across health systems. Objective The objective of this study was to describe the steps and efficiency of the recruitment process and participant characteristics by recruitment strategy. Methods EHR-based eligibility criteria included being an adult patient engaged in outpatient primary or bariatric surgery care at one of 5 health systems in the PaTH Clinical Research Network and having ≥2 weight measurements and 1 height measurement recorded in their EHR within the last 5 years. Recruitment strategies varied by site and included one or more of the following methods: (1) in-person recruitment by study staff from clinical sites, (2) US postal mail recruitment letters, (3) secure email, and (4) direct EHR recruitment through secure patient web portals. We used descriptive statistics to evaluate participant characteristics and proportion of patients recruited (ie, efficiency) by modality. Results The total number of eligible patients from the 5 health systems was 5,051,187. Of these, 40,048 (0.8%) were invited to enter an EHR-based cohort study and 1085 were enrolled. Recruitment efficiency was highest for in-person recruitment (33.5%), followed by electronic messaging (2.9%), including email (2.9%) and EHR patient portal messages (2.9%). Overall, 779 (65.7%) patients were enrolled through electronic messaging, which also showed greater rates of recruitment of Black patients compared with the other strategies. Conclusions We recruited a total of 1085 patients from primary care and bariatric surgery settings using 4 recruitment strategies. The recruitment efficiency was 2.9% for email and EHR patient portals, with the majority of participants recruited electronically. This study can inform the design of future research studies using EHR-based recruitment.
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Affiliation(s)
- Wendy L Bennett
- Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Carolyn T Bramante
- University of Minnesota School of Medicine, Minneapolis, MN, United States
| | | | | | | | | | - Jeanne M Clark
- Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Molly B Conroy
- University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Harold Lehmann
- Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | | | - Megan Gauvey-Kern
- Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Darmawan I, Bakker C, Brockman TA, Patten CA, Eder M. The Role of Social Media in Enhancing Clinical Trial Recruitment: Scoping Review. J Med Internet Res 2020; 22:e22810. [PMID: 33104015 PMCID: PMC7652693 DOI: 10.2196/22810] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/31/2020] [Accepted: 09/15/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Recruiting participants into clinical trials continues to be a challenge, which can result in study delay or termination. Recent studies have used social media to enhance recruitment outcomes. An assessment of the literature on the use of social media for this purpose is required. OBJECTIVE This study aims to answer the following questions: (1) How is the use of social media, in combination with traditional approaches to enhance clinical trial recruitment and enrollment, represented in the literature? and (2) Do the data on recruitment and enrollment outcomes presented in the literature allow for comparison across studies? METHODS We conducted a comprehensive literature search across 7 platforms to identify clinical trials that combined social media and traditional methods to recruit patients. Study and participant characteristics, recruitment methods, and recruitment outcomes were evaluated and compared. RESULTS We identified 2371 titles and abstracts through our systematic search. Of these, we assessed 95 full papers and determined that 33 studies met the inclusion criteria. A total of 17 studies reported enrollment outcomes, of which 9 achieved or exceeded their enrollment target. The proportion of participants enrolled from social media in these studies ranged from 0% to 49%. Across all 33 studies, the proportion of participants recruited and enrolled from social media varied greatly. A total of 9 studies reported higher enrollment rates from social media than any other methods, and 4 studies reported the lowest cost per enrolled participant from social media. CONCLUSIONS While the assessment of the use of social media to improve clinical trial participation is hindered by reporting inconsistencies, preliminary data suggest that social media can increase participation and reduce per-participant cost. The adoption of consistent standards for reporting recruitment and enrollment outcomes is required to advance our understanding and use of social media to support clinical trial success.
