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Messina A, Elmotarajji S, Dalmasso E, Valentini C, Remorgida V, Leo L, Libretti A, Masturzo B. Etonogestrel Subdermal Implant in Adolescents: Everything We Should Know to Conduct Proper Counseling, a Narrative Review. Clin Pract 2025; 15:27. [PMID: 39996697 PMCID: PMC11854511 DOI: 10.3390/clinpract15020027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2024] [Revised: 01/14/2025] [Accepted: 01/24/2025] [Indexed: 02/26/2025] Open
Abstract
Background/Objectives: Comprehensive sexual education and access to contraceptives play a vital role in alleviating the economic, health, and social challenges associated with unplanned pregnancies in adolescents. According to the World Health Organization (WHO), adolescence refers to the transitional stage from childhood to adulthood, encompassing individuals aged 10 to 19. This period is critical for reproductive decision making, making it essential to closely observe patterns of sexual activity and contraceptive use among young people. Despite advancements, many adolescents still encounter significant barriers to accessing and effectively utilizing contraceptive methods. Methods: A bibliographic search was performed across three major biomedical databases: PubMed, Embase, and CINAHL. The research question was developed utilizing the PIO (Population, Intervention, Outcome) framework to guide the investigation. Results: Long-acting reversible contraceptives (LARCs), including the etonogestrel (ENG) implant, have been recognized for their ability to significantly reduce maternal and neonatal mortality and morbidity as well as decrease the incidence of unsafe abortions. Conclusions: Access to adequate counseling and effective contraceptive services can profoundly impact young people's lives, preventing unplanned pregnancies and promoting optimal sexual and reproductive health.
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Affiliation(s)
- Alessandro Messina
- Department of Obstetrics and Gynecology, University Hospital “Degli Infermi”, 13875 Ponderano, Italy; (A.M.); (S.E.); (E.D.); (C.V.); (B.M.)
| | - Safae Elmotarajji
- Department of Obstetrics and Gynecology, University Hospital “Degli Infermi”, 13875 Ponderano, Italy; (A.M.); (S.E.); (E.D.); (C.V.); (B.M.)
- Health Science Interdisciplinary Center, Scuola Superiore Sant’Anna, 56126 Pisa, Italy
| | - Eleonora Dalmasso
- Department of Obstetrics and Gynecology, University Hospital “Degli Infermi”, 13875 Ponderano, Italy; (A.M.); (S.E.); (E.D.); (C.V.); (B.M.)
| | - Costanza Valentini
- Department of Obstetrics and Gynecology, University Hospital “Degli Infermi”, 13875 Ponderano, Italy; (A.M.); (S.E.); (E.D.); (C.V.); (B.M.)
| | - Valentino Remorgida
- Department of Gynaecology and Obstetrics, University Hospital Maggiore della Carità, 28100 Novara, Italy;
| | - Livio Leo
- Department of Obstetrics and Gynecology, Hospital Beauregard, AUSL Valleè d’Aoste, 11100 Aosta, Italy;
| | - Alessandro Libretti
- Department of Gynaecology and Obstetrics, University Hospital Maggiore della Carità, 28100 Novara, Italy;
| | - Bianca Masturzo
- Department of Obstetrics and Gynecology, University Hospital “Degli Infermi”, 13875 Ponderano, Italy; (A.M.); (S.E.); (E.D.); (C.V.); (B.M.)
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Schwinn TM, Weisblum M, Trussell E, Yamshon R, Sheira D. Recruiting sexual minority youth for a drug abuse prevention trial: Comparing Instagram and Facebook. Contemp Clin Trials 2025; 148:107772. [PMID: 39631535 DOI: 10.1016/j.cct.2024.107772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 11/03/2024] [Accepted: 11/29/2024] [Indexed: 12/07/2024]
Abstract
BACKGROUND Despite youth's shift from Facebook to Instagram, the literature on how to use Instagram to recruit youth for clinical trials is scant. This paper reports procedures and comparative metrics on the use of Facebook and Instagram to recruit a nationwide sample (N = 1216) of LGBQ youth, aged 15 and 16 years, for an online drug abuse prevention trial. METHODS Our recruitment campaign used ads on Facebook and promoted posts on Instagram. Ads and posts shared common images, headlines, and captions. Ads and posts directed youth to a study recruitment website for informed consent and enrollment procedures. RESULTS Our campaign ran for 48 non-consecutive days, yielded N = 1216 participants, had a total cost of $25,400.31, and an average cost per participant of $20.89. Facebook ads and Instagram promoted posts ran for a similar number of days. However, compared to Instagram, Facebook ads cost more than twice as much (115 %), had 51 % fewer clicks, and had an average cost-per-click that was 338 % higher. Furthermore, despite being shown to users more than 4 times as often and garnering more than twice as many unique views, Facebook ads had a click-through-rate that was 90 % lower than Instagram promoted posts. CONCLUSION Instagram promoted posts outperformed ads on Facebook by driving more potential participants to the study recruitment website and for less money.
