Background
Methods
Setting
Screening and enrolment process
Recruitment oversight and planning
Planning considerations | Details |
---|---|
Target audience | Men aged 50–74 years who were overweight or obese and living in a capital city with a participating study centre. No further restrictions were placed as other eligibility criteria were to be assessed during the screening process |
Call to action | Prospective participants were invited to visit study website or call a central information line to learn more about the study and complete the pre-screening questionnaire |
Content of promotional material | Content decisions were guided by qualitative research in men’s health communication preferences [32], pro-bono advice from marketing professionals, and pre-testing and ongoing feedback from study participants Communication style: • Frank, humorous and empathetic message [32] • Simple, informal and easy-to-remember language Key components of the message: 1. Identification of the problem: men aged 50–74 years and overweight/obese are at risk of diabetes, weight gain and urinary and sexual problems 2. Positioning of the study as a solution: the Testosterone for the Prevention of Type 2 Diabetes (T4DM) study can support men to lose excess weight and address related health issues 3. Call to action: invitation to join the study and instructions on how to join |
Promotional strategies/platforms | Promising promotional strategies were identified by review of the published literature, discussion with the study’s industry partners, brainstorming by the Steering Committee, suggestions from study participants and pro-bono advice from marketing professionals. Strategies were first tested for a short period of time, and if they appeared effective and affordable, were adopted on an ongoing basis. |
Recruitment strategies
Radio advertising
Mail-outs
Television, radio and newspaper news coverage
Facebook promotions and advertising
Google advertising
Newspaper advertising
Community outreach activities
Healthcare provider referrals and promotions
Recruitment strategy monitoring and enhancement
Outcomes and data analysis
Strategy attributes
Strategy exposure and contribution
Strategy cost
Overall strategy appraisal
Statistical methods
Results
Overall study recruitment
Evaluation of promotional activities
Number of participants recruited
How men reported hearing about the study1 | Description of associated recruitment promotions2 | # Screened | # Randomised (%)3 | Contribution (%)4 |
---|---|---|---|---|
Radio advertising | 7110 × 30-s paid advertisement placements across 20 radio stations | 7667 | 418 (5%) | 42% |
TV news | 8 television news stories (6 national and 2 in single cities) | 4127 | 202 (5%) | 20% |
Mail-out by DHS | 130,000 invitation letters posted to government mailing list | 3211 | 173 (5%) | 17% |
Community promotions | Posters, community events, promotion on other organisations’ websites, newsletters and Facebook pages | 998 | 43 (4%) | 4% |
Word of mouth (not otherwise specified) | N/A | 491 | 34 (7%) | 3% |
Newspaper news | 9 newspaper stories (3 major newspapers, 3 local newspapers, 2 online news sites, 1 professional magazine) | 622 | 31 (5%) | 3% |
Healthcare provider | 1024 GP clinics mailed, attendance at GP events, distribution of posters to pathology collection centres, GPs, clinics and hospitals | 450 | 29 (6%) | 3% |
Facebook | 94 unpaid Facebook posts, 23 paid Facebook advertisements and boosted posts, requests to participants and organisations to share study on Facebook | 369 | 16 (4%) | 2% |
Other internet | Three Google AdWords campaigns, study website, links on other websites | 410 | 15 (4%) | 1% |
Radio news | 7 radio news stories (all in single cities) | 182 | 10 (5%) | 1% |
Mail-out by GP | Invitations mailed from GP clinic near to one study site. Number of invitations sent not known | 47 | 1 (2%) | 0% |
Newspaper advertising | 1 advertisement in a Sunday paper in 1 city | 33 | 1 (3%) | 0% |
Football club promotion | Email newsletter and 1 week of website advertising at one football club near to 1 study site | 5 | 0 (0%) | 0% |
Not specified | N/A | 410 | 34 (8%) | 3% |
Total | 19,022 | 1007 (5%) | 100% |
Recruitment cost
Recruitment strategy2 | Total direct cost1 | Cost per screening | Cost per randomisation |
---|---|---|---|
Radio advertising | $451,705 | $59 | $1081 |
Mail-out by DHS | $128,968 | $40 | $745 |
Community promotions | $1223 | N/A4 | N/A4 |
Healthcare provider | $12723 | N/A4 | N/A4 |
Facebook | $10,029 | N/A4 | N/A4 |
Google advertising | $1931 | N/A4 | N/A4 |
Mail-out by GP | $1104 | $23 | $1104 |
Newspaper advertising | $1941 | $59 | $1941 |
Football club promotion | $1561 | $312 | N/A5 |
Total | $598,633 | $31 | $594 |
Staff time and effort
Attributes | Assessment of outcomes | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
Promotion | Format1, length2 | Direct3 | Targeted3 | High reach3 | Frequent3 | Online component | Contributed to enrolment3 | Direct cost per participant4 | Staff effort per participant4 | Appraisal of effectiveness5 |
