JMIR Publications

ABSTRACT

Background:

The United States population is rapidly aging and expected to experience continued significant growth. While American adults have seen overall gains in technology adoption and increased dependence on digital technologies, especially during the coronavirus disease (COVID-19) pandemic, the digital divide—the unequal access to digital technology and the internet—persists among older adults age 65 and older. Despite rapid technological advancement and a considerably aging US population, there remains a gap in the literature pertaining to online-based recruitment strategies for older adults.

Objective:

The purpose of this paper is to describe our lessons learned from the experience of recruiting a sample comprised of non-English speaking older individuals who are cognitively impaired along with their caregivers for PLAN (Preparing successful aging through dementia Literacy education And Navigation), an ongoing, community-based randomized controlled trial designed to promote the transition of community-dwelling Korean American older adults with probable dementia and their caregivers into the healthcare system for adequate diagnostic follow-up and care. We also present online-based recruitment strategies focused on older adults reported in relevant published studies to compare with our experiences.

Methods:

Data sources used to identify online-based recruitment strategies and challenges for the PLAN trial included study recruitment tracking files, study team meeting minutes, and interviews with community health workers, community site coordinators, and community consultants. We also conducted a review of published studies in PubMed that used digital technology to recruit community-dwelling older adults.

Results:

Five key themes emerged relevant to the online-based recruitment of community-dwelling older adults: unfamiliarity with technology—limited digital literacy; differences in internet access and use across older age groups; providing technological support to promote recruitment; successful and unsuccessful recruitment using social media; and other diverse online-based methods of recruitment. In particular, direct quotes from multiple sources for the PLAN trial revealed technological challenges that were common among immigrant older adults as the study team went through a series of online-based recruitment activities. While available research indicated similar internet accessibility and use between young-old and older-old adults, actual recruitment using online-based methods was least successful in the older-old group. Some study teams ended up providing technological support through 1-on-1 assistance. Most studies included in the review used social media (often, Facebook) but the success varied across these studies with slightly more than half of the studies reporting little to no success. Similarly, other online-based methods such as e-newsletters, emails, or postings on professional organizational websites yielded varying successes.

Conclusions:

Despite an ongoing increase of internet use among older adults, the literature was limited in the discussion of online-based recruitment among the older participants. Reviewing available studies addressing online-based and older adult-focused recruitment strategies, we found that the most frequently used method across studies was social media, with yield rates spanning 0% to 100%. Part of the data sources used in the review revealed the digital divide along with the issue of limited digital literacy, particularly among non-English speaking immigrant older adults and their caregivers. The usefulness of online-based recruitment of older adults is uncertain due, in large part, to limited sociodemographic diversity noted in the samples recruited in the studies included in the review. Future research needs to explore the role of race/ethnicity and other characteristics such as socioeconomic status, gender, education, access to technology, and digital literacy in relation to online-based recruitment for adequate representation of diverse older adults in research. Clinical Trial: ClinicalTrials.gov NCT03909347