JMIR Publications

ABSTRACT

Background:

In-person health surveys and biomarker collections (e.g., blood testing) provide crucial data to monitor and investigate progress on health outcomes in sub-Saharan Africa. Bearing in mind that administrative sampling frames are often outdated and typically lack important information to target individuals with specific health profiles (e.g., underlying conditions such as HIV or diabetes), it is of substantial policy importance to better understand whether recruitment of individuals for in-person health data collection efforts can be accomplished via online environments such as social media sites. Yet, there is little methodological research on (i) the feasibility for recruitment through online environments and (ii) the factors that drive in-person survey participation rates in sub-Saharan African countries.

Objective:

To share our experiences in the recruitment of individuals from sub-Saharan Africa for the participation in in-person, health-related surveys and biomarker collections via Facebook ads and to share lessons learnt for future researchers.

Methods:

We conducted a preregistered 2x4x4 vignette experiment to investigate people’s willingness to participate in in-person health surveys and blood tests. The experiment was part of a web survey (n ~ 10,600) that we conducted in early 2023 in six sub-Saharan African countries (Ghana, Kenya, Nigeria, South Africa, Tanzania, Uganda). In line with the theory of contextual integrity, the economic participation theory, and the social exchange theory, three factors were varied: (a) the topic (HIV or diabetes), (b) the incentive (0 USD, 2 USD cash, 2 USD voucher, 2 USD lottery), and (c) the sponsor (NGO, statistical office, health ministry, or local university).

Results:

Overall, we find that a majority of survey participants is willing to participate in in-person health surveys and provide biomarkers. Moreover, the results provide evidence in favor of the economic participation and the social exchange theories and against the contextual integrity theory. First, providing a financial incentive significantly increased the likelihood of being willing to participate in in-person health surveys and blood testing. Second, individuals with high levels of trust in the respective survey sponsor were more likely to be willing to participate. In contrast, two factors (topic, sponsor) did not show any direct effects. Other factors that related to an increase in stated survey participation were: fertility levels (having children), being more willing to take risk, being more likely to have an illness (HIV, diabetes), better HIV knowledge, survey enjoyment, survey value, and cognitive skills.

Conclusions:

Together, the study’s results suggest that using online environment for recruiting health research participants in sub-Sharan Africa can be a viable option, and emphasize the importance of adequate compensation and trust in the sponsor. The findings also indicated that several attitudinal but almost none of the socio-demographic variables are systematically related to the willingness to participate in health-related in-person data collection activities.