Published on in Vol 18, No 11 (2016): November

The Use of Social Media in Recruitment for Medical Research Studies: A Scoping Review

The Use of Social Media in Recruitment for Medical Research Studies: A Scoping Review

The Use of Social Media in Recruitment for Medical Research Studies: A Scoping Review

Review

1Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada

2Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada

*all authors contributed equally

Corresponding Author:

Jane Topolovec-Vranic, PhD

Li Ka Shing Knowledge Institute

St Michael's Hospital

30 Bond St, Bond 3-012

Toronto, ON, M5B 1W8

Canada

Phone: 1 416 864 6060 ext 3421

Fax:1 416 864 5629

Email: jtopolovecvranic@outlook.com


Background: Recruiting an adequate number of participants into medical research studies is challenging for many researchers. Over the past 10 years, the use of social media websites has increased in the general population. Consequently, social media websites are a new, powerful method for recruiting participants into such studies.

Objective: The objective was to answer the following questions: (1) Is the use of social media more effective at research participant recruitment than traditional methods? (2) Does social media recruit a sample of research participants comparable to that recruited via other methods? (3) Is social media more cost-effective at research participant recruitment than traditional methods?

Methods: Using the MEDLINE, PsycINFO, and EMBASE databases, all medical research studies that used social media and at least one other method for recruitment were identified. These studies were then categorized as either interventional studies or observational studies. For each study, the effectiveness of recruitment, demographic characteristics of the participants, and cost-effectiveness of recruitment using social media were evaluated and compared with that of the other methods used. The social media sites used in recruitment were identified, and if a study stated that the target population was “difficult to reach” as identified by the authors of the study, this was noted.

Results: Out of 30 studies, 12 found social media to be the most effective recruitment method, 15 did not, and 3 found social media to be equally effective as another recruitment method. Of the 12 studies that found social media to be the best recruitment method, 8 were observational studies while 4 were interventional studies. Of the 15 studies that did not find social media to be the best recruitment method, 7 were interventional studies while 8 were observational studies. In total, 8 studies stated that the target population was “hard-to-reach,” and 6 of these studies found social media to be the most effective recruitment method. Out of 14 studies that reported demographic data for participants, 2 studies found that social media recruited a sample comparable to that recruited via traditional methods and 12 did not. Out of 13 studies that reported cost-effectiveness, 5 studies found social media to be the most cost-effective recruitment method, 7 did not, and 1 study found social media equally cost-effective as compared with other methods.

Conclusions: Only 12 studies out of 30 found social media to be the most effective recruitment method. There is evidence that social media can be the best recruitment method for hard-to-reach populations and observational studies. With only 30 studies having compared recruitment through social media with other methods, more studies need to be done that report the effectiveness of recruitment for each strategy, demographics of participants recruited, and cost-effectiveness of each method.

J Med Internet Res 2016;18(11):e286

doi:10.2196/jmir.5698

Keywords



For any study, recruitment of an adequate number of participants who reflect the targeted population is essential. Failure to achieve this goal can compromise the validity of the results, increase costs, and delay or even cause early termination of the study [Gul RB, Ali PA. Clinical trials: the challenge of recruitment and retention of participants. J Clin Nurs 2010 Jan;19(1-2):227-233. [CrossRef] [Medline]1]. This is a major problem today; less than 20% of clinical trials finish on time [Allison M. Can Web 2.0 reboot clinical trials? Nat Biotechnol 2009 Oct;27(10):895-902. [CrossRef] [Medline]2]. Roughly half of these delays are due to difficulties in patient recruitment [Allison M. Can Web 2.0 reboot clinical trials? Nat Biotechnol 2009 Oct;27(10):895-902. [CrossRef] [Medline]2].

Web 2.0, or interactive communication through the Web represents a valuable method of sharing information. In 2015, 90% of Canadian households had access to the Web [Poushter J, Wike R, Bell J, Cuddington D, Deane C, Havemann M, et al. Smartphone ownership and Internet usage continues to climb in emerging economies. Pew Research Center. 2016.   URL: http:/​/www.​pewglobal.org/​files/​2016/​02/​pew_research_center_global_technology_report_final_february_22__2016.​pdf [accessed 2016-06-21] [WebCite Cache]3]. At the forefront of Web usage today are social media websites. For the purposes of this paper, social media websites are defined as websites that let users make profiles and use these profiles to connect and interact with other individuals. The use of such websites is constantly growing, reflecting the population as a whole. As of 2015, the majority of Canadians use social media. The most popular social media website is Facebook with 59% of Canadians having an account [Bozinoff L. Instagram tops in user satisfaction. Forum Research. 2015.   URL: http:/​/poll.​forumresearch.com/​data/​Federal%20Social%20Media%20News%20Release%20(2015%2001%2006)%20Forum%20Research.​pdf [accessed 2016-06-21] [WebCite Cache]4]. While detailed statistics on the increasing use of social media are not available for Canada, in the United States, 65% of US adults used a social media website in 2015, an increase from 7% in 2005 [Perrin A, Duggan M, Rainie L, Smith A, Greenwood S, Porteus M, et al. Social Media Usage: 2005-2015. Social media usage: 2005-2015. Pew Research Center. 2015.   URL: http://www.pewinternet.org/files/2015/10/PI_2015-10-08_Social-Networking-Usage-2005-2015_FINAL.pdf [accessed 2016-06-21] [WebCite Cache]5]. While use increased from 12% to 90% from 2005 to 2015 for the age group 18-29 years, more recently its use has increased rapidly in older populations—it is now used by 77% of 30- to 49-year-olds, 51% of 50- to 64-year-olds, and 35% of those aged 65+ years, increasing from 8%, 5%, and 2%, respectively, in 2005 [Perrin A, Duggan M, Rainie L, Smith A, Greenwood S, Porteus M, et al. Social Media Usage: 2005-2015. Social media usage: 2005-2015. Pew Research Center. 2015.   URL: http://www.pewinternet.org/files/2015/10/PI_2015-10-08_Social-Networking-Usage-2005-2015_FINAL.pdf [accessed 2016-06-21] [WebCite Cache]5]. Furthermore, 56% of low-income individuals now report using social media [Perrin A, Duggan M, Rainie L, Smith A, Greenwood S, Porteus M, et al. Social Media Usage: 2005-2015. Social media usage: 2005-2015. Pew Research Center. 2015.   URL: http://www.pewinternet.org/files/2015/10/PI_2015-10-08_Social-Networking-Usage-2005-2015_FINAL.pdf [accessed 2016-06-21] [WebCite Cache]5].

As a result of these increases in social media usage over the last few years, social media represents a potential source for recruitment of participants. Studies have shown that a high volume of individuals can be successfully recruited for research purposes using social media [Fenner Y, Garland SM, Moore EE, Jayasinghe Y, Fletcher A, Tabrizi SN, et al. Web-based recruiting for health research using a social networking site: an exploratory study. J Med Internet Res 2012;14(1):e20 [FREE Full text] [CrossRef] [Medline]6-Chu JL, Snider CE. Use of a social networking web site for recruiting Canadian youth for medical research. J Adolesc Health 2013 Jun;52(6):792-794. [CrossRef] [Medline]8]. Researchers have utilized these sites, such as Facebook, for recruitment of individuals into their studies [Fenner Y, Garland SM, Moore EE, Jayasinghe Y, Fletcher A, Tabrizi SN, et al. Web-based recruiting for health research using a social networking site: an exploratory study. J Med Internet Res 2012;14(1):e20 [FREE Full text] [CrossRef] [Medline]6,Ramo DE, Prochaska JJ. Broad reach and targeted recruitment using Facebook for an online survey of young adult substance use. J Med Internet Res 2012;14(1):e28 [FREE Full text] [CrossRef] [Medline]7]. Recruitment through this method has been shown to be cost-effective [Fenner Y, Garland SM, Moore EE, Jayasinghe Y, Fletcher A, Tabrizi SN, et al. Web-based recruiting for health research using a social networking site: an exploratory study. J Med Internet Res 2012;14(1):e20 [FREE Full text] [CrossRef] [Medline]6-Chu JL, Snider CE. Use of a social networking web site for recruiting Canadian youth for medical research. J Adolesc Health 2013 Jun;52(6):792-794. [CrossRef] [Medline]8]. Additionally, social media has been shown to recruit populations that cannot be easily accessed through traditional methods of recruitment [Jones L, Saksvig BI, Grieser M, Young DR. Recruiting adolescent girls into a follow-up study: benefits of using a social networking website. Contemp Clin Trials 2012 Mar;33(2):268-272 [FREE Full text] [CrossRef] [Medline]9,O'Connor A, Jackson L, Goldsmith L, Skirton H. Can I get a retweet please? Health research recruitment and the Twittersphere. J Adv Nurs 2014 Mar;70(3):599-609. [CrossRef] [Medline]10], a specific example of which is low-income populations [Lohse B. Facebook is an effective strategy to recruit low-income women to online nutrition education. J Nutr Educ Behav 2013;45(1):69-76. [CrossRef] [Medline]11].

Literature reviews on the role of social media in recruitment have been done by Park and Calamaro [Park BK, Calamaro C. A systematic review of social networking sites: innovative platforms for health research targeting adolescents and young adults. J Nurs Scholarsh 2013 Sep;45(3):256-264. [CrossRef] [Medline]12] and Ryan [Ryan GS. Online social networks for patient involvement and recruitment in clinical research. Nurse Res 2013;21(1):35-39. [CrossRef] [Medline]13]. These reviews also identified social media as being effective in recruiting both hard-to-reach populations and adolescents and young adults (AYAs), as well as being cost-effective. However, the majority of these studies have only looked at AYAs and not older populations where social media usage has increased. Furthermore, many of these studies have not directly compared recruitment via social media with that via traditional methods. To fill these gaps, a scoping review was conducted to answer the following questions: (1) Is social media more effective at research participant recruitment than traditional methods? (2) Does social media recruit a sample of research participants comparable to that recruited via other methods? (3) Is social media more cost-effective at research participant recruitment than traditional methods?


Search Strategy

A scoping review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles appearing in a journal and written in English were included. Review articles, abstracts, dissertations, narratives, and letters were excluded.

Types of Participants

Study participants included adults and children participating in any health care–related research study including recruitment via social media.

Types of Interventions

Any type of interventional study or observational study was included.

Types of Controls or Comparators

Studies with recruitment via at least one other method such as newspaper, in person, and telephone were included.

Types of Outcomes

Three outcomes were assessed for this review: (1) effectiveness of recruitment, (2) comparativeness of recruited participants in relation to the population of interest, and (3) cost-effectiveness of recruitment. The effectiveness of recruitment was measured as the number of participants recruited via social media over a given time period as compared with the other recruitment methods. Comparativeness of the recruitment of participants was assessed by comparing the demographic characteristics of patients recruited via social media with that of other methods. Cost-effectiveness of each recruitment method was determined by dividing the total cost of advertisement for a particular recruitment strategy by the total number of participants recruited through that strategy.

Information Sources and Search Strategy

The original literature search was conducted between July 8 and July 11, 2014, using the databases MEDLINE (1946-2014), PsycINFO (1987-2014), and EMBASE (1980-2014 week 27). The search was updated on May 7 and May 8, 2015, as well as on July 26 and July 27, 2016. The search terms for the MEDLINE database were as follows: (“Recruit*” OR “Patient Selection (MeSH) (Medical Subject Headings) or Patient Recruit*” OR “Subject Recruit*” OR “Participant Recruit*” OR “Recruit* Strategies”) AND (“Social Media (MeSH) or Social Media” OR “Social Network” OR “Social Networking (MeSH) or Social Networking” OR “Facebook” OR “Youtube” OR “Qzone” OR “Sina Weibo” OR “WhatsApp” OR “Google+” OR “Tumblr” OR “Twitter” OR “WeChat” OR “Tencent Weibo” OR “LinkedIn” OR “Youku” OR “Instagram” OR “Tudou” OR “RenRen” OR “Pinterest” OR “Badoo” OR “Orkut” OR “Foursquare” OR “Vine” OR “Vkontakte” OR “Myspace” OR “Snapchat” OR “Reddit” OR “Bebo” OR “Hi5”).

Multimedia Appendix 1

Detailed search strategy.

XLSX File (Microsoft Excel File), 10KBMultimedia Appendix 1 contains the full search strategy. After the articles were found, the reference lists of relevant studies were searched for additional studies. To be as comprehensive as possible, social media sites used primarily outside North America were also included in the search.

Screening Process

The screening process involved 2 stages: (1) title and abstract exclusion and (2) full-text exclusion. Titles were excluded if they were not related to health care or the topic of social media and recruitment. Abstracts were excluded if they were not a primary journal article, unrelated to social media and recruitment, or did not use social media in the recruitment strategy. Full-text studies were excluded if they did not measure the primary outcome (effectiveness of recruitment) or did not have an appropriate control group.

Data Extraction

The relevant studies were then screened for data, including the number of people recruited via each method, the demographic characteristics of the study participants (age, sex, ethnicity, economic status, and educational level), characteristics of the study (country of origin, social media sites used, other recruitment methods, the method used to measure primary outcome, and geographic distribution), reported costs of recruitment activities, and incentives.


Study Selection

The search produced 2658 results, out of which 71 results were duplicates (Figure 1), leaving 2587 results. From these results, 2385 were excluded because the titles were irrelevant to the topic of social media and recruitment, leaving 202 abstracts to be reviewed. From this, 172 more abstracts were excluded because they were not primary research articles (n=65), were not health care–related or did not deal with recruitment specifically (n=35), did not use social media for recruitment (n=55), or did not have a comparison recruitment method (n=17). This left 30 full-text articles to be assessed for eligibility. Out of this total, 16 more of these studies were excluded because they did not measure the number of people recruited via social media over a given period of time (n=11), were not health care–related (n=3), did not use social media sites (n=1), or were not primary research articles (n=1). A total of 6 additional studies were found after redoing the search in May 2015, 9 additional studies were found in July 2016, and 1 additional study was added in August 2016, for a total of n=30 articles that were included in the review.

Recruitment Effectiveness

The percentage of participants recruited via social media ranged from 0% (0/12) to 98.29% (1610/1638) [Balfe M, Doyle F, Conroy R. Using Facebook to recruit young adults for qualitative research projects: how difficult is it? Comput Inform Nurs 2012 Oct;30(10):511-515. [CrossRef] [Medline]14-Frandsen M, Thow M, Ferguson SG. The effectiveness of social media (Facebook) compared with more traditional advertising methods for recruiting eligible participants to health research studies: a randomized, controlled clinical trial. JMIR Res Protoc 2016;5(3):e161 [FREE Full text] [CrossRef] [Medline]42] as shown in Table 1, and the median percentage was 32%. The article by Head et al [Head BF, Dean E, Flanigan T, Swicegood J, Keating MD. Advertising for cognitive interviews: a comparison of Facebook, Craigslist, and snowball recruiting. Soc Sci Computer Rev 2015 Apr 17;34(3):360-377. [CrossRef]35] has 2 studies and has been counted as 2 articles for the purpose of Figure 1. In further sections of this paper, the article by Head et al [Head BF, Dean E, Flanigan T, Swicegood J, Keating MD. Advertising for cognitive interviews: a comparison of Facebook, Craigslist, and snowball recruiting. Soc Sci Computer Rev 2015 Apr 17;34(3):360-377. [CrossRef]35] is counted as a single article or 2 articles, according to whether the conclusions from the 2 studies pertinent to the outcomes of this paper are the same or different. Out of 30 studies, 12 studies (40%) reported higher rates of recruitment through social media as compared with any of the other methods used [Balfe M, Doyle F, Conroy R. Using Facebook to recruit young adults for qualitative research projects: how difficult is it? Comput Inform Nurs 2012 Oct;30(10):511-515. [CrossRef] [Medline]14-Yuan P, Bare MG, Johnson MO, Saberi P. Using online social media for recruitment of human immunodeficiency virus-positive participants: a cross-sectional survey. J Med Internet Res 2014;16(5):e117 [FREE Full text] [CrossRef] [Medline]17,Thériault N, Bi P, Hiller JE, Nor M. Use of web 2.0 to recruit Australian gay men to an online HIV/AIDS survey. J Med Internet Res 2012;14(6):e149 [FREE Full text] [CrossRef] [Medline]26,Carlini BH, Safioti L, Rue TC, Miles L. Using Internet to recruit immigrants with language and culture barriers for tobacco and alcohol use screening: a study among Brazilians. J Immigr Minor Health 2015 Apr;17(2):553-560. [CrossRef] [Medline]28,Wilkerson JM, Shenk JE, Grey JA, Simon Rosser BR, Noor SW. Recruitment strategies of methamphetamine-using men who have sex with men into an online survey. J Subst Use 2015;20(1):33-37 [FREE Full text] [CrossRef] [Medline]31,Ince BU, Cuijpers P, Hof EV, Riper H. Reaching and recruiting Turkish migrants for a clinical trial through Facebook: a process evaluation. Internet Interventions 2014 Apr;1(2):74-83.32,Head BF, Dean E, Flanigan T, Swicegood J, Keating MD. Advertising for cognitive interviews: a comparison of Facebook, Craigslist, and snowball recruiting. Soc Sci Computer Rev 2015 Apr 17;34(3):360-377. [CrossRef]35, Kayrouz R, Dear BF, Karin E, Titov N. Facebook as an effective recruitment strategy for mental health research of hard to reach populations. Internet Interventions 2016 May;4(1):1-10.36,Carter-Harris L, Bartlett ER, Warrick A, Rawl S. Beyond traditional newspaper advertisement: leveraging Facebook-targeted advertisement to recruit long-term smokers for research. J Med Internet Res 2016;18(6):e117 [FREE Full text] [CrossRef] [Medline]41,Frandsen M, Thow M, Ferguson SG. The effectiveness of social media (Facebook) compared with more traditional advertising methods for recruiting eligible participants to health research studies: a randomized, controlled clinical trial. JMIR Res Protoc 2016;5(3):e161 [FREE Full text] [CrossRef] [Medline]42] and 15 studies (50%) reported recruitment via social media to be less effective than at least one other method used [Burrell ER, Pines HA, Robbie E, Coleman L, Murphy RD, Hess KL, et al. Use of the location-based social networking application GRINDR as a recruitment tool in rectal microbicide development research. AIDS Behav 2012 Oct;16(7):1816-1820 [FREE Full text] [CrossRef] [Medline]18-Layi G, Albright CA, Berenberg J, Plant K, Ritter P, Laurent D, et al. UH Cancer Center Hotline: Recruiting cancer survivors for an online health-behavior change intervention: are different strategies more beneficial? Hawaii Med J 2011 Oct;70(10):222-223 [FREE Full text] [Medline]21,Quach S, Pereira JA, Russell ML, Wormsbecker AE, Ramsay H, Crowe L, et al. The good, bad, and ugly of online recruitment of parents for health-related focus groups: lessons learned. J Med Internet Res 2013 Jan;15(11):e250 [FREE Full text] [CrossRef] [Medline]23-Shere M, Zhao XY, Koren G. The role of social media in recruiting for clinical trials in pregnancy. PLoS One 2014;9(3):e92744 [FREE Full text] [CrossRef] [Medline]25, Vial AC, Starks TJ, Parsons JT. Finding and recruiting the highest risk HIV-negative men who have sex with men. AIDS Educ Prev 2014 Feb;26(1):56-67 [FREE Full text] [CrossRef] [Medline]27,Hernandez-Romieu AC, Sullivan PS, Sanchez TH, Kelley CF, Peterson JL, Del Rio C, et al. The comparability of men who have sex with men recruited from venue-time-space sampling and Facebook: a cohort study. JMIR Res Protoc 2014;3(3):e37 [FREE Full text] [CrossRef] [Medline]33-Head BF, Dean E, Flanigan T, Swicegood J, Keating MD. Advertising for cognitive interviews: a comparison of Facebook, Craigslist, and snowball recruiting. Soc Sci Computer Rev 2015 Apr 17;34(3):360-377. [CrossRef]35,Gu LL, Skierkowski D, Florin P, Friend K, Ye Y. Facebook, Twitter, & Qr codes: an exploratory trail examining the feasibility of social media mechanisms for sample recruitment. Comput Hum Behav 2016 Jul;60:86-96. [CrossRef]37-Partridge SR, Balestracci K, Wong AT, Hebden L, McGeechan K, Denney-Wilson E, et al. Effective strategies to recruit young adults into the TXT2BFiT mHealth randomized controlled trial for weight gain prevention. JMIR Res Protoc 2015;4(2):e66 [FREE Full text] [CrossRef] [Medline]40]. Heffner et al [Heffner JL, Wyszynski CM, Comstock B, Mercer LD, Bricker J. Overcoming recruitment challenges of web-based interventions for tobacco use: the case of web-based acceptance and commitment therapy for smoking cessation. Addict Behav 2013 Oct;38(10):2473-2476 [FREE Full text] [CrossRef] [Medline]20] and Rabin et al [Rabin C, Horowitz S, Marcus B. Recruiting young adult cancer survivors for behavioral research. J Clin Psychol Med Settings 2013 Mar;20(1):33-36 [FREE Full text] [CrossRef] [Medline]24] found social media to be the least effective method out of multiple (>2) recruitment methods used. Rabin et al [Rabin C, Horowitz S, Marcus B. Recruiting young adult cancer survivors for behavioral research. J Clin Psychol Med Settings 2013 Mar;20(1):33-36 [FREE Full text] [CrossRef] [Medline]24] were unable to recruit a single participant via social media.

