Currently submitted to: Journal of Medical Internet Research
Date Submitted: Dec 22, 2019
Open Peer Review Period: Dec 22, 2019 - Feb 22, 2020
(currently open for review)
Using Web-Based Social Media to Recruit Heavy-Drinking Young Adults for Sleep Intervention: Prospective Observation
Novel alcohol prevention strategies are needed for heavy-drinking young adults. Sleep problems are common among young adults who drink heavily and a risk factor for developing an alcohol use disorder. Young adults are interested in the connection between sleep and alcohol and are open to getting help for their sleep. Therefore, sleep interventions may offer an innovative solution. This study evaluated social media advertising for reaching young adults and recruiting them for a new alcohol prevention program focused on sleep.
(1) Evaluate the effectiveness and cost of Facebook, Instagram, and Snapchat advertising to reach young adults with heavy drinking for a sleep intervention; (2) characterize sleep, alcohol use, and related concerns and interests among responders; and (3) identify the most appealing advertising content.
In Study 1, advertisements targeting young adults with sleep concerns, heavy alcohol use, and/or interest in participating in a sleep program ran over a 3-month period until enrollment goal achieved. Advertisements directed volunteers to complete a brief Web-based survey to determine initial sleep program eligibility and to characterize the concerns and/or interests that attracted them to click the advertisement. In Study 2, 3 ads ran simultaneously for 2 days to compare the effectiveness of specific advertising themes for reaching and enrolling young adults.
In Study 1, ads generated 13,638 clicks, 909 surveys, and 27 enrolled volunteers in 3 months across all the social media. Fees averaged $0.27 per click, $3.99 per completed survey, $11.43 per volunteer meeting initial screening eligibility, and $106.59 per study enrollee. On average, those who completed the Web-based survey were 21.1 (SD 2.3) yrs of age, and 69.4% (631/909) were female. Most reported sleep concerns (79.8%) and interest in the connection between sleep and alcohol use (60.2%) but few had drinking concerns (5.9%). About a third (34.9%, 317/909) were identified as at risk for developing an alcohol use disorder based on a validated alcohol screener. Among this subsample, 8.5% (27/317) met final criteria and enrolled in the trial. Some volunteers also referred additional volunteers by word-of-mouth. In Study 2, ads targeting sleep yielded a higher response rate than ads targeting alcohol use (0.91% vs 0.56% click rate, P < .001).
Social media advertisements designed to target young adults with sleep concerns reached those who also drank alcohol heavily, despite few being concerned about their drinking. Moreover, advertisements focused on sleep were more effective than those focused on drinking. Compared to prior studies, our cost-effectiveness was moderate for engagement (impressions to clicks), excellent for conversion (clicks to survey completion), and reasonable for study enrollment. These data demonstrate the utility of social media advertising generally and specifically focused on sleep to reach young adults who drink heavily and recruit for them intervention. Clinical Trial: NCT036589
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