Abstract: Designing Theoretically-driven Facebook Advertising Campaigns to Recruit Rural Adults to Develop Healthcare Delivery Interventions

◆ Elizabeth Flood-Grady, University of Florida
◆ Deaven Hough, University of Florida
◆ Rachel E. Damiani, University of Florida
◆ Nioud Mulugeta Gebru, University of Florida
◆ David A. Fedele, University of Florida
◆ Robert F. Leeman, University of Florida
◆ Janice L Krieger, University of Florida

Little is known about designing research recruitment campaigns that connect with underserved, geographically-isolated rural populations. Individuals living in rural areas, who have higher rates of a myriad of preventable diseases[1], are as likely their urban counterparts to use the Internet[2], actively engage social media to obtain health information[3]. With its expansive reach, Facebook is particularly useful for disseminating opportunities to participate in intervention development studies to underserved rural audiences.

However, challenges communicating with rural audiences about research participation can impede recruitment[4]. In addition, rural audiences emphasize independence and self-sufficiency in their definitions of health, and their overall health attitudes and beliefs differ from adults living in urban areas[5]. Thus, the messages and information commonly used to communicate with individuals about health research opportunities may not capture the attention of rural audiences and may adversely affect participation. It is therefore critical to develop theoretically-driven, culturally-informed advertising campaigns that communicate messages that resonate with rural audiences in order to engage and recruit underserved, rural populations into healthcare delivery intervention development studies.

A primary goal of designing Facebook recruitment materials is to highlight the relevance of the study and participation and prompt active processing and message engagement among active and passive members of the target audience. We drew from research and theory in communication (e.g., elaboration likelihood model, social identity theory, message appeals)[6-8] and incorporated process analysis techniques to develop replicable procedures for designing and evaluating Facebook advertising campaigns for rural recruitment. Theoretically-driven strategies were applied to assess feasibility and develop materials for recruiting rural audiences into two healthcare intervention development studies. Study 1 aimed to recruit rural adults to participate in the development of a tailored tobacco intervention development. Study 2 aimed to recruit rural parents of adolescents into a mental health communication intervention development study. Twelve study advertisements (ads) (text, headlines, and images) were developed and disseminated for Study 1, whereas six ads were used for recruitment in Study 2. All ads included one image, multiple message strategies (e.g., identity statements, intrinsic & extrinsic appeals), and emphasized rural cultural values and beliefs about healthcare (e.g., independence, self-sufficiency).

Rural recruitment advertising campaigns received approximately 1,000 link clicks from the target rural demographic and met enrollment criteria using Facebook as the primary method of recruitment. Study 1, the rural tobacco intervention development study received a total of 477 link clicks, cost only $155.80, and enrolled 13 participants over the course of three weeks. Study 2, the rural mental health intervention development study received a total of 518 link clicks, cost only $233.28, and enrolled 178 participants over the course of five weeks.

Our theoretically-informed process for designing Facebook advertising campaigns for rural audiences yielded two successful recruitment campaigns. Facebook was an affordable and efficacious strategy for disseminating theoretically-driven messages about recruitment and enrolling rural adults in behavioral research studies on tobacco and mental health. Future work should apply these theoretical techniques to additional study topics and evaluate specific message features (statistics, testimonials) and formats (videos, images) associated with rural social media recruitment.