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Affiliation(s)
- Ida Darmawan
- Hubbard School of Journalism and Mass Communication, University of Minnesota, Minneapolis, MN, United States
| | - Caitlin Bakker
- Health Sciences Libraries, University of Minnesota, Minneapolis, MN, United States
| | - Tabetha A Brockman
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, United States
| | - Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, United States
| | - Milton Eder
- Department of Family Medicine & Community Health, University of Minnesota, Minneapolis, MN, United States
- Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, United States
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9
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Grace Cannard K, Hacker ML, Molinari A, Heusinkveld LE, Currie AD, Charles D. Recruitment and Retention in Clinical Trials of Deep Brain Stimulation in Early-Stage Parkinson's Disease: Past Experiences and Future Considerations. J Parkinsons Dis 2019; 8:421-428. [PMID: 30010145 DOI: 10.3233/jpd-181381] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Clinical trials are often hindered by inadequate patient recruitment. Overly optimistic investigator predictions of participation can lead to unmet recruitment goals and costly trial extensions. A patient-focused approach estimating recruitment in clinical trials may provide higher accuracy. OBJECTIVE To assess the feasibility of recruitment in a future deep brain stimulation (DBS) in early-stage Parkinson's disease (PD) multicenter trial by understanding motivations and concerns to participation of past and potential future DBS in early-stage PD clinical trial subjects. METHODS To identify motivating factors and barriers influencing trial participation, an end-of-trial survey was administered to subjects enrolled in a DBS in early-stage PD pilot trial with subjects randomized to receive DBS plus optimal drug therapy (DBS+ODT) or ODT alone (NCT#00282152, IDE#G050016). Pilot trial survey results were analyzed in conjunction with results of a previously-reported survey querying PD patients about potential participation in a trial for DBS in early-stage PD with similar inclusion/exclusion criteria. RESULTS Pilot trial subjects reported high levels of satisfaction with their participation in the study. Similar motivations and barriers to participation were expressed in comparable proportions by subjects who successfully completed the pilot trial and patients with early-stage PD considering enrollment in a comparable DBS study. CONCLUSIONS The FDA has approved a prospective, randomized, double-blind, phase III, multicenter, pivotal clinical trial evaluating DBS in early-stage PD (IDE#G050016). These results suggest that the successful recruitment and retention of early-stage PD subjects, as observed in the pilot trial, is attainable in a future pivotal trial.
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Affiliation(s)
- K Grace Cannard
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Mallory L Hacker
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Anna Molinari
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lauren E Heusinkveld
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.,Laboratory of Molecular Immunology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Amanda D Currie
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.,College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - David Charles
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
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10
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Plante TB, Gleason KT, Miller HN, Charleston J, McArthur K, Himmelfarb CD, Lazo M, Ford DE, Miller ER, Appel LJ, Juraschek SP. Recruitment of trial participants through electronic medical record patient portal messaging: A pilot study. Clin Trials 2019; 17:30-38. [PMID: 31581836 DOI: 10.1177/1740774519873657] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND/AIM Cost-efficient methods are essential for successful participant recruitment in clinical trials. Patient portal messages are an emerging means of recruiting potentially eligible patients into trials. We assessed the response rate and complaint rate from direct-to-patient, targeted recruitment through patient portals of an electronic medical record for a clinical trial, and compared response rates by differences in message content. METHODS The Study to Understand Fall Reduction and Vitamin D in You (STURDY) trial is a National Institutes of Health-sponsored, community-based study of vitamin D supplementation for fall prevention in older adults conducted at Johns Hopkins. Potential participants were identified using the Epic electronic medical record at the Johns Hopkins Health System based on age (≥70 years), ZIP code (30-mile radius of study site), and prior activation of a patient portal account. We prepared a shorter message and a longer message. Both had basic information about study participation, but the longer message also contained information about the significance of the study and a personal invitation from the STURDY principal investigator. The Hopkins Institutional Review Board did not require prior consent from the patient or their providers. We calculated the response rate and tracked the number of complaints and requests for removal from future messages. We also determined response rate according to message content. RESULTS Of the 5.5 million individuals receiving care at the Johns Hopkins Health System, a sample of 6896 met our inclusion criteria and were sent one patient portal recruitment message between 6 April 2017 and 3 August 2017. Assessment of enrollment by this method ended on 1 December 2017. There were 116 patients who expressed interest in the study (response rate: 1.7%). Twelve (0.2%) recipients were randomized. There were two complaints (0.03%) and one request to unsubscribe from future recruitment messages (0.01%). Response rate was higher with the longer message than the shorter message (2.1% vs 1.2%; p = 0.005). CONCLUSION Patient portal messages inviting seniors to participate in a randomized controlled trial resulted in a response rate similar to commercial email marketing and resulted in very few complaints or opt-out requests. Furthermore, a longer message with more content enhanced response rate. Recruitment through patient portals might be an effective strategy to enroll trial participants.
