Comparing recruitment strategies for a digital smoking cessation intervention: Technology-assisted peer recruitment, social media, ResearchMatch, and smokefree.gov

https://doi.org/10.1016/j.cct.2021.106314Get rights and content

Highlights

  • Recruitment remains an issue for digital smoking cessation interventions.

  • Technology peer recruitment via Facebook, email and text may increase reach.

  • Peer recruits were lower educated, younger, and more gender-proportionate.

  • Peer recruits had greater connections to other smokers in 4 of 6 social networks.

  • Peer recruitment has real-world dissemination potential in future trials.

Abstract

Background

Choosing the right recruitment strategy has implications for the successful conduct of a trial. Our objective was to compare a novel peer recruitment strategy to four other recruitment strategies for a large randomized trial testing a digital tobacco intervention.

Methods

We compared enrollment rates, demographic and baseline smoking characteristics, and odds of completing the 6-month study by recruitment strategy. Cost of recruitment strategies per retained participant was calculated using staff personnel time and advertisement costs.

Findings

We enrolled 1487 participants between August 2017 and March 2019 from: Peer recruitment n = 273 (18.4%), Facebook Ads n = 505 (34%), Google Ads = 200 (13.4%), ResearchMatch n = 356 (23.9%) and Smokefree.gov n = 153 (10.3%). Mean enrollment rate per active recruitment month: 1) Peer recruitment, n = 13.9, 2) Facebook ads, n = 25.3, 3) Google ads, n = 10.51, 4) Research Match, n = 59.3, and 5) Smokefree.gov, n = 13.9. Peer recruitment recruited the greatest number of males (n = 110, 40.3%), young adults (n = 41, 14.7%), participants with a high school degree or less (n = 24, 12.5%) and smokers within one's social network. Compared to peer recruitment (retention rate = 57%), participants from Facebook were less likely (OR 0.46, p < 0.01, retention rate = 40%), and those from ResearchMatch were more likely to complete the study (OR 1.90, p < 0.01, retention rate = 70%). Peer recruitment was moderate in cost per retained participant ($47.18) and substantially less costly than Facebook ($173.60).

Conclusions

Though peer recruitment had lower enrollment than other strategies, it may provide greater access to harder to reach populations and possibly others who smoke within one's social network while being moderately cost-effective.

ClinicalTrials.gov: NCT03224520

Section snippets

Background

Recruitment of participants to randomized trials is an ongoing challenge. Only about 40% of trials are successful in recruiting their proposed sample [1] and many struggle to recruit diverse populations [2]. Despite the promise of increased reach, this is also true for recruitment to trials evaluating digital interventions, such as web-assisted tobacco interventions [3]. There is now increasing recognition that we need more data on different recruitment strategies [4]. Choosing the right

Study design, setting, and participants

The present report is a cohort study of people who smoke who enrolled into a large 6-month hybrid effectiveness dissemination trial (Patient-Centered Outcomes Research Institute funded award (CDR-1603-34,645) testing a web-assisted tobacco digital intervention (Smoker-to-Smoker, or S2S). Eligible participants were asked to participate in a 6-month trial in which they would receive tailored motivational messages related to smoking cessation via email or text, have access to functions on the

Recruitment overview

We recruited 1487 participants using 5 recruitment approaches. The sample consisted of 18% (273/1478) of participants recruited through peer recruitment, 34% (505/1478) via Facebook, 24% (356/1478) via ResearchMatch, 14% (200/1478) via Google ads, and 10% (153/1478) via Smokefree.gov. The mean enrollment rate per active recruitment month by strategy is as follows: 1) Research Match, n = 59.3, 2) Facebook ads, n = 25.3, 3) peer recruitment, n = 13.9, 4) Smokefree.gov, n = 13.9, and 5) Google

Discussion

Recruitment into research trials, including digital trials, continues to present challenges for researchers. We compared a novel peer recruitment approach with other recruitment strategies that are more widely used [4]. Peer recruitment accounted for 18% of enrolled participants and increased the variability and diversity of the sample. Peer recruitment was modestly cost-effective, but also increased the number of participants with lower education levels, greater number of connections to others

Conclusion

Although peer recruitment had a modest enrollment rate (13.9) in comparison to Facebook (25.3) and ResearchMatch (59.3), this should be evaluated in terms of the other potential benefits of peer recruitment. Our findings suggest that peer recruitment may provide greater access to harder to reach populations and possibly others who smoke within one's social network. It was also modestly cost-effective per retained participant in the trial. Using social media approaches may be prudent for

Funding

This work was supported through a Patient-Centered Outcomes Research Institute (PCORI) Program Award (CDR-1603-34645), NHLBI (1K12HL138049-01), and NCI PRACCTIS Grant (CA172009). The content is solely the responsibility of the authors and does not necessarily represent the official views of PCORI or the National Institutes of Health.

Declaration of Competing Interest

None.

Acknowledgements

We would like to thank the S2S program staff, IT team as well as the patient panel members for their contributions to the project.

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