Figure 1. Search strategy results.
View this figure
Table 1. The percentage of participants recruited through social media by study (the number of participants recruited through social media is also provided in parentheses, when reported).
Primary articlePercentage of participants recruited through social media
Balfe et al [Balfe M, Doyle F, Conroy R. Using Facebook to recruit young adults for qualitative research projects: how difficult is it? Comput Inform Nurs 2012 Oct;30(10):511-515. [CrossRef] [Medline]14]76% (29/38)
Frandsen et al [Frandsen M, Walters J, Ferguson SG. Exploring the viability of using online social media advertising as a recruitment method for smoking cessation clinical trials. Nicotine Tob Res 2014 Feb;16(2):247-251. [CrossRef] [Medline]15]51.9% (138/266)
Johnson et al [Johnson KJ, Mueller NL, Williams K, Gutmann DH. Evaluation of participant recruitment methods to a rare disease online registry. Am J Med Genet A 2014 Jul;164A(7):1686-1694. [CrossRef] [Medline]16]49.6% (402/811)
Yuan et al [Yuan P, Bare MG, Johnson MO, Saberi P. Using online social media for recruitment of human immunodeficiency virus-positive participants: a cross-sectional survey. J Med Internet Res 2014;16(5):e117 [FREE Full text] [CrossRef] [Medline]17]81.09% (1544/1904)
Burrell et al [Burrell ER, Pines HA, Robbie E, Coleman L, Murphy RD, Hess KL, et al. Use of the location-based social networking application GRINDR as a recruitment tool in rectal microbicide development research. AIDS Behav 2012 Oct;16(7):1816-1820 [FREE Full text] [CrossRef] [Medline]18]23.8% (24/105)
Graham et al [Graham AL, Fang Y, Moreno JL, Streiff SL, Villegas J, Muñoz RF, et al. Online advertising to reach and recruit Latino smokers to an internet cessation program: impact and costs. J Med Internet Res 2012;14(4):e116 [FREE Full text] [CrossRef] [Medline]19]8.0% (40/500)
Heffner et al [Heffner JL, Wyszynski CM, Comstock B, Mercer LD, Bricker J. Overcoming recruitment challenges of web-based interventions for tobacco use: the case of web-based acceptance and commitment therapy for smoking cessation. Addict Behav 2013 Oct;38(10):2473-2476 [FREE Full text] [CrossRef] [Medline]20]5.0% (11/222)
Layi et al [Layi G, Albright CA, Berenberg J, Plant K, Ritter P, Laurent D, et al. UH Cancer Center Hotline: Recruiting cancer survivors for an online health-behavior change intervention: are different strategies more beneficial? Hawaii Med J 2011 Oct;70(10):222-223 [FREE Full text] [Medline]21]20.0%
Martinez et al [Martinez O, Wu E, Shultz AZ, Capote J, López Rios J, Sandfort T, et al. Still a hard-to-reach population? Using social media to recruit Latino gay couples for an HIV intervention adaptation study. J Med Internet Res 2014;16(4):e113 [FREE Full text] [CrossRef] [Medline]22]36% (5/14)
Quach et al [Quach S, Pereira JA, Russell ML, Wormsbecker AE, Ramsay H, Crowe L, et al. The good, bad, and ugly of online recruitment of parents for health-related focus groups: lessons learned. J Med Internet Res 2013 Jan;15(11):e250 [FREE Full text] [CrossRef] [Medline]23]17.0% (81/477)
Rabin et al [Rabin C, Horowitz S, Marcus B. Recruiting young adult cancer survivors for behavioral research. J Clin Psychol Med Settings 2013 Mar;20(1):33-36 [FREE Full text] [CrossRef] [Medline]24]0% (0/12)
Shere et al [Shere M, Zhao XY, Koren G. The role of social media in recruiting for clinical trials in pregnancy. PLoS One 2014;9(3):e92744 [FREE Full text] [CrossRef] [Medline]25]4% (2/45)
Theriault et al [Thériault N, Bi P, Hiller JE, Nor M. Use of web 2.0 to recruit Australian gay men to an online HIV/AIDS survey. J Med Internet Res 2012;14(6):e149 [FREE Full text] [CrossRef] [Medline]26]83.8% (201/240)
Vial et al [Vial AC, Starks TJ, Parsons JT. Finding and recruiting the highest risk HIV-negative men who have sex with men. AIDS Educ Prev 2014 Feb;26(1):56-67 [FREE Full text] [CrossRef] [Medline]27]12.77% (163/1276)
Carlini et al [Carlini BH, Safioti L, Rue TC, Miles L. Using Internet to recruit immigrants with language and culture barriers for tobacco and alcohol use screening: a study among Brazilians. J Immigr Minor Health 2015 Apr;17(2):553-560. [CrossRef] [Medline]28]41.4% (286/690)
Haines-Saah et al [Haines-Saah RJ, Kelly MT, Oliffe JL, Bottorff JL. Picture Me Smokefree: a qualitative study using social media and digital photography to engage young adults in tobacco reduction and cessation. J Med Internet Res 2015;17(1):e27 [FREE Full text] [CrossRef] [Medline]29]28% (17/60)
Miyagi et al [Miyagi E, Motoki Y, Asai-Sato M, Taguri M, Morita S, Hirahara F, et al. Web-based recruiting for a survey on knowledge and awareness of cervical cancer prevention among young women living in Kanagawa prefecture, Japan. Int J Gynecol Cancer 2014 Sep;24(7):1347-1355 [FREE Full text] [CrossRef] [Medline]30]52.3% (127/243)
Wilkerson et al [Wilkerson JM, Shenk JE, Grey JA, Simon Rosser BR, Noor SW. Recruitment strategies of methamphetamine-using men who have sex with men into an online survey. J Subst Use 2015;20(1):33-37 [FREE Full text] [CrossRef] [Medline]31]93.3% (320/343)
Ince et al [Ince BU, Cuijpers P, Hof EV, Riper H. Reaching and recruiting Turkish migrants for a clinical trial through Facebook: a process evaluation. Internet Interventions 2014 Apr;1(2):74-83.32]77% (74/96)
Hernandez-Romieu et al [Hernandez-Romieu AC, Sullivan PS, Sanchez TH, Kelley CF, Peterson JL, Del Rio C, et al. The comparability of men who have sex with men recruited from venue-time-space sampling and Facebook: a cohort study. JMIR Res Protoc 2014;3(3):e37 [FREE Full text] [CrossRef] [Medline]33]13.7% (110/803)
Rait et al [Rait MA, Prochaska JJ, Rubinstein ML. Recruitment of adolescents for a smoking study: use of traditional strategies and social media. Transl Behav Med 2015 Sep;5(3):254-259 [FREE Full text] [CrossRef] [Medline]34]22.5% (45/200)
Head et al [Head BF, Dean E, Flanigan T, Swicegood J, Keating MD. Advertising for cognitive interviews: a comparison of Facebook, Craigslist, and snowball recruiting. Soc Sci Computer Rev 2015 Apr 17;34(3):360-377. [CrossRef]35], study 198.29% (1610/1638)
Head et al [Head BF, Dean E, Flanigan T, Swicegood J, Keating MD. Advertising for cognitive interviews: a comparison of Facebook, Craigslist, and snowball recruiting. Soc Sci Computer Rev 2015 Apr 17;34(3):360-377. [CrossRef]35], study 23.8% (5/131)
Kayrouz et al [Kayrouz R, Dear BF, Karin E, Titov N. Facebook as an effective recruitment strategy for mental health research of hard to reach populations. Internet Interventions 2016 May;4(1):1-10.36]86% (70/81)
Gu et al [Gu LL, Skierkowski D, Florin P, Friend K, Ye Y. Facebook, Twitter, & Qr codes: an exploratory trail examining the feasibility of social media mechanisms for sample recruitment. Comput Hum Behav 2016 Jul;60:86-96. [CrossRef]37]37.4% (58/155)
Subbaraman et al [Subbaraman MS, Laudet AB, Ritter LA, Stunz A, Kaskutas LA. Multi-source recruitment strategies for advancing addiction recovery research beyond treated samples. J Community Psychol 2015 Jun 1;43(5):560-575 [FREE Full text] [CrossRef] [Medline]38]7.0%
Khatri et al [Khatri C, Chapman SJ, Glasbey J, Kelly M, Nepogodiev D, Bhangu A, et al. Social media and Internet driven study recruitment: evaluating a new model for promoting collaborator engagement and participation. PLoS One 2015;10(3):e0118899 [FREE Full text] [CrossRef] [Medline]39]18.2% (96/527)
Partridge et al [Partridge SR, Balestracci K, Wong AT, Hebden L, McGeechan K, Denney-Wilson E, et al. Effective strategies to recruit young adults into the TXT2BFiT mHealth randomized controlled trial for weight gain prevention. JMIR Res Protoc 2015;4(2):e66 [FREE Full text] [CrossRef] [Medline]40]2.0% (5/250)
Carter-Harris et al [Carter-Harris L, Bartlett ER, Warrick A, Rawl S. Beyond traditional newspaper advertisement: leveraging Facebook-targeted advertisement to recruit long-term smokers for research. J Med Internet Res 2016;18(6):e117 [FREE Full text] [CrossRef] [Medline]41]91.7% (331/361)
Frandsen et al [Frandsen M, Thow M, Ferguson SG. The effectiveness of social media (Facebook) compared with more traditional advertising methods for recruiting eligible participants to health research studies: a randomized, controlled clinical trial. JMIR Res Protoc 2016;5(3):e161 [FREE Full text] [CrossRef] [Medline]42]52.6% (92/175)

Of the 12 studies that found social media to be the best method of recruitment, 8 were observational studies [Balfe M, Doyle F, Conroy R. Using Facebook to recruit young adults for qualitative research projects: how difficult is it? Comput Inform Nurs 2012 Oct;30(10):511-515. [CrossRef] [Medline]14,Johnson KJ, Mueller NL, Williams K, Gutmann DH. Evaluation of participant recruitment methods to a rare disease online registry. Am J Med Genet A 2014 Jul;164A(7):1686-1694. [CrossRef] [Medline]16,Yuan P, Bare MG, Johnson MO, Saberi P. Using online social media for recruitment of human immunodeficiency virus-positive participants: a cross-sectional survey. J Med Internet Res 2014;16(5):e117 [FREE Full text] [CrossRef] [Medline]17,Thériault N, Bi P, Hiller JE, Nor M. Use of web 2.0 to recruit Australian gay men to an online HIV/AIDS survey. J Med Internet Res 2012;14(6):e149 [FREE Full text] [CrossRef] [Medline]26,Carlini BH, Safioti L, Rue TC, Miles L. Using Internet to recruit immigrants with language and culture barriers for tobacco and alcohol use screening: a study among Brazilians. J Immigr Minor Health 2015 Apr;17(2):553-560. [CrossRef] [Medline]28,Wilkerson JM, Shenk JE, Grey JA, Simon Rosser BR, Noor SW. Recruitment strategies of methamphetamine-using men who have sex with men into an online survey. J Subst Use 2015;20(1):33-37 [FREE Full text] [CrossRef] [Medline]31,Head BF, Dean E, Flanigan T, Swicegood J, Keating MD. Advertising for cognitive interviews: a comparison of Facebook, Craigslist, and snowball recruiting. Soc Sci Computer Rev 2015 Apr 17;34(3):360-377. [CrossRef]35,Carter-Harris L, Bartlett ER, Warrick A, Rawl S. Beyond traditional newspaper advertisement: leveraging Facebook-targeted advertisement to recruit long-term smokers for research. J Med Internet Res 2016;18(6):e117 [FREE Full text] [CrossRef] [Medline]41] and the remaining 4 were interventional studies [Frandsen M, Walters J, Ferguson SG. Exploring the viability of using online social media advertising as a recruitment method for smoking cessation clinical trials. Nicotine Tob Res 2014 Feb;16(2):247-251. [CrossRef] [Medline]15,Ince BU, Cuijpers P, Hof EV, Riper H. Reaching and recruiting Turkish migrants for a clinical trial through Facebook: a process evaluation. Internet Interventions 2014 Apr;1(2):74-83.32,Kayrouz R, Dear BF, Karin E, Titov N. Facebook as an effective recruitment strategy for mental health research of hard to reach populations. Internet Interventions 2016 May;4(1):1-10.36,Frandsen M, Thow M, Ferguson SG. The effectiveness of social media (Facebook) compared with more traditional advertising methods for recruiting eligible participants to health research studies: a randomized, controlled clinical trial. JMIR Res Protoc 2016;5(3):e161 [FREE Full text] [CrossRef] [Medline]42], as shown in

Multimedia Appendix 2

Study characteristics, recruitment effectiveness by method, demographics of participants recruited by method, and geographic areas targeted by method.

