Effectiveness and Cost of Using Facebook Recruitment to Elicit Canadian Women's Perspectives on Bone Health and Osteoporosis: Cross-Sectional Survey Study.

BACKGROUND: Surveys can help health researchers better understand the public's perspectives and needs regarding prevalent conditions such as osteoporosis, which affects more than two-thirds of postmenopausal women. However, recruitment of large cohorts for survey research can be time-consuming and expensive. With 2.9 billion active users across the globe and reasonable advertising costs, Facebook (Meta Platforms, Inc) has emerged as an effective recruitment tool for surveys, although previous studies have targeted young populations (<50 years of age) and none have focused on bone health. OBJECTIVE: We assessed the effectiveness and cost of using Facebook to recruit Canadian women aged ≥45 years to share their perspectives on bone health and osteoporosis via a web-based survey. METHODS: We developed a 15-minute web-based survey with the goal of eliciting perspectives on bone health and osteoporosis. A Facebook advertisement was placed for 2 weeks in February 2022, during which time it was shown to women of age ≥45 years who resided in Canada, inviting them to participate and offering a chance to win 1 of 5 CAD $100 gift cards (at the time of this study [February 14, 2022], a currency exchange rate of CAD $1=US $0.79 was applicable). Those who clicked on the advertisement were taken to an eligibility screening question on the survey home screen. Individuals who confirmed eligibility were automatically directed to the first survey question. All individuals who answered the first survey question were considered participants and included in the analyses. We determined the survey reach, click rate, cooperation rate, completion rate, cost per click, and cost per participant. Sociodemographic characteristics of respondents were compared with data from the 2021 Canadian Census. RESULTS: The Facebook advertisement was shown to 34,086 unique Facebook users, resulting in 2033 link clicks (click rate: 6.0%). A total of 1320 individuals completed the eligibility screening question, 1195 started the survey itself (cooperation rate: 58.8%), and 966 completed the survey (completion rate: 47.5%). The cost of the advertising campaign was CAD $280.12, resulting in a cost per click of CAD $0.14 and a cost per participant of CAD $0.23. The 1195 participants ranged in age from 45-89 years (mean 65, SD 7 years), 921 (93.7%) were of White ethnicity, 854 (88.3%) had completed some postsecondary education, and 637 (65.8%) resided in urban areas. Responses were received from residents of all 10 Canadian provinces and 2 of 3 territories. When compared to 2021 Canadian Census data, postsecondary education and rural residence were overrepresented in our study population. CONCLUSIONS: Facebook advertising is an efficient, effective, and inexpensive way of recruiting large samples of older women for participation in web-based surveys for health research. However, it is important to recognize that this modality is a form of convenience sampling and the benefits of Facebook recruitment must be balanced with its limitations, which include selection bias and coverage error.

Medication adherence support of an in-home electronic medication dispensing system for individuals living with chronic conditions: a pilot randomized controlled trial.

BACKGROUND: Medication adherence is challenging for older adults due to factors such as the number of medications, dosing schedule, and the duration of drug therapy. The objective of this study was to examine the effectiveness of an in-home electronic medication dispensing system (MDS) on improving medication adherence and health perception in older adults with chronic conditions. METHODS: A pilot Randomized Controlled Trial (RCT) was conducted using a two-arm parallel assignment model. The intervention group used an MDS as their medication management method. The control group continued to use their current methods of medication management. Block randomization was used to assign participants into the intervention or control group. The inclusion criteria included 1) English speaking 2) age 50 and over 3) diagnosed with one or more chronic condition(s) 4) currently taking five or more oral medications 5) City of Calgary resident. Participants were recruited from a primary care clinic in Alberta, Canada. The study was open-label where knowledge about group assigned to participants after randomization was not withheld. Medication adherence was captured over a continuous, six-month period and analyzed using Intention-to-Treat (ITT) analysis. RESULTS: A total of 91 participants were assessed for eligibility and 50 were randomized into the two groups. The number of participants analyzed for ITT was 23 and 25 in the intervention and control group, respectively. Most of the demographic characteristics were comparable in the two groups except the mean age of the intervention group, which was higher compared to the control group (63.96 ± 7.86 versus 59.52 ± 5.93, p-value = 0.03). The average recorded adherence over 26 weeks was significantly higher in the intervention group than the control group (98.35% ± 2.15% versus 91.17% ± 9.76%, p < 0.01). The self-rated medication adherence in the intervention group also showed a significant increase from baseline to 6-month (Z=-2.65, p < 0.01). The control group showed a non-significant increase (Z=-1.79, p = 0.07). CONCLUSION: The MDS can be an effective, long-term solution to medication non-adherence in older adults experiencing chronic conditions and taking multiple medications. The technology induces better consistency and improvement in medication taking behaviour than simple, non-technological intervention. TRIAL REGISTRATION: Registered with ClinicalTrials.gov on April 09, 2020 with identifier NCT04339296 .