Screening and Retaining Adolescents Recruited Through Social Media: Secondary Analysis from a Longitudinal Clinical Trial

BACKGROUND

Social media has become a popular method to recruit participants, particularly for studies with hard-to-reach populations. These studies still face challenges in data quality and, for longitudinal studies, sample retention. However, in addition to aiding in recruitment, social media platforms can help researchers with participant verification and tracking procedures during the study. There is limited previous research describing how longitudinal studies can use social media to screen and retain participants.

OBJECTIVE

This paper describes strategies implemented to screen and retain a nationwide sample of sexual minority youth who were recruited through social media platforms for a longitudinal study testing a drug abuse prevention program.

METHODS

Our screening strategies for participants included collecting necessary demographic information (name, phone, email, and social media accounts), verifying this information using publicly available web-based records, and sending confirmation emails to ensure working email addresses and correct dates of birth. Retention strategies included communications designed to develop positive participant relationships, incentives for survey completion, regular updating of participant contact information, targeting hard-to-reach participants, and using social media as an alternative means of contacting participants.

RESULTS

During enrollment, although the only demographic data required were a phone number and an email address, 87.58% (1065/1216) of participants provided their Instagram as an alternative means of contact. This form of alternative communication remains the most preferred with 87.40% (1047/1198) of participants continuing to provide an Instagram username as of January 2023, about 3 years after recruitment began. In comparison, other alternative means of contact (eg, Facebook and alternative email) were provided by only 6.43% (77/1198) to 56.18% (673/1198) of participants. Direct messaging on Instagram was used to successfully confirm participant identity, remind participants to take annual follow-up surveys, and update lost participant contact information. Screening and retention strategies used in the study have helped achieve 96.30% (1171/1216) to 96.79% (1177/1216) sample retention across 3 waves of data collection.

CONCLUSIONS

Though social media can be a helpful tool to recruit participants, attrition and participant authenticity difficulties may be associated with this method. Screening and retention strategies can be implemented to improve retention. Internet searches are effective for screening youth to ensure they meet eligibility requirements. Additionally, social media-Instagram in this study-can help to track and locate participants who do not respond to traditional contact methods.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03954535; https://clinicaltrials.gov/study/NCT03954535.

Using Facebook ads with traditional paper mailings to recruit adolescent girls for a clinical trial

INTRODUCTION

Clinical trials require sufficient samples recruited within limited time and budget constraints. Trials with minors are additionally burdened by the requirement for youth assent and parental permission. This paper details the use of Facebook ads and traditional paper mailings to enroll 797 adolescent girls for a longitudinal, web-based, drug abuse prevention trial. Data on sample representativeness and retention are also provided.

METHODS

Facebook ads appeared on the pages of females aged 13 or 14years who reside in the U.S. Ads linked girls to a recruitment website. Girls who wanted more information submitted contact information and were mailed information packets to their homes containing, among other things, youth assent and parent permission forms. Returned forms were verified for accuracy and validity.

RESULTS

The Facebook ad campaign reached 2,267,848 girls and had a unique click-through rate of 3.0%. The campaign cost $41,202.37 with an average cost of $51.70 per enrolled girl. Information packets were mailed to 1,873 girls. Approximately one-half of girls returned the forms, and 797 girls were enrolled. The Facebook campaign's success varied by ad type, month, and day of the week. Baseline data revealed comparability to national data on demographic and substance use variables.

CONCLUSIONS

Results suggest that Facebook ads provide a useful initial point of access to unparalleled numbers of adolescents. Clinical trials may benefit from a two-fold recruitment strategy that uses online ads to attract interested adolescents followed by traditional recruitment methods to communicate detailed information to adolescents and parents.

Is the Legalization of Marijuana Associated With Its Use by Adolescents?

BACKGROUND

Growing moves in the U.S. toward relaxed laws surrounding adult use of marijuana raise concerns about concurrent increases in adolescent use of marijuana.

OBJECTIVES

This study collected and analyzed primary data on the relationship between marijuana legalization status in U.S. states and adolescents' marijuana use.

METHODS

Recruited through social networking sites and youth-services community agencies, a sample of 1,310 adolescents from 48 U.S. states and the District of Columbia reported their use of marijuana. Youths' use rates were compared with the marijuana legalization status of youths' states of residence.