XLSX File (Microsoft Excel File), 26KBMultimedia Appendix 2. In addition, 6 of these studies targeted populations deemed hard to reach [Johnson KJ, Mueller NL, Williams K, Gutmann DH. Evaluation of participant recruitment methods to a rare disease online registry. Am J Med Genet A 2014 Jul;164A(7):1686-1694. [CrossRef] [Medline]16,Yuan P, Bare MG, Johnson MO, Saberi P. Using online social media for recruitment of human immunodeficiency virus-positive participants: a cross-sectional survey. J Med Internet Res 2014;16(5):e117 [FREE Full text] [CrossRef] [Medline]17,Carlini BH, Safioti L, Rue TC, Miles L. Using Internet to recruit immigrants with language and culture barriers for tobacco and alcohol use screening: a study among Brazilians. J Immigr Minor Health 2015 Apr;17(2):553-560. [CrossRef] [Medline]28,Wilkerson JM, Shenk JE, Grey JA, Simon Rosser BR, Noor SW. Recruitment strategies of methamphetamine-using men who have sex with men into an online survey. J Subst Use 2015;20(1):33-37 [FREE Full text] [CrossRef] [Medline]31,Ince BU, Cuijpers P, Hof EV, Riper H. Reaching and recruiting Turkish migrants for a clinical trial through Facebook: a process evaluation. Internet Interventions 2014 Apr;1(2):74-83.32,Kayrouz R, Dear BF, Karin E, Titov N. Facebook as an effective recruitment strategy for mental health research of hard to reach populations. Internet Interventions 2016 May;4(1):1-10.36], and 6 studies targeted specific conditions or disorders [Balfe M, Doyle F, Conroy R. Using Facebook to recruit young adults for qualitative research projects: how difficult is it? Comput Inform Nurs 2012 Oct;30(10):511-515. [CrossRef] [Medline]14,Johnson KJ, Mueller NL, Williams K, Gutmann DH. Evaluation of participant recruitment methods to a rare disease online registry. Am J Med Genet A 2014 Jul;164A(7):1686-1694. [CrossRef] [Medline]16,Yuan P, Bare MG, Johnson MO, Saberi P. Using online social media for recruitment of human immunodeficiency virus-positive participants: a cross-sectional survey. J Med Internet Res 2014;16(5):e117 [FREE Full text] [CrossRef] [Medline]17,Carlini BH, Safioti L, Rue TC, Miles L. Using Internet to recruit immigrants with language and culture barriers for tobacco and alcohol use screening: a study among Brazilians. J Immigr Minor Health 2015 Apr;17(2):553-560. [CrossRef] [Medline]28,Wilkerson JM, Shenk JE, Grey JA, Simon Rosser BR, Noor SW. Recruitment strategies of methamphetamine-using men who have sex with men into an online survey. J Subst Use 2015;20(1):33-37 [FREE Full text] [CrossRef] [Medline]31,Ince BU, Cuijpers P, Hof EV, Riper H. Reaching and recruiting Turkish migrants for a clinical trial through Facebook: a process evaluation. Internet Interventions 2014 Apr;1(2):74-83.32]. Furthermore, 1 study targeted only young adults (aged 23-30 years) [Balfe M, Doyle F, Conroy R. Using Facebook to recruit young adults for qualitative research projects: how difficult is it? Comput Inform Nurs 2012 Oct;30(10):511-515. [CrossRef] [Medline]14]. Among the 12 studies, 8 studies used only Facebook for recruitment [Balfe M, Doyle F, Conroy R. Using Facebook to recruit young adults for qualitative research projects: how difficult is it? Comput Inform Nurs 2012 Oct;30(10):511-515. [CrossRef] [Medline]14-Johnson KJ, Mueller NL, Williams K, Gutmann DH. Evaluation of participant recruitment methods to a rare disease online registry. Am J Med Genet A 2014 Jul;164A(7):1686-1694. [CrossRef] [Medline]16,Carlini BH, Safioti L, Rue TC, Miles L. Using Internet to recruit immigrants with language and culture barriers for tobacco and alcohol use screening: a study among Brazilians. J Immigr Minor Health 2015 Apr;17(2):553-560. [CrossRef] [Medline]28,Head BF, Dean E, Flanigan T, Swicegood J, Keating MD. Advertising for cognitive interviews: a comparison of Facebook, Craigslist, and snowball recruiting. Soc Sci Computer Rev 2015 Apr 17;34(3):360-377. [CrossRef]35,Kayrouz R, Dear BF, Karin E, Titov N. Facebook as an effective recruitment strategy for mental health research of hard to reach populations. Internet Interventions 2016 May;4(1):1-10.36,Carter-Harris L, Bartlett ER, Warrick A, Rawl S. Beyond traditional newspaper advertisement: leveraging Facebook-targeted advertisement to recruit long-term smokers for research. J Med Internet Res 2016;18(6):e117 [FREE Full text] [CrossRef] [Medline]41,Frandsen M, Thow M, Ferguson SG. The effectiveness of social media (Facebook) compared with more traditional advertising methods for recruiting eligible participants to health research studies: a randomized, controlled clinical trial. JMIR Res Protoc 2016;5(3):e161 [FREE Full text] [CrossRef] [Medline]42]. Of the remaining 4 studies, 2 studies used a combination of Facebook and Twitter [Wilkerson JM, Shenk JE, Grey JA, Simon Rosser BR, Noor SW. Recruitment strategies of methamphetamine-using men who have sex with men into an online survey. J Subst Use 2015;20(1):33-37 [FREE Full text] [CrossRef] [Medline]31,Ince BU, Cuijpers P, Hof EV, Riper H. Reaching and recruiting Turkish migrants for a clinical trial through Facebook: a process evaluation. Internet Interventions 2014 Apr;1(2):74-83.32] and 2 studies used a combination of Facebook and other social media websites [Yuan P, Bare MG, Johnson MO, Saberi P. Using online social media for recruitment of human immunodeficiency virus-positive participants: a cross-sectional survey. J Med Internet Res 2014;16(5):e117 [FREE Full text] [CrossRef] [Medline]17,Thériault N, Bi P, Hiller JE, Nor M. Use of web 2.0 to recruit Australian gay men to an online HIV/AIDS survey. J Med Internet Res 2012;14(6):e149 [FREE Full text] [CrossRef] [Medline]26].

Of the 15 studies that did not find social media to be the best method, 7 studies were interventional studies [Burrell ER, Pines HA, Robbie E, Coleman L, Murphy RD, Hess KL, et al. Use of the location-based social networking application GRINDR as a recruitment tool in rectal microbicide development research. AIDS Behav 2012 Oct;16(7):1816-1820 [FREE Full text] [CrossRef] [Medline]18-Layi G, Albright CA, Berenberg J, Plant K, Ritter P, Laurent D, et al. UH Cancer Center Hotline: Recruiting cancer survivors for an online health-behavior change intervention: are different strategies more beneficial? Hawaii Med J 2011 Oct;70(10):222-223 [FREE Full text] [Medline]21,Rabin C, Horowitz S, Marcus B. Recruiting young adult cancer survivors for behavioral research. J Clin Psychol Med Settings 2013 Mar;20(1):33-36 [FREE Full text] [CrossRef] [Medline]24,Shere M, Zhao XY, Koren G. The role of social media in recruiting for clinical trials in pregnancy. PLoS One 2014;9(3):e92744 [FREE Full text] [CrossRef] [Medline]25,Partridge SR, Balestracci K, Wong AT, Hebden L, McGeechan K, Denney-Wilson E, et al. Effective strategies to recruit young adults into the TXT2BFiT mHealth randomized controlled trial for weight gain prevention. JMIR Res Protoc 2015;4(2):e66 [FREE Full text] [CrossRef] [Medline]40], whereas 8 were observational studies [Quach S, Pereira JA, Russell ML, Wormsbecker AE, Ramsay H, Crowe L, et al. The good, bad, and ugly of online recruitment of parents for health-related focus groups: lessons learned. J Med Internet Res 2013 Jan;15(11):e250 [FREE Full text] [CrossRef] [Medline]23,Vial AC, Starks TJ, Parsons JT. Finding and recruiting the highest risk HIV-negative men who have sex with men. AIDS Educ Prev 2014 Feb;26(1):56-67 [FREE Full text] [CrossRef] [Medline]27,Hernandez-Romieu AC, Sullivan PS, Sanchez TH, Kelley CF, Peterson JL, Del Rio C, et al. The comparability of men who have sex with men recruited from venue-time-space sampling and Facebook: a cohort study. JMIR Res Protoc 2014;3(3):e37 [FREE Full text] [CrossRef] [Medline]33-Head BF, Dean E, Flanigan T, Swicegood J, Keating MD. Advertising for cognitive interviews: a comparison of Facebook, Craigslist, and snowball recruiting. Soc Sci Computer Rev 2015 Apr 17;34(3):360-377. [CrossRef]35,Gu LL, Skierkowski D, Florin P, Friend K, Ye Y. Facebook, Twitter, & Qr codes: an exploratory trail examining the feasibility of social media mechanisms for sample recruitment. Comput Hum Behav 2016 Jul;60:86-96. [CrossRef]37-Khatri C, Chapman SJ, Glasbey J, Kelly M, Nepogodiev D, Bhangu A, et al. Social media and Internet driven study recruitment: evaluating a new model for promoting collaborator engagement and participation. PLoS One 2015;10(3):e0118899 [FREE Full text] [CrossRef] [Medline]39]. Of these studies, 3 studies specifically targeted young and middle-aged adults [Rabin C, Horowitz S, Marcus B. Recruiting young adult cancer survivors for behavioral research. J Clin Psychol Med Settings 2013 Mar;20(1):33-36 [FREE Full text] [CrossRef] [Medline]24,Shere M, Zhao XY, Koren G. The role of social media in recruiting for clinical trials in pregnancy. PLoS One 2014;9(3):e92744 [FREE Full text] [CrossRef] [Medline]25,Partridge SR, Balestracci K, Wong AT, Hebden L, McGeechan K, Denney-Wilson E, et al. Effective strategies to recruit young adults into the TXT2BFiT mHealth randomized controlled trial for weight gain prevention. JMIR Res Protoc 2015;4(2):e66 [FREE Full text] [CrossRef] [Medline]40], 2 studies targeted adolescents [Rait MA, Prochaska JJ, Rubinstein ML. Recruitment of adolescents for a smoking study: use of traditional strategies and social media. Transl Behav Med 2015 Sep;5(3):254-259 [FREE Full text] [CrossRef] [Medline]34,Gu LL, Skierkowski D, Florin P, Friend K, Ye Y. Facebook, Twitter, & Qr codes: an exploratory trail examining the feasibility of social media mechanisms for sample recruitment. Comput Hum Behav 2016 Jul;60:86-96. [CrossRef]37], and 2 studies targeted older adults [Head BF, Dean E, Flanigan T, Swicegood J, Keating MD. Advertising for cognitive interviews: a comparison of Facebook, Craigslist, and snowball recruiting. Soc Sci Computer Rev 2015 Apr 17;34(3):360-377. [CrossRef]35,Carter-Harris L, Bartlett ER, Warrick A, Rawl S. Beyond traditional newspaper advertisement: leveraging Facebook-targeted advertisement to recruit long-term smokers for research. J Med Internet Res 2016;18(6):e117 [FREE Full text] [CrossRef] [Medline]41]. Martinez et al [Martinez O, Wu E, Shultz AZ, Capote J, López Rios J, Sandfort T, et al. Still a hard-to-reach population? Using social media to recruit Latino gay couples for an HIV intervention adaptation study. J Med Internet Res 2014;16(4):e113 [FREE Full text] [CrossRef] [Medline]22] recruited 35.7% of participants via social media and 35.7% of participants via community-based organizations. Haines-Saah et al [Haines-Saah RJ, Kelly MT, Oliffe JL, Bottorff JL. Picture Me Smokefree: a qualitative study using social media and digital photography to engage young adults in tobacco reduction and cessation. J Med Internet Res 2015;17(1):e27 [FREE Full text] [CrossRef] [Medline]29] recruited 28% of participants via social media and 28% of participants via friend referral. Miyagi et al [Miyagi E, Motoki Y, Asai-Sato M, Taguri M, Morita S, Hirahara F, et al. Web-based recruiting for a survey on knowledge and awareness of cervical cancer prevention among young women living in Kanagawa prefecture, Japan. Int J Gynecol Cancer 2014 Sep;24(7):1347-1355 [FREE Full text] [CrossRef] [Medline]30] recruited 52% of participants through Facebook and 48% via a website. The studies by Martinez et al [Martinez O, Wu E, Shultz AZ, Capote J, López Rios J, Sandfort T, et al. Still a hard-to-reach population? Using social media to recruit Latino gay couples for an HIV intervention adaptation study. J Med Internet Res 2014;16(4):e113 [FREE Full text] [CrossRef] [Medline]22] and Haines-Saah et al [Haines-Saah RJ, Kelly MT, Oliffe JL, Bottorff JL. Picture Me Smokefree: a qualitative study using social media and digital photography to engage young adults in tobacco reduction and cessation. J Med Internet Res 2015;17(1):e27 [FREE Full text] [CrossRef] [Medline]29] were both interventional studies, whereas the study by Miyagi et al [Miyagi E, Motoki Y, Asai-Sato M, Taguri M, Morita S, Hirahara F, et al. Web-based recruiting for a survey on knowledge and awareness of cervical cancer prevention among young women living in Kanagawa prefecture, Japan. Int J Gynecol Cancer 2014 Sep;24(7):1347-1355 [FREE Full text] [CrossRef] [Medline]30] was an observational study.

Demographics

A total of 23 studies reported the geographic regions targeted by social media during recruitment, as shown in

Multimedia Appendix 2

Study characteristics, recruitment effectiveness by method, demographics of participants recruited by method, and geographic areas targeted by method.

XLSX File (Microsoft Excel File), 26KBMultimedia Appendix 2. Among these, 13 studies targeted local regions within a country [Frandsen M, Walters J, Ferguson SG. Exploring the viability of using online social media advertising as a recruitment method for smoking cessation clinical trials. Nicotine Tob Res 2014 Feb;16(2):247-251. [CrossRef] [Medline]15,Burrell ER, Pines HA, Robbie E, Coleman L, Murphy RD, Hess KL, et al. Use of the location-based social networking application GRINDR as a recruitment tool in rectal microbicide development research. AIDS Behav 2012 Oct;16(7):1816-1820 [FREE Full text] [CrossRef] [Medline]18,Martinez O, Wu E, Shultz AZ, Capote J, López Rios J, Sandfort T, et al. Still a hard-to-reach population? Using social media to recruit Latino gay couples for an HIV intervention adaptation study. J Med Internet Res 2014;16(4):e113 [FREE Full text] [CrossRef] [Medline]22,Quach S, Pereira JA, Russell ML, Wormsbecker AE, Ramsay H, Crowe L, et al. The good, bad, and ugly of online recruitment of parents for health-related focus groups: lessons learned. J Med Internet Res 2013 Jan;15(11):e250 [FREE Full text] [CrossRef] [Medline]23,Thériault N, Bi P, Hiller JE, Nor M. Use of web 2.0 to recruit Australian gay men to an online HIV/AIDS survey. J Med Internet Res 2012;14(6):e149 [FREE Full text] [CrossRef] [Medline]26,Vial AC, Starks TJ, Parsons JT. Finding and recruiting the highest risk HIV-negative men who have sex with men. AIDS Educ Prev 2014 Feb;26(1):56-67 [FREE Full text] [CrossRef] [Medline]27,Miyagi E, Motoki Y, Asai-Sato M, Taguri M, Morita S, Hirahara F, et al. Web-based recruiting for a survey on knowledge and awareness of cervical cancer prevention among young women living in Kanagawa prefecture, Japan. Int J Gynecol Cancer 2014 Sep;24(7):1347-1355 [FREE Full text] [CrossRef] [Medline]30,Hernandez-Romieu AC, Sullivan PS, Sanchez TH, Kelley CF, Peterson JL, Del Rio C, et al. The comparability of men who have sex with men recruited from venue-time-space sampling and Facebook: a cohort study. JMIR Res Protoc 2014;3(3):e37 [FREE Full text] [CrossRef] [Medline]33-Head BF, Dean E, Flanigan T, Swicegood J, Keating MD. Advertising for cognitive interviews: a comparison of Facebook, Craigslist, and snowball recruiting. Soc Sci Computer Rev 2015 Apr 17;34(3):360-377. [CrossRef]35,Gu LL, Skierkowski D, Florin P, Friend K, Ye Y. Facebook, Twitter, & Qr codes: an exploratory trail examining the feasibility of social media mechanisms for sample recruitment. Comput Hum Behav 2016 Jul;60:86-96. [CrossRef]37,Partridge SR, Balestracci K, Wong AT, Hebden L, McGeechan K, Denney-Wilson E, et al. Effective strategies to recruit young adults into the TXT2BFiT mHealth randomized controlled trial for weight gain prevention. JMIR Res Protoc 2015;4(2):e66 [FREE Full text] [CrossRef] [Medline]40,Frandsen M, Thow M, Ferguson SG. The effectiveness of social media (Facebook) compared with more traditional advertising methods for recruiting eligible participants to health research studies: a randomized, controlled clinical trial. JMIR Res Protoc 2016;5(3):e161 [FREE Full text] [CrossRef] [Medline]42], 8 studies [Balfe M, Doyle F, Conroy R. Using Facebook to recruit young adults for qualitative research projects: how difficult is it? Comput Inform Nurs 2012 Oct;30(10):511-515. [CrossRef] [Medline]14,Graham AL, Fang Y, Moreno JL, Streiff SL, Villegas J, Muñoz RF, et al. Online advertising to reach and recruit Latino smokers to an internet cessation program: impact and costs. J Med Internet Res 2012;14(4):e116 [FREE Full text] [CrossRef] [Medline]19,Carlini BH, Safioti L, Rue TC, Miles L. Using Internet to recruit immigrants with language and culture barriers for tobacco and alcohol use screening: a study among Brazilians. J Immigr Minor Health 2015 Apr;17(2):553-560. [CrossRef] [Medline]28,Wilkerson JM, Shenk JE, Grey JA, Simon Rosser BR, Noor SW. Recruitment strategies of methamphetamine-using men who have sex with men into an online survey. J Subst Use 2015;20(1):33-37 [FREE Full text] [CrossRef] [Medline]31,Head BF, Dean E, Flanigan T, Swicegood J, Keating MD. Advertising for cognitive interviews: a comparison of Facebook, Craigslist, and snowball recruiting. Soc Sci Computer Rev 2015 Apr 17;34(3):360-377. [CrossRef]35,Subbaraman MS, Laudet AB, Ritter LA, Stunz A, Kaskutas LA. Multi-source recruitment strategies for advancing addiction recovery research beyond treated samples. J Community Psychol 2015 Jun 1;43(5):560-575 [FREE Full text] [CrossRef] [Medline]38,Khatri C, Chapman SJ, Glasbey J, Kelly M, Nepogodiev D, Bhangu A, et al. Social media and Internet driven study recruitment: evaluating a new model for promoting collaborator engagement and participation. PLoS One 2015;10(3):e0118899 [FREE Full text] [CrossRef] [Medline]39,Carter-Harris L, Bartlett ER, Warrick A, Rawl S. Beyond traditional newspaper advertisement: leveraging Facebook-targeted advertisement to recruit long-term smokers for research. J Med Internet Res 2016;18(6):e117 [FREE Full text] [CrossRef] [Medline]41] targeted recruitment nationally, and 2 studies targeted recruitment internationally [Johnson KJ, Mueller NL, Williams K, Gutmann DH. Evaluation of participant recruitment methods to a rare disease online registry. Am J Med Genet A 2014 Jul;164A(7):1686-1694. [CrossRef] [Medline]16,Kayrouz R, Dear BF, Karin E, Titov N. Facebook as an effective recruitment strategy for mental health research of hard to reach populations. Internet Interventions 2016 May;4(1):1-10.36].

