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Evaluation of Web-Based and In-Person Methods to Recruit Adults With Type 1 Diabetes for a Mobile Exercise Intervention: Prospective Observational Study.
Ash, Garrett I; Griggs, Stephanie; Nally, Laura M; Stults-Kolehmainen, Matthew; Jeon, Sangchoon; Brandt, Cynthia; Gulanski, Barbara I; Spanakis, Elias K; Baker, Julien S; Whittemore, Robin; Weinzimer, Stuart A; Fucito, Lisa M.
  • Ash GI; Pain, Research, Informatics, Medical Comorbidities and Education Center, Veterans Affairs Connecticut Healthcare System, West Haven, CT, United States.
  • Griggs S; Center for Medical Informatics, Yale University School of Medicine, New Haven, CT, United States.
  • Nally LM; Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, United States.
  • Stults-Kolehmainen M; Section of Pediatric Endocrinology & Diabetes, Yale University School of Medicine, New Haven, CT, United States.
  • Jeon S; Digestive Health Multispecialty Clinic, Yale-New Haven Hospital, New Haven, CT, United States.
  • Brandt C; Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, United States.
  • Gulanski BI; School of Nursing, Yale University, Orange, CT, United States.
  • Spanakis EK; Pain, Research, Informatics, Medical Comorbidities and Education Center, Veterans Affairs Connecticut Healthcare System, West Haven, CT, United States.
  • Baker JS; Center for Medical Informatics, Yale University School of Medicine, New Haven, CT, United States.
  • Whittemore R; Section of Endocrinology, Veterans Affairs Connecticut Healthcare System, West Haven, CT, United States.
  • Weinzimer SA; Section of Endocrinology, Yale University School of Medicine, New Haven, CT, United States.
  • Fucito LM; Division of Endocrinology, Baltimore Veterans Administrative Medical Center, Baltimore, MD, United States.
JMIR Diabetes ; 6(3): e28309, 2021 Jul 08.
Article in English | MEDLINE | ID: covidwho-1526732
ABSTRACT

BACKGROUND:

Our clinical trial of a mobile exercise intervention for adults 18 to 65 years old with type 1 diabetes (T1D) occurred during COVID-19 social distancing restrictions, prompting us to test web-based recruitment methods previously underexplored for this demographic.

OBJECTIVE:

Our objectives for this study were to (1) evaluate the effectiveness and cost of using social media news feed advertisements, a clinic-based approach method, and web-based snowball sampling to reach inadequately active adults with T1D and (2) compare characteristics of enrollees against normative data.

METHODS:

Participants were recruited between November 2019 and August 2020. In method #1, Facebook and Instagram news feed advertisements ran for five 1-to-8-day windows targeting adults (18 to 64 years old) in the greater New Haven and Hartford, Connecticut, areas with one or more diabetes-related profile interest. If interested, participants completed a webform so that the research team could contact them for eligibility screening. In method #2, patients 18 to 24 years old with T1D were approached in person at clinical visits in November and December 2019. Those who were interested immediately completed eligibility screening. Older patients could not be approached due to clinic restrictions. In method #3, snowball sampling was conducted by physically active individuals with T1D contacting their peers on Facebook and via email for 48 days, with details to contact the research staff to express interest and complete eligibility screening. Other methods referred participants to the study similarly to snowball sampling.

RESULTS:

In method #1, advertisements were displayed to 11,738 unique viewers and attracted 274 clickers (2.33%); 20 participants from this group (7.3%) volunteered, of whom 8 (40%) were eligible. Costs averaged US $1.20 per click and US $95.88 per eligible volunteer. Men had lower click rates than women (1.71% vs 3.17%; P<.001), but their responsiveness and eligibility rates did not differ. In method #2, we approached 40 patients; 32 of these patients (80%) inquired about the study, of whom 20 (63%) volunteered, and 2 of these volunteers (10%) were eligible. Costs including personnel for in-person approaches averaged US $21.01 per inquirer and US $479.79 per eligible volunteer. In method #3, snowball sampling generated 13 inquirers; 12 of these inquirers (92%) volunteered, of whom 8 (67%) were eligible. Incremental costs to attract inquirers were negligible, and total costs averaged US $20.59 per eligible volunteer. Other methods yielded 7 inquirers; 5 of these inquirers (71%) volunteered, of whom 2 (40%) were eligible. Incremental costs to attract inquirers were negligible, and total costs averaged US $34.94 per eligible volunteer. Demographic overrepresentations emerged in the overall cohort (ie, optimal glycemic control, obesity, and low exercise), among those recruited by news feed advertisements (ie, obesity and older age), and among those recruited by snowball sampling (ie, optimal glycemic control and low exercise).

CONCLUSIONS:

Web-based advertising and recruitment strategies are a promising means to attract adults with T1D to clinical trials and exercise interventions, with costs comparing favorably to prior trials despite targeting an uncommon condition (ie, T1D) and commitment to an intervention. These strategies should be tailored in future studies to increase access to higher-risk participants. TRIAL REGISTRATION ClinicalTrials.gov NCT04204733; https//clinicaltrials.gov/ct2/show/NCT04204733.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Language: English Journal: JMIR Diabetes Year: 2021 Document Type: Article Affiliation country: 28309

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Language: English Journal: JMIR Diabetes Year: 2021 Document Type: Article Affiliation country: 28309