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Affiliation(s)
- Traci M Schwinn
- Columbia University School of Social Work, 1255 Amsterdam Ave, New York, USA.
| | - Margaret Weisblum
- Columbia University School of Social Work, 1255 Amsterdam Ave, New York, USA.
| | - Emma Trussell
- Columbia University School of Social Work, 1255 Amsterdam Ave, New York, USA.
| | - Rachel Yamshon
- Columbia University School of Social Work, 1255 Amsterdam Ave, New York, USA.
| | - Dina Sheira
- Columbia University School of Social Work, 1255 Amsterdam Ave, New York, USA
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Jones K, Wilson-Keates B, Melrose S. Using social media to recruit research participants: a literature review. Nurse Res 2024; 32:28-34. [PMID: 38105712 DOI: 10.7748/nr.2023.e1859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND It may be challenging for researchers to recruit enough participants to have a diverse and representative sample for their studies. Usual recruitment methods that were historically effective can be difficult to use because of high costs, time constraints and geographical limitations. Social media is a low-cost, time-saving alternative. AIM To summarise the benefits and challenges of using social media for recruitment. DISCUSSION This article provides an overview of social media. It considers the advantages of social media for recruitment, including its cost-effectiveness, accessibility, speed and potential exposure for researchers. It also discusses the challenges of using social media for recruitment, including ethical ambiguity, homogenous sampling and questionable validity of information gathered. CONCLUSION Using social media for research saves time and reduces costs, increasing access to hard-to-reach populations and the reach of recruitment efforts. IMPLICATIONS FOR PRACTICE Options for researchers wishing to use social media for study recruitment are outlined, as are strategies for managing some of the challenges involved in this recruitment method.
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Hogan AH, Herbst KW, Defelice C, Schulman N, Adams AM, Carroll CL, Salazar JC. Going Viral: Assessing the Impact of Social Media on Enrollment in a Coronavirus Disease 2019 (COVID-19) Cohort Study. Cureus 2024; 16:e56096. [PMID: 38618422 PMCID: PMC11009901 DOI: 10.7759/cureus.56096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2024] [Indexed: 04/16/2024] Open
Abstract
Objective This study aimed to quantify the effect of social media posts on study enrollment among children with mild coronavirus disease 2019 (COVID-19). Methods The primary outcome was weekly study enrollments analyzed using a run chart. A secondary analysis used linear regression to assess study enrollments two days before and after a social media post, adjusted for the statewide pediatric seven-day-average severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) case rate, social media posting day, and the interaction of these two variables. Results In seven months before social media posting, only eight patients were enrolled. One week after social media posting began, the median weekly enrollment increased (0 to 3). In the regression model, neither social media post day nor the pediatric SARS-CoV-2 case rate was significantly associated with enrollment rate. However, the interaction of a post day and the pediatric case rate was significant. Conclusion Social media posts significantly increased enrollment among children with mild COVID-19 in a prospective study. This effect was amplified by the presence of high community case rates during the Omicron wave.
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Affiliation(s)
- Alexander H Hogan
- Division of Pediatric Hospital Medicine, Connecticut Children's Medical Center, Hartford, USA
- Department of Pediatrics, University of Connecticut School of Medicine, Farmington, USA
| | - Katherine W Herbst
- Department of Research, Connecticut Children's Medical Center, Hartford, USA
| | - Carlie Defelice
- Department of Research, Connecticut Children's Medical Center, Hartford, USA
| | - Noah Schulman
- Department of Research, Connecticut Children's Medical Center, Hartford, USA
| | - Aaron M Adams
- Department of Geography, University of Connecticut, Storrs, USA
| | - Christopher L Carroll
- Department of Pediatrics, Wolfson Children's Hospital, Jacksonville, USA
- Department of Pediatrics, University of Florida College of Medicine, Jacksonville, USA
| | - Juan C Salazar
- Division of Infectious Disease, Connecticut Children's Medical Center, Hartford, USA
- Department of Pediatrics, University of Connecticut School of Medicine, Farmington, USA