Only 13 studies out of 30 reported at least one demographic characteristic for patients recruited through social media and other methods [Frandsen M, Walters J, Ferguson SG. Exploring the viability of using online social media advertising as a recruitment method for smoking cessation clinical trials. Nicotine Tob Res 2014 Feb;16(2):247-251. [CrossRef] [Medline]15-Burrell ER, Pines HA, Robbie E, Coleman L, Murphy RD, Hess KL, et al. Use of the location-based social networking application GRINDR as a recruitment tool in rectal microbicide development research. AIDS Behav 2012 Oct;16(7):1816-1820 [FREE Full text] [CrossRef] [Medline]18,Heffner JL, Wyszynski CM, Comstock B, Mercer LD, Bricker J. Overcoming recruitment challenges of web-based interventions for tobacco use: the case of web-based acceptance and commitment therapy for smoking cessation. Addict Behav 2013 Oct;38(10):2473-2476 [FREE Full text] [CrossRef] [Medline]20,Shere M, Zhao XY, Koren G. The role of social media in recruiting for clinical trials in pregnancy. PLoS One 2014;9(3):e92744 [FREE Full text] [CrossRef] [Medline]25,Carlini BH, Safioti L, Rue TC, Miles L. Using Internet to recruit immigrants with language and culture barriers for tobacco and alcohol use screening: a study among Brazilians. J Immigr Minor Health 2015 Apr;17(2):553-560. [CrossRef] [Medline]28,Hernandez-Romieu AC, Sullivan PS, Sanchez TH, Kelley CF, Peterson JL, Del Rio C, et al. The comparability of men who have sex with men recruited from venue-time-space sampling and Facebook: a cohort study. JMIR Res Protoc 2014;3(3):e37 [FREE Full text] [CrossRef] [Medline]33,Head BF, Dean E, Flanigan T, Swicegood J, Keating MD. Advertising for cognitive interviews: a comparison of Facebook, Craigslist, and snowball recruiting. Soc Sci Computer Rev 2015 Apr 17;34(3):360-377. [CrossRef]35,Gu LL, Skierkowski D, Florin P, Friend K, Ye Y. Facebook, Twitter, & Qr codes: an exploratory trail examining the feasibility of social media mechanisms for sample recruitment. Comput Hum Behav 2016 Jul;60:86-96. [CrossRef]37,Carter-Harris L, Bartlett ER, Warrick A, Rawl S. Beyond traditional newspaper advertisement: leveraging Facebook-targeted advertisement to recruit long-term smokers for research. J Med Internet Res 2016;18(6):e117 [FREE Full text] [CrossRef] [Medline]41,Frandsen M, Thow M, Ferguson SG. The effectiveness of social media (Facebook) compared with more traditional advertising methods for recruiting eligible participants to health research studies: a randomized, controlled clinical trial. JMIR Res Protoc 2016;5(3):e161 [FREE Full text] [CrossRef] [Medline]42], with 10 studies providing in-depth demographic information [Frandsen M, Walters J, Ferguson SG. Exploring the viability of using online social media advertising as a recruitment method for smoking cessation clinical trials. Nicotine Tob Res 2014 Feb;16(2):247-251. [CrossRef] [Medline]15,Johnson KJ, Mueller NL, Williams K, Gutmann DH. Evaluation of participant recruitment methods to a rare disease online registry. Am J Med Genet A 2014 Jul;164A(7):1686-1694. [CrossRef] [Medline]16,Heffner JL, Wyszynski CM, Comstock B, Mercer LD, Bricker J. Overcoming recruitment challenges of web-based interventions for tobacco use: the case of web-based acceptance and commitment therapy for smoking cessation. Addict Behav 2013 Oct;38(10):2473-2476 [FREE Full text] [CrossRef] [Medline]20,Shere M, Zhao XY, Koren G. The role of social media in recruiting for clinical trials in pregnancy. PLoS One 2014;9(3):e92744 [FREE Full text] [CrossRef] [Medline]25,Hernandez-Romieu AC, Sullivan PS, Sanchez TH, Kelley CF, Peterson JL, Del Rio C, et al. The comparability of men who have sex with men recruited from venue-time-space sampling and Facebook: a cohort study. JMIR Res Protoc 2014;3(3):e37 [FREE Full text] [CrossRef] [Medline]33,Head BF, Dean E, Flanigan T, Swicegood J, Keating MD. Advertising for cognitive interviews: a comparison of Facebook, Craigslist, and snowball recruiting. Soc Sci Computer Rev 2015 Apr 17;34(3):360-377. [CrossRef]35,Gu LL, Skierkowski D, Florin P, Friend K, Ye Y. Facebook, Twitter, & Qr codes: an exploratory trail examining the feasibility of social media mechanisms for sample recruitment. Comput Hum Behav 2016 Jul;60:86-96. [CrossRef]37,Carter-Harris L, Bartlett ER, Warrick A, Rawl S. Beyond traditional newspaper advertisement: leveraging Facebook-targeted advertisement to recruit long-term smokers for research. J Med Internet Res 2016;18(6):e117 [FREE Full text] [CrossRef] [Medline]41,Frandsen M, Thow M, Ferguson SG. The effectiveness of social media (Facebook) compared with more traditional advertising methods for recruiting eligible participants to health research studies: a randomized, controlled clinical trial. JMIR Res Protoc 2016;5(3):e161 [FREE Full text] [CrossRef] [Medline]42]. However, Shere et al [Shere M, Zhao XY, Koren G. The role of social media in recruiting for clinical trials in pregnancy. PLoS One 2014;9(3):e92744 [FREE Full text] [CrossRef] [Medline]25] and Yuan et al [Yuan P, Bare MG, Johnson MO, Saberi P. Using online social media for recruitment of human immunodeficiency virus-positive participants: a cross-sectional survey. J Med Internet Res 2014;16(5):e117 [FREE Full text] [CrossRef] [Medline]17] included Craigslist in their definition of social media; therefore, their demographic analysis was not included in this review because Craigslist does not fall under our definition of a social media website.

With respect to ethnicity, it was found that there was no significant difference between recruitment strategies in 5 studies [Frandsen M, Walters J, Ferguson SG. Exploring the viability of using online social media advertising as a recruitment method for smoking cessation clinical trials. Nicotine Tob Res 2014 Feb;16(2):247-251. [CrossRef] [Medline]15,Johnson KJ, Mueller NL, Williams K, Gutmann DH. Evaluation of participant recruitment methods to a rare disease online registry. Am J Med Genet A 2014 Jul;164A(7):1686-1694. [CrossRef] [Medline]16,Heffner JL, Wyszynski CM, Comstock B, Mercer LD, Bricker J. Overcoming recruitment challenges of web-based interventions for tobacco use: the case of web-based acceptance and commitment therapy for smoking cessation. Addict Behav 2013 Oct;38(10):2473-2476 [FREE Full text] [CrossRef] [Medline]20,Head BF, Dean E, Flanigan T, Swicegood J, Keating MD. Advertising for cognitive interviews: a comparison of Facebook, Craigslist, and snowball recruiting. Soc Sci Computer Rev 2015 Apr 17;34(3):360-377. [CrossRef]35,Gu LL, Skierkowski D, Florin P, Friend K, Ye Y. Facebook, Twitter, & Qr codes: an exploratory trail examining the feasibility of social media mechanisms for sample recruitment. Comput Hum Behav 2016 Jul;60:86-96. [CrossRef]37]. Despite social media recruiting different percentages of white and black participants compared with other avenues, Hernandez-Romieu et al [Hernandez-Romieu AC, Sullivan PS, Sanchez TH, Kelley CF, Peterson JL, Del Rio C, et al. The comparability of men who have sex with men recruited from venue-time-space sampling and Facebook: a cohort study. JMIR Res Protoc 2014;3(3):e37 [FREE Full text] [CrossRef] [Medline]33] concluded that social media did not have a racial bias in recruitment, as in this case the researchers were deliberately aiming at a 50% white and 50% black sample. However, Burrell et al [Burrell ER, Pines HA, Robbie E, Coleman L, Murphy RD, Hess KL, et al. Use of the location-based social networking application GRINDR as a recruitment tool in rectal microbicide development research. AIDS Behav 2012 Oct;16(7):1816-1820 [FREE Full text] [CrossRef] [Medline]18], who used Grindr to recruit, noted a significantly increased white population when compared with traditional methods, which they attributed to the fact that Grindr could only be used by individuals possessing a smartphone. Head et al [Head BF, Dean E, Flanigan T, Swicegood J, Keating MD. Advertising for cognitive interviews: a comparison of Facebook, Craigslist, and snowball recruiting. Soc Sci Computer Rev 2015 Apr 17;34(3):360-377. [CrossRef]35] (studies 1 and 2) and Carter-Harris et al [Carter-Harris L, Bartlett ER, Warrick A, Rawl S. Beyond traditional newspaper advertisement: leveraging Facebook-targeted advertisement to recruit long-term smokers for research. J Med Internet Res 2016;18(6):e117 [FREE Full text] [CrossRef] [Medline]41] also noted a significantly increased white population recruited through Facebook. Out of the 10 studies that formally measured the age of participants recruited, 3 recruited a comparable sample [Johnson KJ, Mueller NL, Williams K, Gutmann DH. Evaluation of participant recruitment methods to a rare disease online registry. Am J Med Genet A 2014 Jul;164A(7):1686-1694. [CrossRef] [Medline]16,Carlini BH, Safioti L, Rue TC, Miles L. Using Internet to recruit immigrants with language and culture barriers for tobacco and alcohol use screening: a study among Brazilians. J Immigr Minor Health 2015 Apr;17(2):553-560. [CrossRef] [Medline]28,Carter-Harris L, Bartlett ER, Warrick A, Rawl S. Beyond traditional newspaper advertisement: leveraging Facebook-targeted advertisement to recruit long-term smokers for research. J Med Internet Res 2016;18(6):e117 [FREE Full text] [CrossRef] [Medline]41]. There was a younger median age in 3 studies [Frandsen M, Walters J, Ferguson SG. Exploring the viability of using online social media advertising as a recruitment method for smoking cessation clinical trials. Nicotine Tob Res 2014 Feb;16(2):247-251. [CrossRef] [Medline]15,Heffner JL, Wyszynski CM, Comstock B, Mercer LD, Bricker J. Overcoming recruitment challenges of web-based interventions for tobacco use: the case of web-based acceptance and commitment therapy for smoking cessation. Addict Behav 2013 Oct;38(10):2473-2476 [FREE Full text] [CrossRef] [Medline]20,Frandsen M, Thow M, Ferguson SG. The effectiveness of social media (Facebook) compared with more traditional advertising methods for recruiting eligible participants to health research studies: a randomized, controlled clinical trial. JMIR Res Protoc 2016;5(3):e161 [FREE Full text] [CrossRef] [Medline]42], and 1 study [Burrell ER, Pines HA, Robbie E, Coleman L, Murphy RD, Hess KL, et al. Use of the location-based social networking application GRINDR as a recruitment tool in rectal microbicide development research. AIDS Behav 2012 Oct;16(7):1816-1820 [FREE Full text] [CrossRef] [Medline]18] had a much higher proportion of 18- to 30-year-olds recruited via social media (56% vs 18.8%). Quach et al [Quach S, Pereira JA, Russell ML, Wormsbecker AE, Ramsay H, Crowe L, et al. The good, bad, and ugly of online recruitment of parents for health-related focus groups: lessons learned. J Med Internet Res 2013 Jan;15(11):e250 [FREE Full text] [CrossRef] [Medline]23], while not formally reporting demographics, noted that social media recruited younger individuals. Although not included in the demographic analysis, Yuan et al [Yuan P, Bare MG, Johnson MO, Saberi P. Using online social media for recruitment of human immunodeficiency virus-positive participants: a cross-sectional survey. J Med Internet Res 2014;16(5):e117 [FREE Full text] [CrossRef] [Medline]17] also noted that the proportion of individuals aged 60+ years recruited through Facebook was lower than that for other age groups. Hernandez-Romieu et al [Hernandez-Romieu AC, Sullivan PS, Sanchez TH, Kelley CF, Peterson JL, Del Rio C, et al. The comparability of men who have sex with men recruited from venue-time-space sampling and Facebook: a cohort study. JMIR Res Protoc 2014;3(3):e37 [FREE Full text] [CrossRef] [Medline]33], on the other hand, noted that participants recruited via Facebook were typically older than those recruited via other avenues, and this difference was significant for black participants recruited. Head et al [Head BF, Dean E, Flanigan T, Swicegood J, Keating MD. Advertising for cognitive interviews: a comparison of Facebook, Craigslist, and snowball recruiting. Soc Sci Computer Rev 2015 Apr 17;34(3):360-377. [CrossRef]35] also noted an older median age in studies 1 and 2, which was attributed to the fact that Craigslist, the main comparative recruitment method used, is more popular with younger individuals. Out of the 8 studies that reported the sex of recruited participants [Frandsen M, Walters J, Ferguson SG. Exploring the viability of using online social media advertising as a recruitment method for smoking cessation clinical trials. Nicotine Tob Res 2014 Feb;16(2):247-251. [CrossRef] [Medline]15,Johnson KJ, Mueller NL, Williams K, Gutmann DH. Evaluation of participant recruitment methods to a rare disease online registry. Am J Med Genet A 2014 Jul;164A(7):1686-1694. [CrossRef] [Medline]16,Heffner JL, Wyszynski CM, Comstock B, Mercer LD, Bricker J. Overcoming recruitment challenges of web-based interventions for tobacco use: the case of web-based acceptance and commitment therapy for smoking cessation. Addict Behav 2013 Oct;38(10):2473-2476 [FREE Full text] [CrossRef] [Medline]20,Carlini BH, Safioti L, Rue TC, Miles L. Using Internet to recruit immigrants with language and culture barriers for tobacco and alcohol use screening: a study among Brazilians. J Immigr Minor Health 2015 Apr;17(2):553-560. [CrossRef] [Medline]28,Head BF, Dean E, Flanigan T, Swicegood J, Keating MD. Advertising for cognitive interviews: a comparison of Facebook, Craigslist, and snowball recruiting. Soc Sci Computer Rev 2015 Apr 17;34(3):360-377. [CrossRef]35,Gu LL, Skierkowski D, Florin P, Friend K, Ye Y. Facebook, Twitter, & Qr codes: an exploratory trail examining the feasibility of social media mechanisms for sample recruitment. Comput Hum Behav 2016 Jul;60:86-96. [CrossRef]37,Carter-Harris L, Bartlett ER, Warrick A, Rawl S. Beyond traditional newspaper advertisement: leveraging Facebook-targeted advertisement to recruit long-term smokers for research. J Med Internet Res 2016;18(6):e117 [FREE Full text] [CrossRef] [Medline]41,Frandsen M, Thow M, Ferguson SG. The effectiveness of social media (Facebook) compared with more traditional advertising methods for recruiting eligible participants to health research studies: a randomized, controlled clinical trial. JMIR Res Protoc 2016;5(3):e161 [FREE Full text] [CrossRef] [Medline]42], 7 studies recruited a comparable sample through social media [Frandsen M, Walters J, Ferguson SG. Exploring the viability of using online social media advertising as a recruitment method for smoking cessation clinical trials. Nicotine Tob Res 2014 Feb;16(2):247-251. [CrossRef] [Medline]15,Johnson KJ, Mueller NL, Williams K, Gutmann DH. Evaluation of participant recruitment methods to a rare disease online registry. Am J Med Genet A 2014 Jul;164A(7):1686-1694. [CrossRef] [Medline]16,Heffner JL, Wyszynski CM, Comstock B, Mercer LD, Bricker J. Overcoming recruitment challenges of web-based interventions for tobacco use: the case of web-based acceptance and commitment therapy for smoking cessation. Addict Behav 2013 Oct;38(10):2473-2476 [FREE Full text] [CrossRef] [Medline]20,Carlini BH, Safioti L, Rue TC, Miles L. Using Internet to recruit immigrants with language and culture barriers for tobacco and alcohol use screening: a study among Brazilians. J Immigr Minor Health 2015 Apr;17(2):553-560. [CrossRef] [Medline]28,Head BF, Dean E, Flanigan T, Swicegood J, Keating MD. Advertising for cognitive interviews: a comparison of Facebook, Craigslist, and snowball recruiting. Soc Sci Computer Rev 2015 Apr 17;34(3):360-377. [CrossRef]35,Carter-Harris L, Bartlett ER, Warrick A, Rawl S. Beyond traditional newspaper advertisement: leveraging Facebook-targeted advertisement to recruit long-term smokers for research. J Med Internet Res 2016;18(6):e117 [FREE Full text] [CrossRef] [Medline]41,Frandsen M, Thow M, Ferguson SG. The effectiveness of social media (Facebook) compared with more traditional advertising methods for recruiting eligible participants to health research studies: a randomized, controlled clinical trial. JMIR Res Protoc 2016;5(3):e161 [FREE Full text] [CrossRef] [Medline]42]. The economic status of individuals was reported in 6 studies and no significant differences were found [Frandsen M, Walters J, Ferguson SG. Exploring the viability of using online social media advertising as a recruitment method for smoking cessation clinical trials. Nicotine Tob Res 2014 Feb;16(2):247-251. [CrossRef] [Medline]15,Hernandez-Romieu AC, Sullivan PS, Sanchez TH, Kelley CF, Peterson JL, Del Rio C, et al. The comparability of men who have sex with men recruited from venue-time-space sampling and Facebook: a cohort study. JMIR Res Protoc 2014;3(3):e37 [FREE Full text] [CrossRef] [Medline]33,Head BF, Dean E, Flanigan T, Swicegood J, Keating MD. Advertising for cognitive interviews: a comparison of Facebook, Craigslist, and snowball recruiting. Soc Sci Computer Rev 2015 Apr 17;34(3):360-377. [CrossRef]35,Carter-Harris L, Bartlett ER, Warrick A, Rawl S. Beyond traditional newspaper advertisement: leveraging Facebook-targeted advertisement to recruit long-term smokers for research. J Med Internet Res 2016;18(6):e117 [FREE Full text] [CrossRef] [Medline]41,Frandsen M, Thow M, Ferguson SG. The effectiveness of social media (Facebook) compared with more traditional advertising methods for recruiting eligible participants to health research studies: a randomized, controlled clinical trial. JMIR Res Protoc 2016;5(3):e161 [FREE Full text] [CrossRef] [Medline]42]. However, Balfe et al [Balfe M, Doyle F, Conroy R. Using Facebook to recruit young adults for qualitative research projects: how difficult is it? Comput Inform Nurs 2012 Oct;30(10):511-515. [CrossRef] [Medline]14] noted that social media recruited more middle-class individuals. A total of 7 studies provided information about educational attainment of recruited individuals [Frandsen M, Walters J, Ferguson SG. Exploring the viability of using online social media advertising as a recruitment method for smoking cessation clinical trials. Nicotine Tob Res 2014 Feb;16(2):247-251. [CrossRef] [Medline]15,Burrell ER, Pines HA, Robbie E, Coleman L, Murphy RD, Hess KL, et al. Use of the location-based social networking application GRINDR as a recruitment tool in rectal microbicide development research. AIDS Behav 2012 Oct;16(7):1816-1820 [FREE Full text] [CrossRef] [Medline]18,Heffner JL, Wyszynski CM, Comstock B, Mercer LD, Bricker J. Overcoming recruitment challenges of web-based interventions for tobacco use: the case of web-based acceptance and commitment therapy for smoking cessation. Addict Behav 2013 Oct;38(10):2473-2476 [FREE Full text] [CrossRef] [Medline]20,Hernandez-Romieu AC, Sullivan PS, Sanchez TH, Kelley CF, Peterson JL, Del Rio C, et al. The comparability of men who have sex with men recruited from venue-time-space sampling and Facebook: a cohort study. JMIR Res Protoc 2014;3(3):e37 [FREE Full text] [CrossRef] [Medline]33,Head BF, Dean E, Flanigan T, Swicegood J, Keating MD. Advertising for cognitive interviews: a comparison of Facebook, Craigslist, and snowball recruiting. Soc Sci Computer Rev 2015 Apr 17;34(3):360-377. [CrossRef]35,Carter-Harris L, Bartlett ER, Warrick A, Rawl S. Beyond traditional newspaper advertisement: leveraging Facebook-targeted advertisement to recruit long-term smokers for research. J Med Internet Res 2016;18(6):e117 [FREE Full text] [CrossRef] [Medline]41]. It was found that education levels were higher in the social media group than in the traditional media group in 2 cases [Burrell ER, Pines HA, Robbie E, Coleman L, Murphy RD, Hess KL, et al. Use of the location-based social networking application GRINDR as a recruitment tool in rectal microbicide development research. AIDS Behav 2012 Oct;16(7):1816-1820 [FREE Full text] [CrossRef] [Medline]18,Heffner JL, Wyszynski CM, Comstock B, Mercer LD, Bricker J. Overcoming recruitment challenges of web-based interventions for tobacco use: the case of web-based acceptance and commitment therapy for smoking cessation. Addict Behav 2013 Oct;38(10):2473-2476 [FREE Full text] [CrossRef] [Medline]20], and Hernandez-Romieu et al [Hernandez-Romieu AC, Sullivan PS, Sanchez TH, Kelley CF, Peterson JL, Del Rio C, et al. The comparability of men who have sex with men recruited from venue-time-space sampling and Facebook: a cohort study. JMIR Res Protoc 2014;3(3):e37 [FREE Full text] [CrossRef] [Medline]33] found this to be the case for white participants recruited. Head et al [Head BF, Dean E, Flanigan T, Swicegood J, Keating MD. Advertising for cognitive interviews: a comparison of Facebook, Craigslist, and snowball recruiting. Soc Sci Computer Rev 2015 Apr 17;34(3):360-377. [CrossRef]35] (study 1) noted lower education levels for individuals in the social media group, which was attributed to the fact that Craigslist is more popular with better educated individuals. Quach et al [Quach S, Pereira JA, Russell ML, Wormsbecker AE, Ramsay H, Crowe L, et al. The good, bad, and ugly of online recruitment of parents for health-related focus groups: lessons learned. J Med Internet Res 2013 Jan;15(11):e250 [FREE Full text] [CrossRef] [Medline]23] also noted that education levels were higher in the social media recruitment group.

