Facebook, email, or text messaging? Recruitment strategies for a teen-based, health-focused social media website for low-income adolescents in California

Nearly one in three California adolescents are recipients of public health insurance. To increase adolescent engagement in their health plan, UCLA partnered with a health insurance company, Health Net of California, to develop a social media website. The purpose of the site is to test whether a social media intervention can encourage adolescents ages 13-17 to better utilize their health insurance benefits. The teen presence on social networking sites is on the rise – 73% of teens in the U.S. used social networking sites in 2009, up from 55% in 2006 and 65% in 2008. Our intervention required two recruitment steps: 1) recruitment into the study and 2) recruitment to the website (intervention group only). Both paper-and-pencil and online strategies were used to enroll members into the study; results show that the consent process must be adapted to meet the needs of online recruitment. For recruitment to the website, we used both traditional and non-traditional methods to enroll teens on the site, including tailored emails, texts, Facebook messages, participant-produced greeting cards, and classroom-based outreach. Conversion rates varied according to the strategy used. Out of a recruitment pool of 52,500, we anticipated randomizing 5,250 teens into control and intervention groups. To date, 1,200 teens have been randomized, with 137 study participants enrolled on the site. Lessons learned from recruitment are numerous and informative. The recruitment of teens to a social media intervention demands innovative strategies that are easily adaptable, including both online and offline techniques that engage youth and their peers.