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Salem M, Pollack L, Zepeda A, Tebb KP. Utilization of online systems to promote youth participation in research: A methodological study. World J Methodol 2023; 13:210-222. [PMID: 37771869 PMCID: PMC10523248 DOI: 10.5662/wjm.v13.i4.210] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 06/09/2023] [Accepted: 07/06/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Online surveys can align with youth's increased use of the internet and can be a mechanism for expanding youth participation in research. This is particularly important during the coronavirus disease 2019 (COVID-19) pandemic, when in-person interactions are limited. However, the advantages and drawbacks of online systems used for research need to be carefully considered before utilizing such methodologies. AIM To describe and discuss the strengths and limitations of an online system developed to recruit adolescent girls for a sexual health research study and conduct a three-month follow up survey. METHODS This methodology paper examines the use of an online system to recruit and follow participants three months after their medical visit to evaluate a mobile sexual and reproductive health application, Health-E You/Salud iTuTM, for adolescent girls attending school-based health centers (SBHCs) across the United States. SBHC staff gave adolescent girls a web link to an online eligibility and consent survey. Participants were then asked to complete two online surveys (baseline and 3-month follow-up). Surveys, reminders, and incentives to complete them were distributed through short message service (SMS) text messages. Upon completing each survey, participants were also sent an email with a link to an electronic gift card as a thank-you for their participation. Barriers to implementing this system were discussed with clinicians and staff at each participating SBHC. RESULTS This online recruitment and retention system enabled participant recruitment at 26 different SBHCs in seven states across the United States. Between September 2021 and June 2022, 415 adolescent girls were screened using the Qualtrics online survey platform, and 182 were eligible to participate. Of those eligible, 78.0% (n = 142) completed the baseline survey. Participants were racially, geographically, and linguistically diverse. Most of the participants (89.4%) were non-White, and 40.8% spoke Spanish. A total of 62.0% (n = 88) completed the 3-month follow-up survey. Limitations of this system included reliance on internet access (via Wi-Fi or cell service), which was not universally available or reliable. In addition, an individual unrelated to the study obtained the survey link, filled out multiple surveys, and received multiple gift cards before the research team discovered and stopped this activity. As a result, additional security protocols were instituted. CONCLUSION Online systems for health research can increase the reach and diversity of study participants, reduce costs for research personnel time and travel, allow for continued study operation when in-person visits are limited (such as during the COVID-19 pandemic), and connect youth with research using technology. However, there are challenges and limitations to online systems, which include limited internet access, intermittent internet connection, data security concerns, and the potential for fraudulent users. These challenges should be considered prior to using online systems for research.
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Affiliation(s)
- Marie Salem
- Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA 94158, United States
| | - Lance Pollack
- Division of Prevention Science, University of California San Francisco, San Francisco, CA 94105, United States
| | - Alex Zepeda
- Research, Los Angeles Trust for Children's Health, Los Angeles, CA 90017, United States
| | - Kathleen P Tebb
- Department of Pediatrics, University of California San Francisco, San Francisco, CA 94143, United States
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Tsaltskan V, Sanchez Baez R, Firestein GS. Cost-effectiveness of social media advertising as a recruitment tool: A systematic review and meta-analysis. J Clin Transl Sci 2023; 7:e180. [PMID: 37745929 PMCID: PMC10514690 DOI: 10.1017/cts.2023.596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 09/26/2023] Open
Abstract
Background Recruitment of study participants is challenging and can incur significant costs. Social media advertising is a promising method for recruiting clinical studies and may improve cost efficiency by targeting populations likely to match a study's qualifications. Prior systematic reviews of social media as a recruitment tool have been favourable, however, there are no meta-analyses of its cost-effectiveness. Methods Studies evaluating recruitment costs through social media and non-social media methods were identified on MEDLINE and EMBASE. Articles were screened through a two-step process in accordance with PRISMA guidelines. Cost data were extracted from selected articles and meta-analyzed using the Mantel-Haenszel method. The primary outcome was the relative cost-effectiveness of social media compared to non-social media recruitment, defined as the odds ratio of recruiting a participant per US dollar spent. The secondary outcome was the cost-effectiveness of social media recruitment compared to other online recruitment methods only. Results In total, 23 studies were included in the meta-analysis. The odds ratio of recruiting a participant through social media advertising compared to non-social media methods per dollar spent was 1.97 [95% CI 1.24-3.00, P = 0.004]. The odds ratio of recruiting a participant through social media compared to other online methods only was 1.66 [95% CI 1.02-2.72, P = 0.04]. Conclusions Social media advertising may be more cost-effective than other methods of recruitment, however, the magnitude of cost-effectiveness is highly variable between studies. There are limited data on newer social media platforms and on difficult-to-reach populations such as non-English speakers or older individuals.