Cost-Effectiveness and Incentives

A total of 13 studies directly compared cost-effectiveness across different recruitment strategies [Frandsen M, Walters J, Ferguson SG. Exploring the viability of using online social media advertising as a recruitment method for smoking cessation clinical trials. Nicotine Tob Res 2014 Feb;16(2):247-251. [CrossRef] [Medline]15,Johnson KJ, Mueller NL, Williams K, Gutmann DH. Evaluation of participant recruitment methods to a rare disease online registry. Am J Med Genet A 2014 Jul;164A(7):1686-1694. [CrossRef] [Medline]16,Graham AL, Fang Y, Moreno JL, Streiff SL, Villegas J, Muñoz RF, et al. Online advertising to reach and recruit Latino smokers to an internet cessation program: impact and costs. J Med Internet Res 2012;14(4):e116 [FREE Full text] [CrossRef] [Medline]19,Heffner JL, Wyszynski CM, Comstock B, Mercer LD, Bricker J. Overcoming recruitment challenges of web-based interventions for tobacco use: the case of web-based acceptance and commitment therapy for smoking cessation. Addict Behav 2013 Oct;38(10):2473-2476 [FREE Full text] [CrossRef] [Medline]20,Carlini BH, Safioti L, Rue TC, Miles L. Using Internet to recruit immigrants with language and culture barriers for tobacco and alcohol use screening: a study among Brazilians. J Immigr Minor Health 2015 Apr;17(2):553-560. [CrossRef] [Medline]28,Wilkerson JM, Shenk JE, Grey JA, Simon Rosser BR, Noor SW. Recruitment strategies of methamphetamine-using men who have sex with men into an online survey. J Subst Use 2015;20(1):33-37 [FREE Full text] [CrossRef] [Medline]31,Hernandez-Romieu AC, Sullivan PS, Sanchez TH, Kelley CF, Peterson JL, Del Rio C, et al. The comparability of men who have sex with men recruited from venue-time-space sampling and Facebook: a cohort study. JMIR Res Protoc 2014;3(3):e37 [FREE Full text] [CrossRef] [Medline]33,Rait MA, Prochaska JJ, Rubinstein ML. Recruitment of adolescents for a smoking study: use of traditional strategies and social media. Transl Behav Med 2015 Sep;5(3):254-259 [FREE Full text] [CrossRef] [Medline]34,Kayrouz R, Dear BF, Karin E, Titov N. Facebook as an effective recruitment strategy for mental health research of hard to reach populations. Internet Interventions 2016 May;4(1):1-10.36,Gu LL, Skierkowski D, Florin P, Friend K, Ye Y. Facebook, Twitter, & Qr codes: an exploratory trail examining the feasibility of social media mechanisms for sample recruitment. Comput Hum Behav 2016 Jul;60:86-96. [CrossRef]37,Khatri C, Chapman SJ, Glasbey J, Kelly M, Nepogodiev D, Bhangu A, et al. Social media and Internet driven study recruitment: evaluating a new model for promoting collaborator engagement and participation. PLoS One 2015;10(3):e0118899 [FREE Full text] [CrossRef] [Medline]39,Carter-Harris L, Bartlett ER, Warrick A, Rawl S. Beyond traditional newspaper advertisement: leveraging Facebook-targeted advertisement to recruit long-term smokers for research. J Med Internet Res 2016;18(6):e117 [FREE Full text] [CrossRef] [Medline]41,Frandsen M, Thow M, Ferguson SG. The effectiveness of social media (Facebook) compared with more traditional advertising methods for recruiting eligible participants to health research studies: a randomized, controlled clinical trial. JMIR Res Protoc 2016;5(3):e161 [FREE Full text] [CrossRef] [Medline]42], and the results are presented in Table 2. The cost of advertisement on social media websites was determined by bidding prices for ads, which varied on a daily basis, or the cost of placing a banner ad on a particular website. Among these studies, 5 studies [Johnson KJ, Mueller NL, Williams K, Gutmann DH. Evaluation of participant recruitment methods to a rare disease online registry. Am J Med Genet A 2014 Jul;164A(7):1686-1694. [CrossRef] [Medline]16,Wilkerson JM, Shenk JE, Grey JA, Simon Rosser BR, Noor SW. Recruitment strategies of methamphetamine-using men who have sex with men into an online survey. J Subst Use 2015;20(1):33-37 [FREE Full text] [CrossRef] [Medline]31,Hernandez-Romieu AC, Sullivan PS, Sanchez TH, Kelley CF, Peterson JL, Del Rio C, et al. The comparability of men who have sex with men recruited from venue-time-space sampling and Facebook: a cohort study. JMIR Res Protoc 2014;3(3):e37 [FREE Full text] [CrossRef] [Medline]33,Kayrouz R, Dear BF, Karin E, Titov N. Facebook as an effective recruitment strategy for mental health research of hard to reach populations. Internet Interventions 2016 May;4(1):1-10.36,Carter-Harris L, Bartlett ER, Warrick A, Rawl S. Beyond traditional newspaper advertisement: leveraging Facebook-targeted advertisement to recruit long-term smokers for research. J Med Internet Res 2016;18(6):e117 [FREE Full text] [CrossRef] [Medline]41] found social media to be the most cost-effective method, whereas 7 studies found it less cost-effective than another method used [Frandsen M, Walters J, Ferguson SG. Exploring the viability of using online social media advertising as a recruitment method for smoking cessation clinical trials. Nicotine Tob Res 2014 Feb;16(2):247-251. [CrossRef] [Medline]15,Graham AL, Fang Y, Moreno JL, Streiff SL, Villegas J, Muñoz RF, et al. Online advertising to reach and recruit Latino smokers to an internet cessation program: impact and costs. J Med Internet Res 2012;14(4):e116 [FREE Full text] [CrossRef] [Medline]19,Heffner JL, Wyszynski CM, Comstock B, Mercer LD, Bricker J. Overcoming recruitment challenges of web-based interventions for tobacco use: the case of web-based acceptance and commitment therapy for smoking cessation. Addict Behav 2013 Oct;38(10):2473-2476 [FREE Full text] [CrossRef] [Medline]20,Carlini BH, Safioti L, Rue TC, Miles L. Using Internet to recruit immigrants with language and culture barriers for tobacco and alcohol use screening: a study among Brazilians. J Immigr Minor Health 2015 Apr;17(2):553-560. [CrossRef] [Medline]28,Rait MA, Prochaska JJ, Rubinstein ML. Recruitment of adolescents for a smoking study: use of traditional strategies and social media. Transl Behav Med 2015 Sep;5(3):254-259 [FREE Full text] [CrossRef] [Medline]34,Gu LL, Skierkowski D, Florin P, Friend K, Ye Y. Facebook, Twitter, & Qr codes: an exploratory trail examining the feasibility of social media mechanisms for sample recruitment. Comput Hum Behav 2016 Jul;60:86-96. [CrossRef]37,Frandsen M, Thow M, Ferguson SG. The effectiveness of social media (Facebook) compared with more traditional advertising methods for recruiting eligible participants to health research studies: a randomized, controlled clinical trial. JMIR Res Protoc 2016;5(3):e161 [FREE Full text] [CrossRef] [Medline]42]. Wilkerson et al [Wilkerson JM, Shenk JE, Grey JA, Simon Rosser BR, Noor SW. Recruitment strategies of methamphetamine-using men who have sex with men into an online survey. J Subst Use 2015;20(1):33-37 [FREE Full text] [CrossRef] [Medline]31] reported no cost using social media for recruitment, and Khatri et al [Khatri C, Chapman SJ, Glasbey J, Kelly M, Nepogodiev D, Bhangu A, et al. Social media and Internet driven study recruitment: evaluating a new model for promoting collaborator engagement and participation. PLoS One 2015;10(3):e0118899 [FREE Full text] [CrossRef] [Medline]39] reported no costs for all methods used. Among the 5 studies that found social media to be the most cost-effective method, 4 were observational studies [Johnson KJ, Mueller NL, Williams K, Gutmann DH. Evaluation of participant recruitment methods to a rare disease online registry. Am J Med Genet A 2014 Jul;164A(7):1686-1694. [CrossRef] [Medline]16,Wilkerson JM, Shenk JE, Grey JA, Simon Rosser BR, Noor SW. Recruitment strategies of methamphetamine-using men who have sex with men into an online survey. J Subst Use 2015;20(1):33-37 [FREE Full text] [CrossRef] [Medline]31,Hernandez-Romieu AC, Sullivan PS, Sanchez TH, Kelley CF, Peterson JL, Del Rio C, et al. The comparability of men who have sex with men recruited from venue-time-space sampling and Facebook: a cohort study. JMIR Res Protoc 2014;3(3):e37 [FREE Full text] [CrossRef] [Medline]33,Carter-Harris L, Bartlett ER, Warrick A, Rawl S. Beyond traditional newspaper advertisement: leveraging Facebook-targeted advertisement to recruit long-term smokers for research. J Med Internet Res 2016;18(6):e117 [FREE Full text] [CrossRef] [Medline]41], whereas 1 study was an interventional study [Kayrouz R, Dear BF, Karin E, Titov N. Facebook as an effective recruitment strategy for mental health research of hard to reach populations. Internet Interventions 2016 May;4(1):1-10.36]. Of the 7 studies that found recruitment through social media less cost-effective than another method, 4 were interventional studies [Frandsen M, Walters J, Ferguson SG. Exploring the viability of using online social media advertising as a recruitment method for smoking cessation clinical trials. Nicotine Tob Res 2014 Feb;16(2):247-251. [CrossRef] [Medline]15,Graham AL, Fang Y, Moreno JL, Streiff SL, Villegas J, Muñoz RF, et al. Online advertising to reach and recruit Latino smokers to an internet cessation program: impact and costs. J Med Internet Res 2012;14(4):e116 [FREE Full text] [CrossRef] [Medline]19,Heffner JL, Wyszynski CM, Comstock B, Mercer LD, Bricker J. Overcoming recruitment challenges of web-based interventions for tobacco use: the case of web-based acceptance and commitment therapy for smoking cessation. Addict Behav 2013 Oct;38(10):2473-2476 [FREE Full text] [CrossRef] [Medline]20,Frandsen M, Thow M, Ferguson SG. The effectiveness of social media (Facebook) compared with more traditional advertising methods for recruiting eligible participants to health research studies: a randomized, controlled clinical trial. JMIR Res Protoc 2016;5(3):e161 [FREE Full text] [CrossRef] [Medline]42] and 3 were observational studies [Carlini BH, Safioti L, Rue TC, Miles L. Using Internet to recruit immigrants with language and culture barriers for tobacco and alcohol use screening: a study among Brazilians. J Immigr Minor Health 2015 Apr;17(2):553-560. [CrossRef] [Medline]28,Rait MA, Prochaska JJ, Rubinstein ML. Recruitment of adolescents for a smoking study: use of traditional strategies and social media. Transl Behav Med 2015 Sep;5(3):254-259 [FREE Full text] [CrossRef] [Medline]34,Gu LL, Skierkowski D, Florin P, Friend K, Ye Y. Facebook, Twitter, & Qr codes: an exploratory trail examining the feasibility of social media mechanisms for sample recruitment. Comput Hum Behav 2016 Jul;60:86-96. [CrossRef]37]. Despite not formally measuring cost-effectiveness, Theriault et al [Thériault N, Bi P, Hiller JE, Nor M. Use of web 2.0 to recruit Australian gay men to an online HIV/AIDS survey. J Med Internet Res 2012;14(6):e149 [FREE Full text] [CrossRef] [Medline]26] noted social media to be “less costly” than traditional methods. This study was also an observational study. A total of 15 studies reported the use of incentives during recruitment, 12 of which were monetary [Balfe M, Doyle F, Conroy R. Using Facebook to recruit young adults for qualitative research projects: how difficult is it? Comput Inform Nurs 2012 Oct;30(10):511-515. [CrossRef] [Medline]14,Frandsen M, Walters J, Ferguson SG. Exploring the viability of using online social media advertising as a recruitment method for smoking cessation clinical trials. Nicotine Tob Res 2014 Feb;16(2):247-251. [CrossRef] [Medline]15,Martinez O, Wu E, Shultz AZ, Capote J, López Rios J, Sandfort T, et al. Still a hard-to-reach population? Using social media to recruit Latino gay couples for an HIV intervention adaptation study. J Med Internet Res 2014;16(4):e113 [FREE Full text] [CrossRef] [Medline]22,Quach S, Pereira JA, Russell ML, Wormsbecker AE, Ramsay H, Crowe L, et al. The good, bad, and ugly of online recruitment of parents for health-related focus groups: lessons learned. J Med Internet Res 2013 Jan;15(11):e250 [FREE Full text] [CrossRef] [Medline]23,Shere M, Zhao XY, Koren G. The role of social media in recruiting for clinical trials in pregnancy. PLoS One 2014;9(3):e92744 [FREE Full text] [CrossRef] [Medline]25,Haines-Saah RJ, Kelly MT, Oliffe JL, Bottorff JL. Picture Me Smokefree: a qualitative study using social media and digital photography to engage young adults in tobacco reduction and cessation. J Med Internet Res 2015;17(1):e27 [FREE Full text] [CrossRef] [Medline]29-Wilkerson JM, Shenk JE, Grey JA, Simon Rosser BR, Noor SW. Recruitment strategies of methamphetamine-using men who have sex with men into an online survey. J Subst Use 2015;20(1):33-37 [FREE Full text] [CrossRef] [Medline]31,Rait MA, Prochaska JJ, Rubinstein ML. Recruitment of adolescents for a smoking study: use of traditional strategies and social media. Transl Behav Med 2015 Sep;5(3):254-259 [FREE Full text] [CrossRef] [Medline]34,Head BF, Dean E, Flanigan T, Swicegood J, Keating MD. Advertising for cognitive interviews: a comparison of Facebook, Craigslist, and snowball recruiting. Soc Sci Computer Rev 2015 Apr 17;34(3):360-377. [CrossRef]35,Carter-Harris L, Bartlett ER, Warrick A, Rawl S. Beyond traditional newspaper advertisement: leveraging Facebook-targeted advertisement to recruit long-term smokers for research. J Med Internet Res 2016;18(6):e117 [FREE Full text] [CrossRef] [Medline]41] and 1 of which was nonmonetary [Yuan P, Bare MG, Johnson MO, Saberi P. Using online social media for recruitment of human immunodeficiency virus-positive participants: a cross-sectional survey. J Med Internet Res 2014;16(5):e117 [FREE Full text] [CrossRef] [Medline]17]. The remaining 2 studies used a combination of monetary and nonmonetary incentives [Gu LL, Skierkowski D, Florin P, Friend K, Ye Y. Facebook, Twitter, & Qr codes: an exploratory trail examining the feasibility of social media mechanisms for sample recruitment. Comput Hum Behav 2016 Jul;60:86-96. [CrossRef]37,Partridge SR, Balestracci K, Wong AT, Hebden L, McGeechan K, Denney-Wilson E, et al. Effective strategies to recruit young adults into the TXT2BFiT mHealth randomized controlled trial for weight gain prevention. JMIR Res Protoc 2015;4(2):e66 [FREE Full text] [CrossRef] [Medline]40]. Quach et al [Quach S, Pereira JA, Russell ML, Wormsbecker AE, Ramsay H, Crowe L, et al. The good, bad, and ugly of online recruitment of parents for health-related focus groups: lessons learned. J Med Internet Res 2013 Jan;15(11):e250 [FREE Full text] [CrossRef] [Medline]23] specifically looked at the effect of incentives on recruitment. Recruitment was split into 2 phases: phase 1, which offered a Can $5 gift card upon survey completion, and phase 2, which had no incentives. It was found that phase 1 attracted significantly more individuals than phase 2 (355 vs 125).

