Recruiting young people for digital mental health trials: lessons learned (Preprint)

Abstract

With increasing adoption of remote clinical trials in digital mental health, identifying recruitment methodologies that are both cost-effective and time-efficient is crucial for the success of such trials. Past research suggests that overall, there is no consistent evidence on whether web-based recruitment methods are more effective than traditional methods such as newspapers, media, or flyers. In this paper, we present insights from our experience recruiting Tertiary Education students for a digital mental health trial, Vibe Up.

This study aims to evaluate the effectiveness of recruitment via Facebook/Instagram compared to traditional methods for a treatment trial and compare retention rates of different recruitment methods. With recruitment coinciding with COVID lockdowns across Australia, we also compared the cost effectiveness of social media recruitment during and after COVID lockdowns.

Recruitment was completed for two pilot trials and six mini-trials from June 2021 to May 2022. To recruit participants, paid social media advertising on Facebook and Instagram was used, alongside mailing lists of university networks and students organisations/services, media releases, announcements during classes and events, study posters/flyers on university campuses, and health professional networks. Recruitment data, including engagement metrics collected by Meta (Facebook/Instagram), advertising costs, and Qualtrics data on recruitment methods and rates of survey completion, were analysed using RStudio with R 3.6.3.

In total, 1,314 eligible participants were recruited to 2 pilot trials and 6 mini-trials. Participants were 22.79 years of age (SD = 4.71) and predominately female (n=1079; 82.1%). Of these participants, the vast majority were recruited via Facebook/Instagram advertising (n= 1203; 92%). Pairwise comparisons revealed that the lead institution’s website was more effective in recruiting eligible participants compared to Facebook (z=3.47, P=.003) and Instagram (z=4.23, P<.001). No differences were found between recruitment methods in retaining participants at baseline, at mid-point, and at study completion. Wilcoxon tests found statistically significant differences between COVID lockdown (Pilot 1 & Pilot 2) and post COVID lockdown (mini-trials 1-6) on costs incurred per link click (Lockdown: median cost per click = AUD$0.35 vs. post-lockdown: median cost per click = AUD$1.00; W = 9087, P<.001), and the amount spent per hour to reach the target sample size (Lockdown: median cost per hour = AUD$4.75 vs. post-lockdown: median cost per hour = AUD$13.29; W = 16044, P<.001).

Social media advertising via Facebook and Instagram was the most successful recruitment strategy for recruiting distressed tertiary students into this intervention trial. No recruitment method stood out in terms of participant retention. Perhaps a reflection of the added distress experienced by young people, social media recruitment during the COVID lockdown period was more cost-effective.

ACTRN12621001092886 (Pilots) & ACTRN12621001223820 (Mini-trials)