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Affiliation(s)
- Vladislav Tsaltskan
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Roel Sanchez Baez
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Gary S. Firestein
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
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Darko EM, Kleib M, Olson J. Social Media Use for Research Participant Recruitment: Integrative Literature Review. J Med Internet Res 2022; 24:e38015. [PMID: 35925655 PMCID: PMC9389385 DOI: 10.2196/38015] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 06/15/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Social media tools have provided health researchers with the opportunity to engage with communities and groups in a nonconventional manner to recruit participants for health research. Using social media to advertise research opportunities and recruit participants facilitates accessibility to participants from broad geographical areas and diverse populations. However, little guidance is provided by ethics review boards for researchers to effectively use this recruitment method in their research. OBJECTIVE This study sought to explore the literature on the use of social media for participant recruitment for research studies and identify the best practices for recruiting participants using this method. METHODS An integrative review approach was used to synthesize the literature. A total of 5 health sciences databases, namely, EMBASE (Ovid), MEDLINE (Ovid and EBSCOhost), PsycINFO (Ovid), Scopus (Elsevier), and CINAHL Plus with Full Text (EBSCOhost), were searched using predefined keywords and inclusion and exclusion criteria. The initial search was conducted in October 2020 and was updated in February 2022. Descriptive and content analyses were applied to synthesize the results, and the findings are presented in a narrative and tabular format. RESULTS A total of 96 records were included in this review, 83 (86%) from the initial search and 13 (14%) from the updated search. The publication year ranged between 2011 and 2022, with most publications (63/96, 66%) being from the United States. Regarding recruitment strategy, 45% (43/96) of the studies exclusively used social media, whereas 51% (49/96) used social media in conjunction with other strategies. The remaining 4% (4/96) provided guidelines and recommendations for social media recruitment. Notably, 38% (36/96) of these studies involved hard-to-reach populations. The findings also revealed that the use of social media is a cost-effective and efficient strategy for recruiting research participants. Despite the expanded use across different populations, there is limited participation of older adults in social media recruitment. CONCLUSIONS This review provides important insights into the current use of social media for health research participant recruitment. Ethics boards and research support services in academic institutions are encouraged to explicitly provide researchers with guidelines on the use of social media for health research participant recruitment. A preliminary guideline prepared based on the findings of this review is proposed to spark further development in this area.
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Affiliation(s)
- Elizabeth Mirekuwaa Darko
- College of Health Sciences, Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, Edmonton, AB, Canada
| | - Manal Kleib
- College of Health Sciences, Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, Edmonton, AB, Canada
| | - Joanne Olson
- College of Health Sciences, Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, Edmonton, AB, Canada
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Grubb LK. School-based Health Centers, Computer-delivered Health Care, and the Value of the Warm Handoff: Optimizing Behavioral Interventions for At-risk Adolescents. J Adolesc Health 2022; 70:523-524. [PMID: 35305789 PMCID: PMC8924470 DOI: 10.1016/j.jadohealth.2022.01.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 01/10/2022] [Indexed: 11/29/2022]
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Promoting teen-to-teen contraceptive communication with the SpeakOut intervention, a cluster randomized trial. Contraception 2021; 105:80-85. [PMID: 34520728 DOI: 10.1016/j.contraception.2021.08.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 08/25/2021] [Accepted: 08/28/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND To improve teen contraceptive use, the SpeakOut intervention combines structured counseling, online resources, and text reminders to encourage teens to share their experiences using intrauterine contraception (IUC) or an implant with peers. METHODS To evaluate the effectiveness of remote delivery of the SpeakOut intervention in increasing teen contraceptive use, we conducted a cluster randomized trial involving female adolescents who were recruited online. Primary participants (n = 520) were randomly assigned to receive SpeakOut or an attention control; each primary participant recruited a cluster of up to 5 female peers as secondary participants (n = 581). We assessed contraceptive communication, knowledge, and use, at baseline, 3 and 9 months after participants enrolled. We examined differences between study groups, controlling for clustering by primary participant and baseline characteristics. RESULTS The trial's primary outcome, contraceptive use by secondary participants, was similar between groups at both 3 and 9 months postintervention. Compared to controls, primary participants receiving SpeakOut tended to be less likely to discontinue contraception within 9 months (4.8% vs 7.8%, p = 0.11 for IUC; 7.8% vs 9.8%, p = 0.45 for implants), but this did not reach statistical significance. SpeakOut failed to increase contraceptive communication; regardless of study group, most secondary participants reported peer communication about contraception (86% vs 88%, p = 0.57). Most secondary participants were aware of the hormonal IUC (91.4% vs 90.4%, p = 0.72), copper IUC (92.9% vs 88.6%, p = 0.13), and implant (96.5% vs 96.1%, p = 0.83) 3 months after enrolling, regardless of the intervention their primary participant received. However, contraceptive knowledge remained incomplete in all study groups. CONCLUSION Remote delivery of the SpeakOutintervention did not improve contraceptive communication, knowledge or use among participating teens or their peers. IMPLICATIONS Efforts to support teen-to-teen contraceptive communication and ensure that teens have accurate information about the full range of contraceptive methods, including highly effective reversible contraceptives, require refinement.
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