Table 2. Cost of recruitment for different strategies.
ReferenceCost of recruitment
Frandsen et al [Frandsen M, Walters J, Ferguson SG. Exploring the viability of using online social media advertising as a recruitment method for smoking cessation clinical trials. Nicotine Tob Res 2014 Feb;16(2):247-251. [CrossRef] [Medline]15]Facebook, AU $42.34/participant; newspaper, AU $21.52/participant.
Johnson et al [Johnson KJ, Mueller NL, Williams K, Gutmann DH. Evaluation of participant recruitment methods to a rare disease online registry. Am J Med Genet A 2014 Jul;164A(7):1686-1694. [CrossRef] [Medline]16]First ad campaign: Google, US $13.43/registrant; Facebook, US $3.80/registrant. Second ad campaign: Google, US $18.97/registrant; Facebook, US $7.71/registrant. Mailed campaign, US $154.95/registrant.
Graham et al [Graham AL, Fang Y, Moreno JL, Streiff SL, Villegas J, Muñoz RF, et al. Online advertising to reach and recruit Latino smokers to an internet cessation program: impact and costs. J Med Internet Res 2012;14(4):e116 [FREE Full text] [CrossRef] [Medline]19]Myspace Latino, US $600/registrant; Yahoo en Espanol, US $119.95/registrant; MSN Latino, US $141.15/registrant; MiGente, US $4166.67/registrant.
Heffner et al [Heffner JL, Wyszynski CM, Comstock B, Mercer LD, Bricker J. Overcoming recruitment challenges of web-based interventions for tobacco use: the case of web-based acceptance and commitment therapy for smoking cessation. Addict Behav 2013 Oct;38(10):2473-2476 [FREE Full text] [CrossRef] [Medline]20]Social media, US $172.76/participant; standard media, US $46.98/participant; broadcast emails, US $27.10/participant; word of mouth, US $5.27/participant; medical Internet media, US $26.19/participant; Google AdWords, US $50.26/participant.
Carlini et al [Carlini BH, Safioti L, Rue TC, Miles L. Using Internet to recruit immigrants with language and culture barriers for tobacco and alcohol use screening: a study among Brazilians. J Immigr Minor Health 2015 Apr;17(2):553-560. [CrossRef] [Medline]28]Facebook, US $8.92/respondent. Google, US $16.22/respondent. Email, US $5.95/respondent. Newsletter: Florida, US $13.12/respondent; New Jersey, US $35.60/respondent; California, US $250.00/respondent.
Wilkerson et al [Wilkerson JM, Shenk JE, Grey JA, Simon Rosser BR, Noor SW. Recruitment strategies of methamphetamine-using men who have sex with men into an online survey. J Subst Use 2015;20(1):33-37 [FREE Full text] [CrossRef] [Medline]31]Facebook, US $0/participant; email, US $0/participant; mobile ads, US $375.00/participant; browser ads, US $187.50/participant.
Hernandez-Romieu et al [Hernandez-Romieu AC, Sullivan PS, Sanchez TH, Kelley CF, Peterson JL, Del Rio C, et al. The comparability of men who have sex with men recruited from venue-time-space sampling and Facebook: a cohort study. JMIR Res Protoc 2014;3(3):e37 [FREE Full text] [CrossRef] [Medline]33]Facebook, US $68.6/participant; venues, US $91.2/participant.
Rait et al [Rait MA, Prochaska JJ, Rubinstein ML. Recruitment of adolescents for a smoking study: use of traditional strategies and social media. Transl Behav Med 2015 Sep;5(3):254-259 [FREE Full text] [CrossRef] [Medline]34]Facebook, US $149.64/registrant; bus ads, US $255/registrant; referral, US $7/registrant; school talks, US $336/registrant; fliers, US $10/registrant.
Kayrouz et al [Kayrouz R, Dear BF, Karin E, Titov N. Facebook as an effective recruitment strategy for mental health research of hard to reach populations. Internet Interventions 2016 May;4(1):1-10.36]Facebook, US $37/participant; traditional, US $40/participant.
Gu et al [Gu LL, Skierkowski D, Florin P, Friend K, Ye Y. Facebook, Twitter, & Qr codes: an exploratory trail examining the feasibility of social media mechanisms for sample recruitment. Comput Hum Behav 2016 Jul;60:86-96. [CrossRef]37]Facebook, US $30.29/participant; Twitter, US $22.20/participant; QR Codes, US $6.57/participant.
Khatri et al [Khatri C, Chapman SJ, Glasbey J, Kelly M, Nepogodiev D, Bhangu A, et al. Social media and Internet driven study recruitment: evaluating a new model for promoting collaborator engagement and participation. PLoS One 2015;10(3):e0118899 [FREE Full text] [CrossRef] [Medline]39]US $0 for all methods.
Carter-Harris et al [Carter-Harris L, Bartlett ER, Warrick A, Rawl S. Beyond traditional newspaper advertisement: leveraging Facebook-targeted advertisement to recruit long-term smokers for research. J Med Internet Res 2016;18(6):e117 [FREE Full text] [CrossRef] [Medline]41]Facebook, US $1.51/participant; newspaper, US $40.80/participant.
Frandsen et al [Frandsen M, Thow M, Ferguson SG. The effectiveness of social media (Facebook) compared with more traditional advertising methods for recruiting eligible participants to health research studies: a randomized, controlled clinical trial. JMIR Res Protoc 2016;5(3):e161 [FREE Full text] [CrossRef] [Medline]42]Facebook, AU $56.34/participant; traditional media, AU $52.33/participant.

Setting

Out of 30 studies, 18 studies were done in the United States [Johnson KJ, Mueller NL, Williams K, Gutmann DH. Evaluation of participant recruitment methods to a rare disease online registry. Am J Med Genet A 2014 Jul;164A(7):1686-1694. [CrossRef] [Medline]16-Martinez O, Wu E, Shultz AZ, Capote J, López Rios J, Sandfort T, et al. Still a hard-to-reach population? Using social media to recruit Latino gay couples for an HIV intervention adaptation study. J Med Internet Res 2014;16(4):e113 [FREE Full text] [CrossRef] [Medline]22,Rabin C, Horowitz S, Marcus B. Recruiting young adult cancer survivors for behavioral research. J Clin Psychol Med Settings 2013 Mar;20(1):33-36 [FREE Full text] [CrossRef] [Medline]24,Vial AC, Starks TJ, Parsons JT. Finding and recruiting the highest risk HIV-negative men who have sex with men. AIDS Educ Prev 2014 Feb;26(1):56-67 [FREE Full text] [CrossRef] [Medline]27,Carlini BH, Safioti L, Rue TC, Miles L. Using Internet to recruit immigrants with language and culture barriers for tobacco and alcohol use screening: a study among Brazilians. J Immigr Minor Health 2015 Apr;17(2):553-560. [CrossRef] [Medline]28,Wilkerson JM, Shenk JE, Grey JA, Simon Rosser BR, Noor SW. Recruitment strategies of methamphetamine-using men who have sex with men into an online survey. J Subst Use 2015;20(1):33-37 [FREE Full text] [CrossRef] [Medline]31,Hernandez-Romieu AC, Sullivan PS, Sanchez TH, Kelley CF, Peterson JL, Del Rio C, et al. The comparability of men who have sex with men recruited from venue-time-space sampling and Facebook: a cohort study. JMIR Res Protoc 2014;3(3):e37 [FREE Full text] [CrossRef] [Medline]33-Head BF, Dean E, Flanigan T, Swicegood J, Keating MD. Advertising for cognitive interviews: a comparison of Facebook, Craigslist, and snowball recruiting. Soc Sci Computer Rev 2015 Apr 17;34(3):360-377. [CrossRef]35,Gu LL, Skierkowski D, Florin P, Friend K, Ye Y. Facebook, Twitter, & Qr codes: an exploratory trail examining the feasibility of social media mechanisms for sample recruitment. Comput Hum Behav 2016 Jul;60:86-96. [CrossRef]37,Subbaraman MS, Laudet AB, Ritter LA, Stunz A, Kaskutas LA. Multi-source recruitment strategies for advancing addiction recovery research beyond treated samples. J Community Psychol 2015 Jun 1;43(5):560-575 [FREE Full text] [CrossRef] [Medline]38,Carter-Harris L, Bartlett ER, Warrick A, Rawl S. Beyond traditional newspaper advertisement: leveraging Facebook-targeted advertisement to recruit long-term smokers for research. J Med Internet Res 2016;18(6):e117 [FREE Full text] [CrossRef] [Medline]41], 5 studies in Australia [Frandsen M, Walters J, Ferguson SG. Exploring the viability of using online social media advertising as a recruitment method for smoking cessation clinical trials. Nicotine Tob Res 2014 Feb;16(2):247-251. [CrossRef] [Medline]15,Thériault N, Bi P, Hiller JE, Nor M. Use of web 2.0 to recruit Australian gay men to an online HIV/AIDS survey. J Med Internet Res 2012;14(6):e149 [FREE Full text] [CrossRef] [Medline]26,Kayrouz R, Dear BF, Karin E, Titov N. Facebook as an effective recruitment strategy for mental health research of hard to reach populations. Internet Interventions 2016 May;4(1):1-10.36,Partridge SR, Balestracci K, Wong AT, Hebden L, McGeechan K, Denney-Wilson E, et al. Effective strategies to recruit young adults into the TXT2BFiT mHealth randomized controlled trial for weight gain prevention. JMIR Res Protoc 2015;4(2):e66 [FREE Full text] [CrossRef] [Medline]40,Frandsen M, Thow M, Ferguson SG. The effectiveness of social media (Facebook) compared with more traditional advertising methods for recruiting eligible participants to health research studies: a randomized, controlled clinical trial. JMIR Res Protoc 2016;5(3):e161 [FREE Full text] [CrossRef] [Medline]42], 3 studies in Canada [Quach S, Pereira JA, Russell ML, Wormsbecker AE, Ramsay H, Crowe L, et al. The good, bad, and ugly of online recruitment of parents for health-related focus groups: lessons learned. J Med Internet Res 2013 Jan;15(11):e250 [FREE Full text] [CrossRef] [Medline]23,Shere M, Zhao XY, Koren G. The role of social media in recruiting for clinical trials in pregnancy. PLoS One 2014;9(3):e92744 [FREE Full text] [CrossRef] [Medline]25,Haines-Saah RJ, Kelly MT, Oliffe JL, Bottorff JL. Picture Me Smokefree: a qualitative study using social media and digital photography to engage young adults in tobacco reduction and cessation. J Med Internet Res 2015;17(1):e27 [FREE Full text] [CrossRef] [Medline]29], 1 study in Ireland [Balfe M, Doyle F, Conroy R. Using Facebook to recruit young adults for qualitative research projects: how difficult is it? Comput Inform Nurs 2012 Oct;30(10):511-515. [CrossRef] [Medline]14], 1 study in the Netherlands [Ince BU, Cuijpers P, Hof EV, Riper H. Reaching and recruiting Turkish migrants for a clinical trial through Facebook: a process evaluation. Internet Interventions 2014 Apr;1(2):74-83.32], 1 study in Japan [Miyagi E, Motoki Y, Asai-Sato M, Taguri M, Morita S, Hirahara F, et al. Web-based recruiting for a survey on knowledge and awareness of cervical cancer prevention among young women living in Kanagawa prefecture, Japan. Int J Gynecol Cancer 2014 Sep;24(7):1347-1355 [FREE Full text] [CrossRef] [Medline]30], and 1 study in the United Kingdom [Khatri C, Chapman SJ, Glasbey J, Kelly M, Nepogodiev D, Bhangu A, et al. Social media and Internet driven study recruitment: evaluating a new model for promoting collaborator engagement and participation. PLoS One 2015;10(3):e0118899 [FREE Full text] [CrossRef] [Medline]39].

It was found that 14 out of 30 studies used Facebook solely [Balfe M, Doyle F, Conroy R. Using Facebook to recruit young adults for qualitative research projects: how difficult is it? Comput Inform Nurs 2012 Oct;30(10):511-515. [CrossRef] [Medline]14-Johnson KJ, Mueller NL, Williams K, Gutmann DH. Evaluation of participant recruitment methods to a rare disease online registry. Am J Med Genet A 2014 Jul;164A(7):1686-1694. [CrossRef] [Medline]16,Vial AC, Starks TJ, Parsons JT. Finding and recruiting the highest risk HIV-negative men who have sex with men. AIDS Educ Prev 2014 Feb;26(1):56-67 [FREE Full text] [CrossRef] [Medline]27,Carlini BH, Safioti L, Rue TC, Miles L. Using Internet to recruit immigrants with language and culture barriers for tobacco and alcohol use screening: a study among Brazilians. J Immigr Minor Health 2015 Apr;17(2):553-560. [CrossRef] [Medline]28,Miyagi E, Motoki Y, Asai-Sato M, Taguri M, Morita S, Hirahara F, et al. Web-based recruiting for a survey on knowledge and awareness of cervical cancer prevention among young women living in Kanagawa prefecture, Japan. Int J Gynecol Cancer 2014 Sep;24(7):1347-1355 [FREE Full text] [CrossRef] [Medline]30,Hernandez-Romieu AC, Sullivan PS, Sanchez TH, Kelley CF, Peterson JL, Del Rio C, et al. The comparability of men who have sex with men recruited from venue-time-space sampling and Facebook: a cohort study. JMIR Res Protoc 2014;3(3):e37 [FREE Full text] [CrossRef] [Medline]33-Kayrouz R, Dear BF, Karin E, Titov N. Facebook as an effective recruitment strategy for mental health research of hard to reach populations. Internet Interventions 2016 May;4(1):1-10.36,Partridge SR, Balestracci K, Wong AT, Hebden L, McGeechan K, Denney-Wilson E, et al. Effective strategies to recruit young adults into the TXT2BFiT mHealth randomized controlled trial for weight gain prevention. JMIR Res Protoc 2015;4(2):e66 [FREE Full text] [CrossRef] [Medline]40-Frandsen M, Thow M, Ferguson SG. The effectiveness of social media (Facebook) compared with more traditional advertising methods for recruiting eligible participants to health research studies: a randomized, controlled clinical trial. JMIR Res Protoc 2016;5(3):e161 [FREE Full text] [CrossRef] [Medline]42]. Although Twitter was never used by itself, 9 studies used a combination of both Facebook and Twitter during the recruitment process [Heffner JL, Wyszynski CM, Comstock B, Mercer LD, Bricker J. Overcoming recruitment challenges of web-based interventions for tobacco use: the case of web-based acceptance and commitment therapy for smoking cessation. Addict Behav 2013 Oct;38(10):2473-2476 [FREE Full text] [CrossRef] [Medline]20,Layi G, Albright CA, Berenberg J, Plant K, Ritter P, Laurent D, et al. UH Cancer Center Hotline: Recruiting cancer survivors for an online health-behavior change intervention: are different strategies more beneficial? Hawaii Med J 2011 Oct;70(10):222-223 [FREE Full text] [Medline]21,Quach S, Pereira JA, Russell ML, Wormsbecker AE, Ramsay H, Crowe L, et al. The good, bad, and ugly of online recruitment of parents for health-related focus groups: lessons learned. J Med Internet Res 2013 Jan;15(11):e250 [FREE Full text] [CrossRef] [Medline]23,Shere M, Zhao XY, Koren G. The role of social media in recruiting for clinical trials in pregnancy. PLoS One 2014;9(3):e92744 [FREE Full text] [CrossRef] [Medline]25,Haines-Saah RJ, Kelly MT, Oliffe JL, Bottorff JL. Picture Me Smokefree: a qualitative study using social media and digital photography to engage young adults in tobacco reduction and cessation. J Med Internet Res 2015;17(1):e27 [FREE Full text] [CrossRef] [Medline]29,Wilkerson JM, Shenk JE, Grey JA, Simon Rosser BR, Noor SW. Recruitment strategies of methamphetamine-using men who have sex with men into an online survey. J Subst Use 2015;20(1):33-37 [FREE Full text] [CrossRef] [Medline]31,Ince BU, Cuijpers P, Hof EV, Riper H. Reaching and recruiting Turkish migrants for a clinical trial through Facebook: a process evaluation. Internet Interventions 2014 Apr;1(2):74-83.32,Gu LL, Skierkowski D, Florin P, Friend K, Ye Y. Facebook, Twitter, & Qr codes: an exploratory trail examining the feasibility of social media mechanisms for sample recruitment. Comput Hum Behav 2016 Jul;60:86-96. [CrossRef]37,Subbaraman MS, Laudet AB, Ritter LA, Stunz A, Kaskutas LA. Multi-source recruitment strategies for advancing addiction recovery research beyond treated samples. J Community Psychol 2015 Jun 1;43(5):560-575 [FREE Full text] [CrossRef] [Medline]38]. The overwhelming majority of studies (28/30) used Facebook in some way during recruitment, indicating that this was the most popular website for this purpose. The only times Facebook was not used were when there were social media sites that targeted a specific population of interest, such as MSM (men who have sex with men) [Burrell ER, Pines HA, Robbie E, Coleman L, Murphy RD, Hess KL, et al. Use of the location-based social networking application GRINDR as a recruitment tool in rectal microbicide development research. AIDS Behav 2012 Oct;16(7):1816-1820 [FREE Full text] [CrossRef] [Medline]18] and Latinos [Graham AL, Fang Y, Moreno JL, Streiff SL, Villegas J, Muñoz RF, et al. Online advertising to reach and recruit Latino smokers to an internet cessation program: impact and costs. J Med Internet Res 2012;14(4):e116 [FREE Full text] [CrossRef] [Medline]19]. Other recruitment methods included visiting various community venues such as clubs and bars, health care centers, and universities. There was also recruitment done via numerous websites that would not be classified as social media based on our definition, such as Craigslist, Kijiji, and Google AdWords. Overall, using a combination of social media websites, or not using Facebook, resulted in lower recruitment through social media (Figure 2).

