JMIR Publications

ABSTRACT

Background:

In the US, there are lower rates of breastfeeding among African American mothers, particularly those who are younger women. Recent epidemiological studies have shown a strong association of more aggressive types of breast cancer (ER-) among African American women, with higher risk in those African American women who did not breastfeed their children.

Objective:

This paper describes the methodological processes, benefits and limitations for recruiting and engaging pregnant African American women through a social media conduit for an intervention study addressing the relation between breastfeeding and breast cancer risk reduction. The overarching goal of the pilot study was to determine if social media messaging about breast cancer risk reduction through breastfeeding may positively influence breastfeeding rates among these African American mothers.

Methods:

A mixed methods, randomized study was developed in collaboration with a local Women, Infants and Children (WIC) program to recruit and engage African American pregnant women within their last trimester of pregnancy. Over 200 women were recruited through outgoing e-blast messages, flyers including text keyword response and in-person clinical recruitment to complete pre- and postpartum electronic surveys delivered on smart phones and engage participants in an educational program through private Facebook groups. The intervention group received messages about breast cancer risk reduction and breast feeding and the control group received breastfeeding only messages. Data were obtained through Survey Monkey and qualitative focus groups and interviews.

Results:

Over 3,000 text messages were sent and received over the course of 16 months recruiting women to the study through WIC, local OB/GYN offices and community based organizations. A total of 633 women were assessed for eligibility to participate in the study. Exclusions included n=345 due to not meeting inclusion criteria based on race, n= 29 declined, n=37 did not provide follow up contact information for enrollment, n=26 did not complete pre-survey assessments, and n=9 women gave birth prior to enrolling in Facebook group. A total of n=288 African American pregnant women were enrolled, consented and completed pre-survey assessments (103% of goal). Of these participants, n=135 were randomized into the intervention and n=153 into the control arm. Five electronic applications were used to recruit and engage women for the study: Telerivet, Bitly, Survey Monkey, Facebook and WIC texts.

Conclusions:

Methodologically, this social media approach holds promise for both recruitment and conduct of future intervention studies and researchers should fully explore the capabilities of the social media platforms for African American women. Providing messaging and resources through social media to reinforce breastfeeding and possibly provide lactation support is intriguing. Convenience is a major attribute of social media for this demographic of women and worthy of further research as an educational tool. Clinical Trial: Trial Registration: ClinicalTrials.gov NCT03680235; https://clinicaltrials.gov/ct2/show/NCT03680235