RESULTS

Study findings failed to show a relationship between adolescents' use of marijuana and state laws regarding marijuana use. Relationships were found for increased marijuana use by older youths, females, and non-Hispanic youths. Youths whose parents completed 2 or more years of college were less likely to report marijuana use than those whose parents completed fewer than 2 years of college.

CONCLUSIONS

Albeit study findings do not support predictions of growing marijuana use by adolescents in states with liberalized adult use laws, further monitoring of adolescents' use with larger and more representative samples is needed.

Drug abuse risk and protective factors among Hispanic adolescents

Drug use is a disquieting problem among the growing population of U.S. Hispanic adolescents. This study examined risk and protective factors associated with drug use in a sample of 507 Hispanic adolescents. Data were collected in 2014 and 2015 from youths across the United States. The sample had a mean age of 14.1 years and was 37.3% male. Youths responded to an online questionnaire about their drug use and risk and protective factors associated with drug use. Negative self-image, higher levels of stress, weaker coping skills, peer drug use, lower levels of self-control, goal-setting, problem-solving skills, and self-efficacy, and higher intentions to use drugs in the future were associated with increased odds of past-month drug use. Youths with higher self-images who spoke mostly English at home were less likely to use drugs than youths with higher self-images who spoke mostly Spanish at home.Study results have implications for gaining a better understanding of drug use risk and protective factors among America's growing population of Hispanic adolescents. Efforts to better examine and enhance Hispanic youths' cognitive-behavioral skills seem a wise investment.

Drug abuse risk and protective factors among black urban adolescent girls: a group-randomized trial of computer-delivered mother-daughter intervention

A group-randomized design tested a mother-daughter intervention in which researchers aimed to increase protective factors in a community sample of Black urban adolescent girls. Girls and their mothers at 2 community agencies were pretested and, by agency, were randomized to either an intervention arm or a control arm. Intervention arm girls and their mothers received a program for improving mother- daughter rapport. Posttest data collected 3 weeks after program delivery revealed that intervention arm mothers and daughters improved more than did control arm mothers and daughters on measures of communication and closeness. At 3-month follow-up, intervention arm mothers, relative to control arm mothers, continued to report better communication with and closeness to their daughters. Girls and mothers in the intervention arm rated the computer program favorably on parameters of enjoyment, comfort, relevance, usefulness of information, improvements to their relationship with one another, and whether they would recommend the computer program to friends.

Preventing Alcohol Abuse among Early Adolescents through Family and Computer-Based Interventions: Four-Year Outcomes and Mediating Variables

III-timed and excessive use of alcohol is associated with multiple and irreversible disabilities. The relationship between perinatal alcohol use and developmental disabilities, including fetal alcohol syndrome, is well documented. Empirical evidence also links alcohol use to a host of other developmental and physical problems among the offspring of drinkers and among drinkers themselves. Toward advancing the science of how to reduce alcohol abuse risks, this study developed and tested family and computer-based approaches for preventing alcohol use among a community sample of inner-city minority youth. Original findings from 4-year follow-up data obtained from over 90% of the study sample document continued positive program outcomes and shed light on cognitive problem solving, peer, and family mediators of alcohol use risk and protective factors among target youth.

Gender-specific computer-based intervention for preventing drug abuse among girls

This study developed and tested a gender-specific intervention for preventing substance abuse among adolescent girls. Delivered on CD-ROM by computer, the program was compared with a conventional substance abuse prevention program delivered live in a group setting. Seventh-grade girls in New York City middle schools completed pretests, and, by school, were randomly assigned to receive either gender-specific computer intervention (GSI) or conventional intervention, and were posttested. Analyses of pretest to posttest gain scores showed GSI girls compared to girls receiving conventional intervention to possess a larger repertoire of stress-reduction methods, to report lower approval of cigarettes, alcohol, and drugs, to identify more unhealthy ways to deal with stress, to report lower likelihood of cigarette use or alcohol consumption if asked to do so by best friends, and to hold stronger plans to avoid cigarettes, alcohol, and drugs in the next year. These modest findings lend credence to the promise of gender-specific, computerized interventions for substance abuse prevention among adolescent girls.