Figure 2. Recruitment success based on social media website(s) used. Note: Other = GRINDR, Myspace Latino + MiGente, Facebook + Google AdWords, Facebook + Twitter + Ning, Facebook + Gaydar, Facebook + Twitter + Youtube, Facebook + Twitter + LinkedIn + Tumblr, Facebook + Twitter + Instagram + Grindr + Jack’d + Scruff.
View this figure

Principal Findings

It was found that social media was the most effective method in 12/30 studies and not the most effective method for recruiting patients in 15/30 studies. The effectiveness of social media for recruitment of study participants is highly variable and dependent on specific study characteristics such as age, whether the population is difficult to reach through traditional methods, and the method used to measure the primary outcome. This contrasts with the finding that social media is a highly effective recruitment method presented in studies such as those by Fenner et al [Fenner Y, Garland SM, Moore EE, Jayasinghe Y, Fletcher A, Tabrizi SN, et al. Web-based recruiting for health research using a social networking site: an exploratory study. J Med Internet Res 2012;14(1):e20 [FREE Full text] [CrossRef] [Medline]6] and Ramo and Prochaska [Ramo DE, Prochaska JJ. Broad reach and targeted recruitment using Facebook for an online survey of young adult substance use. J Med Internet Res 2012;14(1):e28 [FREE Full text] [CrossRef] [Medline]7]. One possible reason for this is the fact that these studies did not use other methods of recruitment, and therefore solely focused their efforts on recruitment through social media. Among the studies where the effort put into each recruitment method was discernible, it was generally found that the effort put into recruitment via social media correlated with the number of participants recruited through this method. Effort was defined as the combination of the number of social media websites used, the extensiveness of the social media recruitment strategy as compared with that of traditional methods, the frequency with which recruitment was conducted, and the time spent on recruitment through social media when this information was reported. Studies that put more effort into recruitment via social media than via other methods generally recruited the most number of participants through social media [Yuan P, Bare MG, Johnson MO, Saberi P. Using online social media for recruitment of human immunodeficiency virus-positive participants: a cross-sectional survey. J Med Internet Res 2014;16(5):e117 [FREE Full text] [CrossRef] [Medline]17,Martinez O, Wu E, Shultz AZ, Capote J, López Rios J, Sandfort T, et al. Still a hard-to-reach population? Using social media to recruit Latino gay couples for an HIV intervention adaptation study. J Med Internet Res 2014;16(4):e113 [FREE Full text] [CrossRef] [Medline]22,Ince BU, Cuijpers P, Hof EV, Riper H. Reaching and recruiting Turkish migrants for a clinical trial through Facebook: a process evaluation. Internet Interventions 2014 Apr;1(2):74-83.32,Kayrouz R, Dear BF, Karin E, Titov N. Facebook as an effective recruitment strategy for mental health research of hard to reach populations. Internet Interventions 2016 May;4(1):1-10.36,Carter-Harris L, Bartlett ER, Warrick A, Rawl S. Beyond traditional newspaper advertisement: leveraging Facebook-targeted advertisement to recruit long-term smokers for research. J Med Internet Res 2016;18(6):e117 [FREE Full text] [CrossRef] [Medline]41] and vice versa [Burrell ER, Pines HA, Robbie E, Coleman L, Murphy RD, Hess KL, et al. Use of the location-based social networking application GRINDR as a recruitment tool in rectal microbicide development research. AIDS Behav 2012 Oct;16(7):1816-1820 [FREE Full text] [CrossRef] [Medline]18,Heffner JL, Wyszynski CM, Comstock B, Mercer LD, Bricker J. Overcoming recruitment challenges of web-based interventions for tobacco use: the case of web-based acceptance and commitment therapy for smoking cessation. Addict Behav 2013 Oct;38(10):2473-2476 [FREE Full text] [CrossRef] [Medline]20,Shere M, Zhao XY, Koren G. The role of social media in recruiting for clinical trials in pregnancy. PLoS One 2014;9(3):e92744 [FREE Full text] [CrossRef] [Medline]25,Vial AC, Starks TJ, Parsons JT. Finding and recruiting the highest risk HIV-negative men who have sex with men. AIDS Educ Prev 2014 Feb;26(1):56-67 [FREE Full text] [CrossRef] [Medline]27,Hernandez-Romieu AC, Sullivan PS, Sanchez TH, Kelley CF, Peterson JL, Del Rio C, et al. The comparability of men who have sex with men recruited from venue-time-space sampling and Facebook: a cohort study. JMIR Res Protoc 2014;3(3):e37 [FREE Full text] [CrossRef] [Medline]33,Gu LL, Skierkowski D, Florin P, Friend K, Ye Y. Facebook, Twitter, & Qr codes: an exploratory trail examining the feasibility of social media mechanisms for sample recruitment. Comput Hum Behav 2016 Jul;60:86-96. [CrossRef]37,Subbaraman MS, Laudet AB, Ritter LA, Stunz A, Kaskutas LA. Multi-source recruitment strategies for advancing addiction recovery research beyond treated samples. J Community Psychol 2015 Jun 1;43(5):560-575 [FREE Full text] [CrossRef] [Medline]38,Partridge SR, Balestracci K, Wong AT, Hebden L, McGeechan K, Denney-Wilson E, et al. Effective strategies to recruit young adults into the TXT2BFiT mHealth randomized controlled trial for weight gain prevention. JMIR Res Protoc 2015;4(2):e66 [FREE Full text] [CrossRef] [Medline]40].

It was found that in 2 cases [Johnson KJ, Mueller NL, Williams K, Gutmann DH. Evaluation of participant recruitment methods to a rare disease online registry. Am J Med Genet A 2014 Jul;164A(7):1686-1694. [CrossRef] [Medline]16,Carlini BH, Safioti L, Rue TC, Miles L. Using Internet to recruit immigrants with language and culture barriers for tobacco and alcohol use screening: a study among Brazilians. J Immigr Minor Health 2015 Apr;17(2):553-560. [CrossRef] [Medline]28] social media was able to recruit a sample that was comparable to the control group. However, in 12 cases the sample recruited via social media was not comparable to the general population. Participants were found to be younger [Frandsen M, Walters J, Ferguson SG. Exploring the viability of using online social media advertising as a recruitment method for smoking cessation clinical trials. Nicotine Tob Res 2014 Feb;16(2):247-251. [CrossRef] [Medline]15,Yuan P, Bare MG, Johnson MO, Saberi P. Using online social media for recruitment of human immunodeficiency virus-positive participants: a cross-sectional survey. J Med Internet Res 2014;16(5):e117 [FREE Full text] [CrossRef] [Medline]17,Burrell ER, Pines HA, Robbie E, Coleman L, Murphy RD, Hess KL, et al. Use of the location-based social networking application GRINDR as a recruitment tool in rectal microbicide development research. AIDS Behav 2012 Oct;16(7):1816-1820 [FREE Full text] [CrossRef] [Medline]18,Heffner JL, Wyszynski CM, Comstock B, Mercer LD, Bricker J. Overcoming recruitment challenges of web-based interventions for tobacco use: the case of web-based acceptance and commitment therapy for smoking cessation. Addict Behav 2013 Oct;38(10):2473-2476 [FREE Full text] [CrossRef] [Medline]20,Quach S, Pereira JA, Russell ML, Wormsbecker AE, Ramsay H, Crowe L, et al. The good, bad, and ugly of online recruitment of parents for health-related focus groups: lessons learned. J Med Internet Res 2013 Jan;15(11):e250 [FREE Full text] [CrossRef] [Medline]23,Frandsen M, Thow M, Ferguson SG. The effectiveness of social media (Facebook) compared with more traditional advertising methods for recruiting eligible participants to health research studies: a randomized, controlled clinical trial. JMIR Res Protoc 2016;5(3):e161 [FREE Full text] [CrossRef] [Medline]42], older [Hernandez-Romieu AC, Sullivan PS, Sanchez TH, Kelley CF, Peterson JL, Del Rio C, et al. The comparability of men who have sex with men recruited from venue-time-space sampling and Facebook: a cohort study. JMIR Res Protoc 2014;3(3):e37 [FREE Full text] [CrossRef] [Medline]33,Head BF, Dean E, Flanigan T, Swicegood J, Keating MD. Advertising for cognitive interviews: a comparison of Facebook, Craigslist, and snowball recruiting. Soc Sci Computer Rev 2015 Apr 17;34(3):360-377. [CrossRef]35], more white [Burrell ER, Pines HA, Robbie E, Coleman L, Murphy RD, Hess KL, et al. Use of the location-based social networking application GRINDR as a recruitment tool in rectal microbicide development research. AIDS Behav 2012 Oct;16(7):1816-1820 [FREE Full text] [CrossRef] [Medline]18,Head BF, Dean E, Flanigan T, Swicegood J, Keating MD. Advertising for cognitive interviews: a comparison of Facebook, Craigslist, and snowball recruiting. Soc Sci Computer Rev 2015 Apr 17;34(3):360-377. [CrossRef]35,Carter-Harris L, Bartlett ER, Warrick A, Rawl S. Beyond traditional newspaper advertisement: leveraging Facebook-targeted advertisement to recruit long-term smokers for research. J Med Internet Res 2016;18(6):e117 [FREE Full text] [CrossRef] [Medline]41], had a higher education level [Burrell ER, Pines HA, Robbie E, Coleman L, Murphy RD, Hess KL, et al. Use of the location-based social networking application GRINDR as a recruitment tool in rectal microbicide development research. AIDS Behav 2012 Oct;16(7):1816-1820 [FREE Full text] [CrossRef] [Medline]18,Heffner JL, Wyszynski CM, Comstock B, Mercer LD, Bricker J. Overcoming recruitment challenges of web-based interventions for tobacco use: the case of web-based acceptance and commitment therapy for smoking cessation. Addict Behav 2013 Oct;38(10):2473-2476 [FREE Full text] [CrossRef] [Medline]20,Quach S, Pereira JA, Russell ML, Wormsbecker AE, Ramsay H, Crowe L, et al. The good, bad, and ugly of online recruitment of parents for health-related focus groups: lessons learned. J Med Internet Res 2013 Jan;15(11):e250 [FREE Full text] [CrossRef] [Medline]23,Hernandez-Romieu AC, Sullivan PS, Sanchez TH, Kelley CF, Peterson JL, Del Rio C, et al. The comparability of men who have sex with men recruited from venue-time-space sampling and Facebook: a cohort study. JMIR Res Protoc 2014;3(3):e37 [FREE Full text] [CrossRef] [Medline]33], had a lower education level [Head BF, Dean E, Flanigan T, Swicegood J, Keating MD. Advertising for cognitive interviews: a comparison of Facebook, Craigslist, and snowball recruiting. Soc Sci Computer Rev 2015 Apr 17;34(3):360-377. [CrossRef]35], more female [Gu LL, Skierkowski D, Florin P, Friend K, Ye Y. Facebook, Twitter, & Qr codes: an exploratory trail examining the feasibility of social media mechanisms for sample recruitment. Comput Hum Behav 2016 Jul;60:86-96. [CrossRef]37], and had higher socioeconomic status [Balfe M, Doyle F, Conroy R. Using Facebook to recruit young adults for qualitative research projects: how difficult is it? Comput Inform Nurs 2012 Oct;30(10):511-515. [CrossRef] [Medline]14]. It was also noted that all studies were from developed countries.

There is evidence that social media is best able to recruit individuals for observational survey-type studies as opposed to interventional studies; however, with a limited number of studies (n=12) to evaluate, more studies are needed. There is also evidence that social media can be a better recruitment method than other Internet sources alone. Of the 7 studies that compared recruitment via social media only with other Internet sources, 5 found social media to be the top method of recruitment [Yuan P, Bare MG, Johnson MO, Saberi P. Using online social media for recruitment of human immunodeficiency virus-positive participants: a cross-sectional survey. J Med Internet Res 2014;16(5):e117 [FREE Full text] [CrossRef] [Medline]17,Carlini BH, Safioti L, Rue TC, Miles L. Using Internet to recruit immigrants with language and culture barriers for tobacco and alcohol use screening: a study among Brazilians. J Immigr Minor Health 2015 Apr;17(2):553-560. [CrossRef] [Medline]28,Miyagi E, Motoki Y, Asai-Sato M, Taguri M, Morita S, Hirahara F, et al. Web-based recruiting for a survey on knowledge and awareness of cervical cancer prevention among young women living in Kanagawa prefecture, Japan. Int J Gynecol Cancer 2014 Sep;24(7):1347-1355 [FREE Full text] [CrossRef] [Medline]30,Wilkerson JM, Shenk JE, Grey JA, Simon Rosser BR, Noor SW. Recruitment strategies of methamphetamine-using men who have sex with men into an online survey. J Subst Use 2015;20(1):33-37 [FREE Full text] [CrossRef] [Medline]31,Head BF, Dean E, Flanigan T, Swicegood J, Keating MD. Advertising for cognitive interviews: a comparison of Facebook, Craigslist, and snowball recruiting. Soc Sci Computer Rev 2015 Apr 17;34(3):360-377. [CrossRef]35]. Studies that targeted more specific groups, rather than a more general audience, can also potentially be more successful at recruiting via social media. For instance, social media seemed to be successful at recruiting hard-to-reach populations [Johnson KJ, Mueller NL, Williams K, Gutmann DH. Evaluation of participant recruitment methods to a rare disease online registry. Am J Med Genet A 2014 Jul;164A(7):1686-1694. [CrossRef] [Medline]16,Yuan P, Bare MG, Johnson MO, Saberi P. Using online social media for recruitment of human immunodeficiency virus-positive participants: a cross-sectional survey. J Med Internet Res 2014;16(5):e117 [FREE Full text] [CrossRef] [Medline]17,Carlini BH, Safioti L, Rue TC, Miles L. Using Internet to recruit immigrants with language and culture barriers for tobacco and alcohol use screening: a study among Brazilians. J Immigr Minor Health 2015 Apr;17(2):553-560. [CrossRef] [Medline]28,Wilkerson JM, Shenk JE, Grey JA, Simon Rosser BR, Noor SW. Recruitment strategies of methamphetamine-using men who have sex with men into an online survey. J Subst Use 2015;20(1):33-37 [FREE Full text] [CrossRef] [Medline]31,Ince BU, Cuijpers P, Hof EV, Riper H. Reaching and recruiting Turkish migrants for a clinical trial through Facebook: a process evaluation. Internet Interventions 2014 Apr;1(2):74-83.32,Kayrouz R, Dear BF, Karin E, Titov N. Facebook as an effective recruitment strategy for mental health research of hard to reach populations. Internet Interventions 2016 May;4(1):1-10.36] and individuals with specific conditions or disorders [Balfe M, Doyle F, Conroy R. Using Facebook to recruit young adults for qualitative research projects: how difficult is it? Comput Inform Nurs 2012 Oct;30(10):511-515. [CrossRef] [Medline]14,Johnson KJ, Mueller NL, Williams K, Gutmann DH. Evaluation of participant recruitment methods to a rare disease online registry. Am J Med Genet A 2014 Jul;164A(7):1686-1694. [CrossRef] [Medline]16,Yuan P, Bare MG, Johnson MO, Saberi P. Using online social media for recruitment of human immunodeficiency virus-positive participants: a cross-sectional survey. J Med Internet Res 2014;16(5):e117 [FREE Full text] [CrossRef] [Medline]17,Carlini BH, Safioti L, Rue TC, Miles L. Using Internet to recruit immigrants with language and culture barriers for tobacco and alcohol use screening: a study among Brazilians. J Immigr Minor Health 2015 Apr;17(2):553-560. [CrossRef] [Medline]28,Wilkerson JM, Shenk JE, Grey JA, Simon Rosser BR, Noor SW. Recruitment strategies of methamphetamine-using men who have sex with men into an online survey. J Subst Use 2015;20(1):33-37 [FREE Full text] [CrossRef] [Medline]31,Ince BU, Cuijpers P, Hof EV, Riper H. Reaching and recruiting Turkish migrants for a clinical trial through Facebook: a process evaluation. Internet Interventions 2014 Apr;1(2):74-83.32]. This finding was in agreement with the findings of Park and Calamaro [Park BK, Calamaro C. A systematic review of social networking sites: innovative platforms for health research targeting adolescents and young adults. J Nurs Scholarsh 2013 Sep;45(3):256-264. [CrossRef] [Medline]12] and Ryan [Ryan GS. Online social networks for patient involvement and recruitment in clinical research. Nurse Res 2013;21(1):35-39. [CrossRef] [Medline]13]. This is likely because in such a case it is difficult for any one conventional source to find a sufficient number of individuals, as was noted in the study by Johnson et al [Johnson KJ, Mueller NL, Williams K, Gutmann DH. Evaluation of participant recruitment methods to a rare disease online registry. Am J Med Genet A 2014 Jul;164A(7):1686-1694. [CrossRef] [Medline]16]. Once again, however, there is limited evidence for this. More studies need to be done looking at the effectiveness of recruitment using social media in these specific groups. Interestingly, the use of multiple social media websites appeared to result in lower recruitment through social media. When multiple social media websites were used, however, the most successful website at recruitment was Facebook. Low recruitment through Facebook alone typically indicated low overall recruitment through social media and vice versa. Therefore, we speculate that this finding is not due to the use of multiple social media sites but due to the success of recruitment through other methods in these studies.