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Affiliation(s)
- Timothy B Plante
- Department of Medicine, Larner College of Medicine, The University of Vermont, Burlington, VT, USA
| | - Kelly T Gleason
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Hailey N Miller
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Jeanne Charleston
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | - Mariana Lazo
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Daniel E Ford
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Edgar R Miller
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lawrence J Appel
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Stephen P Juraschek
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Milo Rasouly H, Wynn J, Marasa M, Reingold R, Chatterjee D, Kapoor S, Piva S, Kil BH, Mu X, Alvarez M, Nestor J, Mehl K, Revah-Politi A, Lippa N, Ernst ME, Bier L, Espinal A, Haser B, Sinha A, Halim I, Fasel D, Cuneo N, Thompson JJ, Verbitsky M, Cohn EG, Goldman J, Marder K, Klitzman RL, Orjuela MA, So YS, Fedotov A, Crew KD, Kiryluk K, Appelbaum PS, Weng C, Siegel K, Gharavi AG, Chung WK. Evaluation of the cost and effectiveness of diverse recruitment methods for a genetic screening study. Genet Med 2019; 21:2371-80. [PMID: 30930462 DOI: 10.1038/s41436-019-0497-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 03/12/2019] [Indexed: 11/08/2022] Open
Abstract
PURPOSE Recruitment of participants from diverse backgrounds is crucial to the generalizability of genetic research, but has proven challenging. We retrospectively evaluated recruitment methods used for a study on return of genetic results. METHODS The costs of study design, development, and participant enrollment were calculated, and the characteristics of the participants enrolled through the seven recruitment methods were examined. RESULTS A total of 1118 participants provided consent, a blood sample, and questionnaire data. The estimated cost across recruitment methods ranged from $579 to $1666 per participant and required a large recruitment team. Recruitment methods using flyers and staff networks were the most cost-efficient and resulted in the highest completion rate. Targeted sampling that emphasized the importance of Latino/a participation, utilization of translated materials, and in-person recruitments contributed to enrolling a demographically diverse sample. CONCLUSIONS Although all methods were deployed in the same hospital or neighborhood and shared the same staff, each recruitment method was different in terms of cost and characteristics of the enrolled participants, suggesting the importance of carefully choosing the recruitment methods based on the desired composition of the final study sample. This analysis provides information about the effectiveness and cost of different methods to recruit adults for genetic research.
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Hequembourg AL, Panagakis C. Maximizing respondent-driven sampling field procedures in the recruitment of sexual minorities for health research. SAGE Open Med 2019; 7:2050312119829983. [PMID: 30800299 PMCID: PMC6379799 DOI: 10.1177/2050312119829983] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 01/14/2019] [Indexed: 11/24/2022] Open
Abstract
Objectives: Research to address the significant health burden experienced by sexual
minority populations remains hampered by a lack of appropriate sampling
methods to support evidence-based studies. Respondent-driven sampling offers
one viable strategy to recruit these hidden populations. Because few studies
systematically report their experiences using respondent-driven sampling to
recruit sexual minorities, this article aligns with recent recommendations
for the standardization of reporting and transparency in studies utilizing
respondent-driven sampling. We (1) provide detailed descriptions about the
successful execution of respondent-driven sampling in two community-based
studies of sexual minority individuals, (2) outline procedures to enhance
the effectiveness of respondent-driven sampling referral processes, (3)
present mixed-methods results regarding the effectiveness of
respondent-driven sampling in our studies, and (4) offer recommendations for
other researchers when using respondent-driven sampling. Methods: We successfully recruited 655 sexual minority men and women for two studies
using respondent-driven sampling. Results: Resulting metrics indicate the successful achievement of equilibrium in each
study. In addition, exit interviews elucidated strategies to effectively
target referrals who meet the study criteria and procedures to promote the
study that will maximize referral chains and ensure attainment of
equilibrium. Conclusion: Mixed-methods results suggest that respondent-driven sampling can be an
effective means of recruiting a community-based sample of sexual minorities
in smaller urban regions. Limitations are presented and suggestions are
offered to researchers utilizing respondent-driven sampling in future
studies.
