JMIR Publications

ABSTRACT

Background:

Over 80% of trials worldwide fail to complete patient recruitment within the initially planned timeframe. Over the past decade, the use of social media for recruitment in medical research has become increasingly popular. While Google and Facebook are well established, newer social media channels such as Instagram and TikTok have received less research attention as recruitment tools. Although some studies have investigated the advantages and disadvantages of using social media for recruitment, a considerable gap still exists in understanding the precise mechanisms and factors that make different social media platforms most effective and cost-efficient for patient recruitment in (mental) health studies.

Objective:

This study used a cross-sectional observational design to systematically evaluate the effectiveness of recruitment strategies implemented during the investigative phase of a validation study of a new suicidality assessment questionnaire optimized for primary care.

Methods:

This observational study describes how online recruitment contributed within a few months to 46% of all patients with depressive symptoms for the validation of the suicidality questionnaire (“SuPr-X – Suicide Prevention in Primary Care”), which required over 500 participants. We analyzed differences in sample demographics between traditionally recruited and online participants, compared advertising metrics and conversion rates, and conducted a cost-benefit analysis.

Results:

We found online recruitment to be a fast and efficient method of securing the required number of participants with depressive symptoms for the study and increasing patient diversity. Considering the distribution of gender, age and Patient Health Questionnaire (PHQ)-9 scores, participants found offline and online were equally eligible for the study. Online recruitment demonstrated high advertising efficiency. For example, the study population responded well to video ads on social media, with these performing 50–70% more cost-efficiently than the best image ads. Moreover, a long website copy proved slightly better than a short version. Pixel tracking for improved ad targeting reduced advertising costs per suitable participant by 83.3%, making the ads 6x more cost-efficient.

Conclusions:

Social media recruitment increased the diversity of patients in the studies and proved suitable for vulnerable and hard-to-reach populations. The total cost per patient recruited online was comparable to that achieved using offline methods, but overall recruitment progressed faster. In this study, the implementation of video ads and pixel tracking resulted in significant cost savings.