Internet-based recruitment to a depression prevention intervention: lessons from the Mood Memos study.

BACKGROUND: Recruiting participants to randomized controlled trials of health interventions can be very difficult. Internet-based recruitment is becoming an increasingly important mode of recruitment, yet there are few detailed accounts of experiences recruiting participants to mental health interventions. OBJECTIVE: To report on our experience with Internet-based recruitment to an online depression prevention intervention and pass on lessons we learned. METHODS: Participants were recruited to the Mood Memos study, an online preventive depression intervention, purely through Internet-based sources. The study was targeted to adults with subthreshold depression symptoms from several English-speaking countries. A variety of online recruitment sources were trialed, including search engine advertising (Google, Yahoo!, Bing), Facebook advertising, posts in forums and online noticeboards, and promotion through relevant websites and email newsletters of mental health organizations. RESULTS: The study website received visits from 94,808 individuals over the 14-month recruitment period. The recruitment target was reached with 1699 individuals signing up to the randomized controlled trial and 1326 fully enrolling. Most visitors arrived via Google advertising, which promoted a depression-screening questionnaire. Google advertising accounted for nearly half of the total participants who signed up to the study, at an average cost of AUD $12 per participant. Promoting the study through trustworthy organizations and websites known to participants was also effective. Recruitment techniques that were less effective were contacting forums, email groups, and community noticeboards. CONCLUSIONS: Several techniques, including Google advertising, were successful in recruiting participants to a trial evaluating an online depression intervention. Results suggest that Internet-based recruitment to mental health interventions is feasible and can be relatively affordable. TRIAL REGISTRATION: ACTRN12609000925246.

Psychiatric labels and other influences on young people's stigmatizing attitudes: Findings from an Australian national survey.

BACKGROUND: Stigma is a major impediment to help seeking for mental disorders by young people. To reduce stigma and improve help seeking, a better understanding of the influences on different components of stigma for different disorders is required. METHODS: In 2011, a telephone interview was conducted with a national sample of 2522 Australians aged 15-25 years. Participants were presented with a vignette of a young person portraying either depression, depression with suicidal thoughts, social phobia, post-traumatic stress disorder or psychosis. They were then asked what they thought was wrong with the person, exposure to mental health problems in themselves and in family or friends, stigmatizing attitudes, and their awareness of beyondblue. RESULTS: Accurate psychiatric labeling of the mental disorder presented in the vignette and beyondblue awareness were the best predictors of less stigmatizing attitudes, followed closely by exposure to family or friends with mental health problems. Across vignettes, the personally held stigmatizing perception of mental health problems as a weakness rather than an illness was most strongly associated with these predictors. LIMITATIONS: Stigma and labeling were assessed with reference to a vignette character and may not reflect actual experience or behaviors. Other limitations include the cross-sectional design and potential for social desirability bias in the stigma measure. CONCLUSIONS: Findings suggest that community awareness campaigns (such as those by beyondblue) that encourage appropriate close contact with others affected by mental health problems and improved accurate psychiatric label use may have potential to counter various aspects of stigma, especially personal beliefs that mental illness is a weakness.