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Frandsen M, Thow M, Ferguson SG. The Effectiveness Of Social Media (Facebook) Compared With More Traditional Advertising Methods for Recruiting Eligible Participants To Health Research Studies: A Randomized, Controlled Clinical Trial. JMIR Res Protoc 2016; 5:e161. [PMID: 27511829 PMCID: PMC4997003 DOI: 10.2196/resprot.5747] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 06/21/2016] [Accepted: 07/20/2016] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Recruiting participants for research studies can be difficult and costly. The popularity of social media platforms (eg, Facebook) has seen corresponding growth in the number of researchers turning to social networking sites and their embedded advertising frameworks to locate eligible participants for studies. Compared with traditional recruitment strategies such as print media, social media advertising has been shown to be favorable in terms of its reach (especially with hard-to-reach populations), cost effectiveness, and usability. However, to date, no studies have examined how participants recruited via social media progress through a study compared with those recruited using more traditional recruitment strategies. OBJECTIVES (1) Examine whether visiting the study website prior to being contacted by researchers creates self-screened participants who are more likely to progress through all study phases (eligible, enrolled, completed); (2) compare conversion percentages and cost effectiveness of each recruitment method at each study phase; and, (3) compare demographic and smoking characteristics of participants recruited through each strategy to determine if they attract similar samples. METHODS Participants recruited to a smoking cessation clinical trial were grouped by how they had become aware of the study: via social media (Facebook) or traditional media (eg, newspaper, flyers, radio, word of mouth). Groups were compared based on throughput data (conversion percentages and cost) as well as demographic and smoking characteristics. RESULTS Visiting the study website did not result in individuals who were more likely to be eligible for (P=.24), enroll in (P=.20), or complete (P=.25) the study. While using social media was more cost effective than traditional methods when we examined earlier endpoints of the recruitment process (cost to obtain a screened respondent: AUD $22.73 vs $29.35; cost to obtain an eligible respondent: $37.56 vs $44.77), it was less cost effective in later endpoints (cost per enrolled participant: $56.34 vs $52.33; cost per completed participant: $103.66 vs $80.43). Participants recruited via social media were more likely to be younger (P=.001) and less confident in their quit attempts (P=.004) compared to those recruited via traditional methods. CONCLUSIONS Our study suggests that while social media advertising may be effective in generating interest from potential participants, this strategy's ability to attract conscientious recruits is more questionable. Researchers considering using online resources (eg, social media advertising, matrix codes) should consider including prescreening questions to promote conversion percentages. Ultimately, researchers seeking to maximize their recruitment budget should consider using a combination of advertising strategies. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN 12614000329662; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=365947l (Archived by WebCite at http://www.webcitation.org/6jc6zXWZI).
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Affiliation(s)
- Mai Frandsen
- School of Health Sciences, Faculty of Health, University of Tasmania, Launceston, Australia.
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Prescott TL, Phillips Ii G, DuBois LZ, Bull SS, Mustanski B, Ybarra ML. Reaching Adolescent Gay, Bisexual, and Queer Men Online: Development and Refinement of a National Recruitment Strategy. J Med Internet Res 2016; 18:e200. [PMID: 27492781 PMCID: PMC4990715 DOI: 10.2196/jmir.5602] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 06/12/2016] [Accepted: 06/13/2016] [Indexed: 11/13/2022] Open
Abstract
Background Using social networking websites to recruit research participants is increasingly documented in the literature, although few studies have leveraged these sites to reach those younger than 18 years. Objective To discuss the development and refinement of a recruitment protocol to reach and engage adolescent gay, bisexual, and other teenaged men who have sex with men (AGBM). Participants were recruited for development and evaluation activities related to Guy2Guy, a text messaging–based human immunodeficiency virus infection prevention program. Methods Eligibility criteria included being between 14 to 18 years old; being a cisgender male; self-identifying as gay, bisexual, and/or queer; being literate in English, exclusively owning a cell phone, enrolled in an unlimited text messaging plan, intending to keep their current phone number over the next 6 months, and having used text messaging for at least the past 6 months. Recruitment experiences and subsequent steps to refine the Internet-based recruitment