Potential of Using Twitter to Recruit Cancer Survivors and Their Willingness to Participate in Nutrition Research and Web-Based Interventions: A Cross-Sectional Study

Abstract

BackgroundSocial media is rapidly changing how cancer survivors search for and share health information and can potentially serve as a cost-effective channel to reach cancer survivors and invite them to participate in nutrition intervention programs.ObjectiveThis study aimed to assess the feasibility of using Twitter to recruit cancer survivors for a web-based survey and assess their willingness to complete web-based nutrition surveys, donate biospecimens, and to be contacted about web-based nutrition programs.MethodsWe contacted 301 Twitter accounts of cancer organizations, advocates, and survivors to request assistance promoting a web-based survey among cancer survivors. The survey asked respondents whether they would be willing to complete web-based nutrition or lifestyle surveys, donate biospecimens, and be contacted about web-based nutrition programs. Survey promotion rate was assessed by the percentage of Twitter accounts that tweeted the survey link at least once. Survey response was assessed by the number of survey respondents who answered at least 85% (26/30). We compared the characteristics of cancer survivors who responded to this survey with those who participated in the National Health and Nutrition Examination Survey (NHANES) 1999-2010 and evaluated factors associated with willingness to complete web-based surveys, donate biospecimens, and be contacted to participate in web-based nutrition programs among those who responded to the social media survey.ResultsOver 10 weeks, 113 Twitter account owners and 165 of their followers promoted the survey, and 444 cancer survivors provided complete responses. Two-thirds of respondents indicated that they would be willing to complete web-based nutrition or lifestyle surveys (297/444, 67.0%) and to be contacted to participate in web-based nutrition interventions (294/444, 66.2%). The percentage of respondents willing to donate biospecimens were 59.3% (263/444) for oral swab, 52.1% (231/444) for urine sample, 37.9% (168/444) for blood sample, and 35.6% (158/444) for stool sample. Compared with a nationally representative sample of 1550 cancer survivors in NHANES, those who responded to the social media survey were younger (53.1 years vs 60.8 years; P<.001), more likely to be female (93.9% [417/444] vs 58.7% [909/1550]; P<.001), non-Hispanic whites (85.4% [379/444] vs 64.0% [992/1550]; P<.001), to have completed college or graduate school (30.1 [133/444] vs 19.9% [308/444]; P<.001), and to be within 5 years of their initial diagnosis (55.2% [244/444] vs 34.1% [528/1550]; P<.001). Survivors younger than 45 years, female, and non-Hispanic whites were more willing to complete web-based nutrition surveys than older (65+ years), male, and racial or ethnic minority survivors. Non-Hispanic whites and breast cancer survivors were more willing to donate biospecimens than those with other race, ethnicity or cancer types.ConclusionsTwitter could be a feasible approach to recruit cancer survivors into nutrition research and web-based interventions with potentially high yields....

Recruiting cancer survivors into research studies using online methods: a secondary analysis from an international cancer survivorship cohort study

“…An audit of the reach of our study advertisements demonstrates that in both the cases, Twitter and Facebook are inefficient sources of identifying cancer survivors: as reported elsewhere too [57,58], there was very low pull-through recruitment rate from the total population reached, despite high (and increasing) population-level prevalence of cancer. It is interesting that our Twitter recruitment was so much poorer than that reported by Keaver et al [28]; however, there are two important differences between that publication and our own work. First, our work recruited directly into a comparatively high-burden research study rather than exploring (in a cross-sectional survey) willingness to participate in future studies.…”

“…There may well be a case to be made for a recruitment strategy with mixed traditional and online recruitment until generational issues in social media usage become less pronounced. Based on the study by Keaver et al [28], we were also not able to demonstrate that online recruitment can overcome the gender bias of participants in cancer survivorship research; this is a considerable problem for our field and there are clearly other reasons why men do not participate in our research than need to be further explored. We were interested to see that we recruited a larger sub-sample of participants who identified as non-heterosexual than in other survivorship research [44,59]; we suspect that the anonymity of our recruitment and data collection methods may have led to a higher rate of disclosure of non-heterosexuality.…”

“…Rabin et al [27] reached 11 potential participants through social media (no data were provided on comparisons between Twitter and other platforms) though none were actually eligible to participate, highlighting potential self-screening issues. Keaver et al [28] recruited through Twitter for a cross-sectional study on willingness to participate in a nutrition and web-based intervention research. They concluded that while Twitter is a feasible recruitment method, samples might be biased towards younger, female, more educated and less ethnically diverse participants.…”

Recruitment via social media: advantages and potential biases

“…compared a sample recruited via Twitter with a nationally representative sample of 1550 cancer survivors in NHANES (National Health and Nutrition Examination Survey) and similarly found that respondents to social media posts were younger and more likely to be female, non-Hispanic White, to have a higher education and to be within five years of their initial diagnosis. 23 This may be due to the makeup of users on social media platforms, user activity or platform algorithms that determine exposure to study-relevant posts, effectiveness (or lack thereof) of targeted marketing to reach different groups, or differences in response rates across groups. Conversely, registry-based sampling and recruitment through cancer centers and clinics have been shown to be biased toward patients with private health insurance or Medicare and those who are in active or recent treatment and engaged with clinical care teams, with differences in ‘opt-out’ rates across demographic subgroups reported.…”

A Bibliometric Analysis of the Health Field Regarding Social Networks and Young People

“…Table 1 summarizes some of the latest publications regarding social networks as health problems or interventions. This research focused on the latest publications in major journals in the health field, such as the Journal of Medical Internet Research [25]. In this sense, the results showed that the health and education area tend to focus on the positive outcomes of using social networks.…”