JMIR Publications

ABSTRACT

Background:

Annual lung cancer screening can decrease lung cancer-related mortality by finding cancer at earlier, more treatable stages, yet uptake remains abysmally low in the United States – especially among adults who seldom interact with the health system. Many eligible individuals are unaware that lung cancer screening exists, underscoring the critical need for scalable, population-level communication strategies that increase awareness and engagement.

Objective:

To evaluate Reach, as defined by the RE-AIM framework as the extent to which the target population come in contact with a social media–based strategy, FBTA, designed to connect lung cancer screening–eligible individuals in the United States with a digital health communication message. The advertisement served as a digital outreach strategy for promoting engagement with LungTalk, an evidence-based intervention aimed at increasing awareness and informed decision-making about lung cancer screening (LCS).

Methods:

As part of the INSPIRE Lung Study, five FBTA campaigns were launched over a 79-day period throughout the United States. Advertisements targeted adults aged 50–80 years with interests related to smoking or smoking cessation and linked to a study website where participants could complete an eligibility screener and learn more about the trial. Facebook analytics were used to assess Reach, defined by the number, proportion, and demographic characteristics of individuals exposed to and interacting with FBTA content. Key metrics included total reach, impressions, link clicks, and cost-efficiency.

Results:

The FBTA campaigns reached 1,048,191 unique users and generated 3,109,482 impressions. A total of 24,816 individuals clicked on the ads (2.37% click-through rate), and 7,117 completed the eligibility screener. Of those eligible, 1,272 (17.9%) met lung screening criteria, and of these 483 (38%) enrolled in the trial. The cost per click was $0.40, and the cost per enrolled participant was $19.46. Individuals reached via FBTA were demographically diverse and included many who may be disconnected from traditional healthcare systems.

Conclusions:

FBTA is a scalable, cost-effective strategy to achieve population-level Reach of LCS-eligible adults. By conceptualizing Reach as exposure to an upstream digital message – rather than enrollment alone – this study illustrates how social media can broaden population access to evidence-based cancer prevention tools like LungTalk. Future research should explore embedding intervention content directly into social media platforms and tracking downstream clinical outcomes. Clinical Trial: ClinicalTrials.gov NCT05824273