Internet-based recruitment to a depression prevention intervention: lessons from the Mood Memos study

Abstract

Background: Recruiting participants to randomized controlled trials of health interventions can be very difficult. Internet-based recruitment is becoming an increasingly important mode of recruitment, yet there are few detailed accounts of experiences recruiting participants to mental health interventions.

Objective: To report on our experience with Internet-based recruitment to an online depression prevention intervention and pass on lessons we learned.

Methods: Participants were recruited to the Mood Memos study, an online preventive depression intervention, purely through Internet-based sources. The study was targeted to adults with subthreshold depression symptoms from several English-speaking countries. A variety of online recruitment sources were trialed, including search engine advertising (Google, Yahoo!, Bing), Facebook advertising, posts in forums and online noticeboards, and promotion through relevant websites and email newsletters of mental health organizations.

Results: The study website received visits from 94,808 individuals over the 14-month recruitment period. The recruitment target was reached with 1699 individuals signing up to the randomized controlled trial and 1326 fully enrolling. Most visitors arrived via Google advertising, which promoted a depression-screening questionnaire. Google advertising accounted for nearly half of the total participants who signed up to the study, at an average cost of AUD $12 per participant. Promoting the study through trustworthy organizations and websites known to participants was also effective. Recruitment techniques that were less effective were contacting forums, email groups, and community noticeboards.

Conclusions: Several techniques, including Google advertising, were successful in recruiting participants to a trial evaluating an online depression intervention. Results suggest that Internet-based recruitment to mental health interventions is feasible and can be relatively affordable.

Trial registration: ACTRN12609000925246.

Figure 1

Examples of paid advertisements in the Mood Memos study. CTR=click-through rate (percentage of clicks per impressions); CPC=cost per click; Conv rate=conversion rate (percentage of sign-ups per clicks); CPS=cost per sign-up; N/A=not applicable.

Figure 2

Distribution of scores on the Patient Health Questionnaire (PHQ-9) from those participants screened through Google advertising. Subthreshold depression scores for participants eligible for inclusion in the Mood Memos study ranged from 3 to 17 on the PHQ-9.