A total of 5 studies found social media to be the most cost-effective method [Johnson KJ, Mueller NL, Williams K, Gutmann DH. Evaluation of participant recruitment methods to a rare disease online registry. Am J Med Genet A 2014 Jul;164A(7):1686-1694. [CrossRef] [Medline]16,Wilkerson JM, Shenk JE, Grey JA, Simon Rosser BR, Noor SW. Recruitment strategies of methamphetamine-using men who have sex with men into an online survey. J Subst Use 2015;20(1):33-37 [FREE Full text] [CrossRef] [Medline]31,Hernandez-Romieu AC, Sullivan PS, Sanchez TH, Kelley CF, Peterson JL, Del Rio C, et al. The comparability of men who have sex with men recruited from venue-time-space sampling and Facebook: a cohort study. JMIR Res Protoc 2014;3(3):e37 [FREE Full text] [CrossRef] [Medline]33,Kayrouz R, Dear BF, Karin E, Titov N. Facebook as an effective recruitment strategy for mental health research of hard to reach populations. Internet Interventions 2016 May;4(1):1-10.36,Carter-Harris L, Bartlett ER, Warrick A, Rawl S. Beyond traditional newspaper advertisement: leveraging Facebook-targeted advertisement to recruit long-term smokers for research. J Med Internet Res 2016;18(6):e117 [FREE Full text] [CrossRef] [Medline]41], whereas 7 studies found that it was not the most cost-effective method [Frandsen M, Walters J, Ferguson SG. Exploring the viability of using online social media advertising as a recruitment method for smoking cessation clinical trials. Nicotine Tob Res 2014 Feb;16(2):247-251. [CrossRef] [Medline]15,Graham AL, Fang Y, Moreno JL, Streiff SL, Villegas J, Muñoz RF, et al. Online advertising to reach and recruit Latino smokers to an internet cessation program: impact and costs. J Med Internet Res 2012;14(4):e116 [FREE Full text] [CrossRef] [Medline]19,Heffner JL, Wyszynski CM, Comstock B, Mercer LD, Bricker J. Overcoming recruitment challenges of web-based interventions for tobacco use: the case of web-based acceptance and commitment therapy for smoking cessation. Addict Behav 2013 Oct;38(10):2473-2476 [FREE Full text] [CrossRef] [Medline]20,Carlini BH, Safioti L, Rue TC, Miles L. Using Internet to recruit immigrants with language and culture barriers for tobacco and alcohol use screening: a study among Brazilians. J Immigr Minor Health 2015 Apr;17(2):553-560. [CrossRef] [Medline]28,Rait MA, Prochaska JJ, Rubinstein ML. Recruitment of adolescents for a smoking study: use of traditional strategies and social media. Transl Behav Med 2015 Sep;5(3):254-259 [FREE Full text] [CrossRef] [Medline]34,Gu LL, Skierkowski D, Florin P, Friend K, Ye Y. Facebook, Twitter, & Qr codes: an exploratory trail examining the feasibility of social media mechanisms for sample recruitment. Comput Hum Behav 2016 Jul;60:86-96. [CrossRef]37,Frandsen M, Thow M, Ferguson SG. The effectiveness of social media (Facebook) compared with more traditional advertising methods for recruiting eligible participants to health research studies: a randomized, controlled clinical trial. JMIR Res Protoc 2016;5(3):e161 [FREE Full text] [CrossRef] [Medline]42]. Therefore, no significant conclusions on cost-effectiveness can be made. This finding is slightly different from Park and Calamaro’s [Park BK, Calamaro C. A systematic review of social networking sites: innovative platforms for health research targeting adolescents and young adults. J Nurs Scholarsh 2013 Sep;45(3):256-264. [CrossRef] [Medline]12] conclusion of social media being cost-effective. One potential explanation for this is that other studies, which focused solely on recruitment using social media, recruited higher numbers of individuals (450 in the study by Ramo and Prochaska and 426 in the study by Fenner et al) [Fenner Y, Garland SM, Moore EE, Jayasinghe Y, Fletcher A, Tabrizi SN, et al. Web-based recruiting for health research using a social networking site: an exploratory study. J Med Internet Res 2012;14(1):e20 [FREE Full text] [CrossRef] [Medline]6,Ramo DE, Prochaska JJ. Broad reach and targeted recruitment using Facebook for an online survey of young adult substance use. J Med Internet Res 2012;14(1):e28 [FREE Full text] [CrossRef] [Medline]7]. However, these studies also did not compare cost-effectiveness of other methods in recruiting the same target population, so it is uncertain whether traditional methods would be even more cost-effective in these cases. Additionally, the sample sizes of both the study by Park and Calamaro [Park BK, Calamaro C. A systematic review of social networking sites: innovative platforms for health research targeting adolescents and young adults. J Nurs Scholarsh 2013 Sep;45(3):256-264. [CrossRef] [Medline]12] (n=3) and our review (n=12) are likely too small to draw highly accurate conclusions. The cost of recruitment is also highly variable and depends on interactions between recruitment sites, study size, and target population. Advertisements are additionally affected by the bid price needed to display the advertisements, as noted by Fenner et al [Fenner Y, Garland SM, Moore EE, Jayasinghe Y, Fletcher A, Tabrizi SN, et al. Web-based recruiting for health research using a social networking site: an exploratory study. J Med Internet Res 2012;14(1):e20 [FREE Full text] [CrossRef] [Medline]6] and Ramo and Prochaska [Ramo DE, Prochaska JJ. Broad reach and targeted recruitment using Facebook for an online survey of young adult substance use. J Med Internet Res 2012;14(1):e28 [FREE Full text] [CrossRef] [Medline]7]. Therefore, a more complex analysis is needed to understand cost-effectiveness when recruiting through social media.

Recruitment through social media is affected by several factors. Quach et al [Quach S, Pereira JA, Russell ML, Wormsbecker AE, Ramsay H, Crowe L, et al. The good, bad, and ugly of online recruitment of parents for health-related focus groups: lessons learned. J Med Internet Res 2013 Jan;15(11):e250 [FREE Full text] [CrossRef] [Medline]23] explicitly showed that adding a monetary incentive can increase recruitment through social media. Although 1 study represents limited evidence for the effectiveness of incentives, this finding is in line with the conclusion by Bower et al [Bower P, Brueton V, Gamble C, Treweek S, Smith CT, Young B, et al. Interventions to improve recruitment and retention in clinical trials: a survey and workshop to assess current practice and future priorities. Trials 2014;15:399 [FREE Full text] [CrossRef] [Medline]43] that monetary incentives can increase recruitment into medical health studies. Another important factor is sex. It has been shown that women are more likely to search the Web for health information than men [Bidmon S, Terlutter R. Gender differences in searching for health information on the Internet and the virtual patient-physician relationship in Germany: exploratory results on how men and women differ and why. J Med Internet Res 2015;17(6):e156 [FREE Full text] [CrossRef] [Medline]44] and are more likely to participate in health studies [Galea S, Tracy M. Participation rates in epidemiologic studies. Ann Epidemiol 2007 Sep;17(9):643-653. [CrossRef] [Medline]45]. Although no differences between male and female recruitment were found in this review, having an adequate representativeness in sex needs to be kept in mind by researchers when designing recruitment mechanisms.

When recruiting a target population, it is also important to consider how that population uses social media. For instance, for young MSM, Holloway et al [Holloway IW, Rice E, Gibbs J, Winetrobe H, Dunlap S, Rhoades H. Acceptability of smartphone application-based HIV prevention among young men who have sex with men. AIDS Behav 2014 Feb;18(2):285-296 [FREE Full text] [CrossRef] [Medline]46] noted that this population was more likely to use dating sites when meeting new sexual partners and used Facebook when communicating with individuals they already knew. Therefore, researchers interested in targeting this population for a sexual health study should use these dating sites for recruitment and use Facebook for a nonsexual health study. Some social media sites are also more popular among certain demographics—for instance, within MSM, Grindr is more popular among whites, whereas Jack’d is more popular among African Americans [Sun CJ, Stowers J, Miller C, Bachmann LH, Rhodes SD. Acceptability and feasibility of using established geosocial and sexual networking mobile applications to promote HIV and STD testing among men who have sex with men. AIDS Behav 2015 Mar;19(3):543-552. [CrossRef] [Medline]47].

Overall, researchers should consider how the target population uses social media when deciding which recruitment strategies to use, taking into account factors such as age, sex, the likelihood of a comparable sample, and whether the population would be difficult to reach through traditional methods. Even if social media can recruit more individuals than other methods, researchers must still estimate the cost-effectiveness of recruitment via this method, and in the event that cost-effectiveness is low, determine if recruitment is worth the low cost-effectiveness.

Limitations of Using Social Media for Research Recruitment

Ads on social media websites were targeted at specific age groups and locations based only on the information an individual provided on his or her profile. Therefore, there is no guarantee that awareness of the study reached all potential participants, and this could bias the results. Many studies created a separate page to recruit participants. Once again, not all potential participants may have been made aware of this page. For the studies that involved surveys, individuals could have reported false demographic information in the survey or could have given multiple responses, and verification of information on the Web remains more difficult than in person. In addition, individuals may not have correctly reported their source of recruitment, as Johnson et al [Johnson KJ, Mueller NL, Williams K, Gutmann DH. Evaluation of participant recruitment methods to a rare disease online registry. Am J Med Genet A 2014 Jul;164A(7):1686-1694. [CrossRef] [Medline]16] noted.

Within social media itself different types of recruiting strategies were used across different studies, such as creating a separate page to advertise the study, targeted advertisements, and private messages. Different strategies can alter the number or demographics of participants recruited and thus may not necessarily lead to a fair comparison between social media and other methods.

There is also the possibility that neither social media nor traditional methods were representative of the target population, as Ince et al [Ince BU, Cuijpers P, Hof EV, Riper H. Reaching and recruiting Turkish migrants for a clinical trial through Facebook: a process evaluation. Internet Interventions 2014 Apr;1(2):74-83.32] and Gu et al [Gu LL, Skierkowski D, Florin P, Friend K, Ye Y. Facebook, Twitter, & Qr codes: an exploratory trail examining the feasibility of social media mechanisms for sample recruitment. Comput Hum Behav 2016 Jul;60:86-96. [CrossRef]37] noted. This can result from self-selection bias, where individuals who agree to participate in a study are more motivated than the general target population, and the demographic characteristics of these individuals differ from the remainder of the target population [Khazaal Y, van Singer M, Chatton A, Achab S, Zullino D, Rothen S, et al. Does self-selection affect samples' representativeness in online surveys? An investigation in online video game research. J Med Internet Res 2014;16(7):e164 [FREE Full text] [CrossRef] [Medline]48]. Although this may limit the ability to have a representative outcome when recruiting with social media, if researchers can understand the ways in which self-selection bias takes place, then recruitment of a representative outcome, as compared with the target population, is still possible. For example, Fenner et al [Fenner Y, Garland SM, Moore EE, Jayasinghe Y, Fletcher A, Tabrizi SN, et al. Web-based recruiting for health research using a social networking site: an exploratory study. J Med Internet Res 2012;14(1):e20 [FREE Full text] [CrossRef] [Medline]6] noted that, at their study site, rural participants were underrepresented because of the increased driving distance to reach the site. Oversampling of rural participants can therefore create a representative outcome [Fenner Y, Garland SM, Moore EE, Jayasinghe Y, Fletcher A, Tabrizi SN, et al. Web-based recruiting for health research using a social networking site: an exploratory study. J Med Internet Res 2012;14(1):e20 [FREE Full text] [CrossRef] [Medline]6].

Limitations of This Study

To identify relevant studies, an extensive list of keywords was used in the search strategy, and the reference lists of the identified studies were additionally scanned in order to extract more relevant studies. However, although we have tried to be as thorough as possible in identifying the literature, it is possible that some relevant studies were missed. Also, given the rapidly growing adoption of social media, we anticipate this body of literature to expand exponentially; this review is limited to studies published before August 10, 2016. Although we included all popular social media sites in the search strategy, not all existing social media sites were included because of the sheer number of such sites. Additionally, only studies written in English were selected.

This review looked at the recruitment strategies of different studies, rather than the main result of these studies themselves. To the best of our knowledge, there is no checklist for measuring the quality of recruitment strategy. Therefore, the quality of these studies cannot be measured in this regard.

Another limitation of the study is that the definition of a social media website varies across the literature. For instance, according to the definition by Shere et al [Shere M, Zhao XY, Koren G. The role of social media in recruiting for clinical trials in pregnancy. PLoS One 2014;9(3):e92744 [FREE Full text] [CrossRef] [Medline]25], the sites Craigslist and Kijiji would be classified as social media, and so these authors concluded that social media was the most effective method owing to high recruitment via Craigslist and Kijiji even though recruitment via Facebook and Twitter was low. According to the definition by Theriault et al [Thériault N, Bi P, Hiller JE, Nor M. Use of web 2.0 to recruit Australian gay men to an online HIV/AIDS survey. J Med Internet Res 2012;14(6):e149 [FREE Full text] [CrossRef] [Medline]26], the site Gaydar would not be classified as social media, but under our definition it would be. In such cases, we tried to fit the results to our definition of a social media site, but others may have a different definition of a social media site. This has an effect on the conclusions that can be drawn about recruitment of participants.

In addition, to measure the comparativeness of the population recruited, demographic characteristics of participants recruited through social media were only compared with characteristics of those recruited through other methods. We cannot rule out the possibility that neither social media nor traditional methods had outcomes that were representative of the target population, as is what occurred in the studies by Ince et al [Ince BU, Cuijpers P, Hof EV, Riper H. Reaching and recruiting Turkish migrants for a clinical trial through Facebook: a process evaluation. Internet Interventions 2014 Apr;1(2):74-83.32] and Gu et al [Gu LL, Skierkowski D, Florin P, Friend K, Ye Y. Facebook, Twitter, & Qr codes: an exploratory trail examining the feasibility of social media mechanisms for sample recruitment. Comput Hum Behav 2016 Jul;60:86-96. [CrossRef]37]. This can limit the conclusions that can be made regarding representativeness.

Future Directions

Despite several studies pointing to social media as a potential method of recruiting patients in the preliminary search, the fact that only 30 studies were identified that explicitly compare recruitment methods shows that more studies need to be done in this area. Furthermore, several of these studies also did not assess the demographics of the recruited participants—such as age, ethnicity, income, and education level—or the cost-effectiveness of each recruitment strategy. In order to truly assess the viability of social media as a recruitment tool, future studies should measure these factors as well. Studies that found social media to be effective tended to target specific populations and used surveys, but sample sizes were too low to make strong conclusions. More studies need to be done to determine the validity of these statements.

Conclusions

Given the rising cost of conducting health research, and increased competition for such funds in Canada, new and innovative methods to recruit study participants are needed. Leveraging the growing popularity of social media has the potential to enhance research recruitment methods. However, based on our scoping review of the literature, social media was found to be the best recruitment method in only 12 out of 30 (40%) studies assessed in terms of number of individuals recruited. Social media also tended to recruit younger individuals (when this information was reported). However, for hard-to-reach populations, for populations with specific conditions or disorders, and for observational studies, social media can potentially be the most effective recruitment strategy. Although many studies used social media in recruitment, only 30 studies have explicitly compared social media with other recruitment methods. Additionally, many of these studies did not measure demographics of the population recruited. Therefore, more studies need to be done in this area. These studies should not only measure how many participants can be recruited through each strategy, but also clearly report demographics and the cost-effectiveness of each strategy.

Conflicts of Interest

None declared.

Multimedia Appendix 1

Detailed search strategy.

XLSX File (Microsoft Excel File), 10KB

Multimedia Appendix 2

Study characteristics, recruitment effectiveness by method, demographics of participants recruited by method, and geographic areas targeted by method.

XLSX File (Microsoft Excel File), 26KB

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AYA: adolescent and young adult
MeSH: Medical Subject Headings
MSM: men who have sex with men
PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses


Edited by G Eysenbach; submitted 25.02.16; peer-reviewed by R Haines-Saah, E Hall, J Apolinário-Hagen; comments to author 31.03.16; revised version received 28.06.16; accepted 12.08.16; published 07.11.16

Copyright

©Jane Topolovec-Vranic, Karthik Natarajan. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 07.11.2016.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.


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