TV news and current affair coverage | Audio-visual, medium | +++ | + | Yes | +++ | – – | Highly effective Advantages: no cost, very high reach, audio-visual format, credible source Disadvantages: single exposure, challenging to arrange | |||
Mass mail-out by DHS | Text + image, long | +++ | ++ | +++ | + | No | +++ | – – | – | Highly effective Advantages: direct, targeted, high reach, credible source Disadvantages: administrative process for approval, cost |
Radio advertising | Audio, short | + | +++ | +++ | No | +++ | – – – | – | Highly effective Advantages: high reach and frequency Disadvantages: costly, short audio-only format | |
Newsletter mentions: businesses and community organisations | Text (+ image), usually short | + | + | ++ | + | Yes | ++ | – – | Effective Advantages: no cost, moderate reach, credible source, potential to identify influencer/champion within organisation Disadvantages: challenge of identifying willing organisations | |
Word of mouth | UNK | + | UNK | + | UNK | UNK | ++ | Effective Advantages: no cost, trusted source Disadvantages: usually incidental | ||
Newspaper articles: print and online | Text (+ image), medium | +++ | + | Yes | ++ | – – | Effective Advantages: high reach (although shrinking), offline and online options, credible source Disadvantages: single exposure, challenging to arrange | |||
Publicly displayed posters | Text + image, medium | + | + | ++ | No | ++ | – – – | Effective Advantages: low/no cost, simple, local to centres Disadvantages: small potential reach, time-consuming | ||
Online promotion: businesses and community organisations | Text (+ image), short | + | ++ | + | Yes | + | – – | Moderately effective Advantages: no cost, can be a credible source Disadvantages: single exposure, challenging to arrange | ||
Radio news coverage/interviews | Audio, medium | +++ | + | No | + | – – | Moderately effective Advantages: high reach, credible source Disadvantages: audio-only, single exposure, challenging to arrange | |||
Referral by GP | Face-to-face | +++ | +++ | + | + | No | + | – – | Limited effectiveness Advantages: direct and very targeted, a trusted medical source Disadvantages: limited reach, challenging to seek referrals from health professionals not affiliated with trial | |
Direct approach/invitation from study centre | Text, long | ++ | +++ | + | + | No | + | – – – | Limited effectiveness Advantages: direct and very targeted, a trusted medical source Disadvantages: very limited reach, challenging to identify potential participants through hospitals due to nature of trial | |
Referral by pathology service (printed on bottom of path results) | Text, short | ++ | +++ | + | + | No | + | – – | Limited effectiveness Advantages: direct and very targeted, a trusted medical source Disadvantages: limited reach, challenging to arrange | |
Organic Google search | Text, short | ++ | ++ | UNK | Yes | + | – | Limited effectiveness Advantages: no cost Disadvantages: limited reach due to nature of trial | ||
Paid Google search | Text, short | +++ | + | UNK | Yes | + | – | – – | Limited effectiveness Advantages: potentially high reach, affordable compared to other paid strategies, flexible Disadvantages: technically challenging, potential limited by the nature of trial | |
Facebook-paid ad | Text + image (+ audio-visual), short | ++ | ++ | +++ | Yes | + | – | – – | Limited effectiveness Advantages: affordable compared to other paid strategies, potential to use images and video, high frequency, flexible Disadvantages: technically challenging, limited engagement with trial demographic | |
Community events: presentation/stand | Mixed | ++ | ++ | + | + | No | – | – – – | Ineffective Advantages: direct and potentially targeted Disadvantages: very limited reach. Time-consuming | |
Newspaper advertisement: print | Text + image, short | ++ | ++ | No6 | – | – – – | – | Ineffective Advantages: Potential to use images Disadvantages: Costly, falling reach | ||
Mass mail-out by GP | Text, long | +++ | +++ | + | + | No | – | – – – | – | Ineffective Advantages: direct and very targeted, a trusted medical source Disadvantages: limited reach, costly |
Unpaid post on study Facebook page | Text + image, short | + | + | + | ++ | Yes | – | – – – | Ineffective Advantages: no cost Disadvantages: limited engagement with trial demographic, time-consuming if done with high frequency |
Overall strategy appraisal
Response to online recruitment strategies
Campaign | Date range | Maximum cost per click bid1 | # Clicks2 | # Impressions3 | Click-through rate4 | Total cost5 | Average cost per click |
---|---|---|---|---|---|---|---|
Diabetes prevention: Campaign 1 | Jul 13—Oct 14 | Auto6: $1.01 | 4940 | 46,325 | 10.66% | $1040 | $0.21 |
Diabetes prevention: Campaign 2 | Oct 15 | $2.00 | 684 | 4971 | 13.76% | $356 | $0.52 |
Nocturia campaign | Oct 15—Dec 15 | $3.00 | 315 | 5906 | 5.33% | $535 | $1.70 |
Total | 5939 | 57,202 | 10% | $1931 | $0.33 |