Ethical Issues in Social Media Recruitment for Clinical Studies: Ethical Analysis and Framework

Abstract

Background: Social media recruitment for clinical studies holds the promise of being a cost-effective way of attracting traditionally marginalized populations and promoting patient engagement with researchers and a particular study. However, using social media for recruiting clinical study participants also poses a range of ethical issues.

Objective: This study aims to provide a comprehensive overview of the ethical benefits and risks to be considered for social media recruitment in clinical studies and develop practical recommendations on how to implement these considerations.

Methods: On the basis of established principles of clinical ethics and research ethics, we reviewed the conceptual and empirical literature for ethical benefits and challenges related to social media recruitment. From these, we derived a conceptual framework to evaluate the eligibility of social media use for recruitment for a specific clinical study.

Results: We identified three eligibility criteria for social media recruitment for clinical studies: information and consent, risks for target groups, and recruitment effectiveness. These criteria can be used to evaluate the implementation of a social media recruitment strategy at its planning stage. We have discussed the practical implications of these criteria for researchers.

Conclusions: The ethical challenges related to social media recruitment are context sensitive. Therefore, social media recruitment should be planned rigorously, taking into account the target group, the appropriateness of social media as a recruitment channel, and the resources available to execute the strategy.

Keywords: clinical studies; clinical trials; ethics; recruitment; social media.

Figure 1

Overview of the benefits and challenges of social media recruitment (part A) and the eligibility criteria to be used for context-specific assessments of social media recruitment strategies.

Figure 2

Mock recruitment strategies to illustrate recruitment types A to D. SMR: social media recruitment.

Figure 3

(A) Eligibility matrix for the assessment of social media recruitment for clinical studies. If the result of an assessment of the 3 dimensions occurs within the green volume, social media recruitment can be considered ethical for a particular study. Suitability for using social media for recruitment increases with the respective increase in dimensions X and Z (X: informed consent and Z: recruitment effectiveness) and decreases with a rising risk for the target group (Y: risk for target group). (B) Dashed lines indicate an example of a high-risk target group. X indicates a very limited scope for social media recruitment. (C) Dashed lines indicate an example of a low-risk target group. Dashes represent the scope of the informed consent procedure.