strategy are discussed for 4 research activities: online focus groups, content advisory team, beta test, and randomized controlled trial (RCT). Recruitment relied primarily on Facebook advertising. To a lesser extent, Google AdWords and promotion through partner organizations working with AGBM youth were also utilized. Results Facebook advertising strategies were regularly adjusted based on preidentified recruitment targets for race, ethnicity, urban-rural residence, and sexual experience. The result was a diverse sample of participants, of whom 30% belonged to a racial minority and 20% were Hispanic. Facebook advertising was the most cost-effective method, and it was also able to reach diverse recruitment goals: recruitment for the first focus group cost an average of US $2.50 per enrolled participant, and it took 9 days to enroll 40 participants; the second focus group cost an average of US $6.96 per enrolled participant, and it took 11 days to enroll 40 participants. Recruitment for the first content advisory team cost an average of US $32.52 per enrolled participant; the second cost US $29.52 per participant. Both recruitment drives required 10 days to enroll 24 participants. For the beta test, recruitment cost an average of US $17.19 per enrolled participant, and it took 16 days to complete enrollment of 20 participants. For the RCT, recruitment cost an average of US $12.54 per enrolled participant, and it took 148 days to enroll 302 participants. Google AdWords campaigns did not result in any enrolled participants of whom the research staff members were aware. Conclusions Internet-based strategies can be a cost-efficient means to recruit and retain hard-to-reach populations from across the country. With real-time monitoring of participant demographic characteristics, diverse samples can be achieved. Although Facebook advertising was particularly successful in this study, alternative social media strategies can be explored in future research as these media are ever-changing.
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Affiliation(s)
- Tonya L Prescott
- Center for Innovative Public Health Research, San Clemente, CA, United States
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Carter-Harris L, Bartlett Ellis R, Warrick A, Rawl S. Beyond Traditional Newspaper Advertisement: Leveraging Facebook-Targeted Advertisement to Recruit Long-Term Smokers for Research. J Med Internet Res 2016; 18:e117. [PMID: 27306780 PMCID: PMC4927805 DOI: 10.2196/jmir.5502] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 02/24/2016] [Accepted: 03/21/2016] [Indexed: 12/18/2022] Open
Abstract
Background Smokers are a stigmatized population, but an important population to reach for the purpose of research. Therefore, innovative recruitment methods are needed that are both cost-effective and efficacious in recruiting this population. Objective The aim of the present article was to evaluate the feasibility of Facebook-targeted advertisement to recruit long-term smokers eligible for lung cancer screening for a descriptive, cross-sectional survey. Methods A social media recruitment campaign was launched using Facebook-targeted advertisement to target age and keywords related to tobacco smoking in the Facebook users profile, interests, and likes. A 3-day newspaper advertisement recruitment campaign was used as a comparison. The study that used both recruitment methods aimed to test the psychometric properties of 4 newly developed lung cancer screening health belief scales. Data were collected via cross-sectional survey methodology using an Web-based survey platform. Results The Facebook-targeted advertisements were viewed 56,621 times over an 18-day campaign in 2015 in the United States. The advertisement campaign yielded 1121 unique clicks to the Web-based survey platform at a cost of $1.51 per completed survey. Of those who clicked through to the study survey platform, 423 (37.7%) consented to participate; 92 (8.2%) dropped out during completion of the survey yielding a final study pool of 331 completed surveys. Recruitment by newspaper advertisement yielded a total of 30 participants in response to a 3-day advertisement campaign; recruitment efficacy resulted in 10 participants/day at $40.80 per completed survey. Participants represented current (n=182; 51%) and former smokers (n=178; 49%) with a mean age of 63.4 years (SD 6.0). Cost of the advertisement campaign was $500 total for the 18-day campaign. Conclusions Recruitment by Facebook was more efficacious and cost-effective compared with newspaper advertisement. Facebook offers a new venue for recruitment into research studies that offer the potential for wider reach at a lower cost while providing privacy and flexibility for potential study participants. The study’s findings extend recent work of other researchers who have demonstrated Facebook’s utility with younger smokers, and Facebook is an effective tool to recruit older smokers. Furthermore, Facebook is a cost-effective alternative to traditional newspaper advertisement offering a new, affordable venue to recruit large numbers of older smokers efficiently.
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