Understanding Recruitment Yield From Social Media Advertisements and Associated Costs of a Telehealth Randomized Controlled Trial: Descriptive Study.

BACKGROUND: Recruiting study participants for clinical research is a challenging yet essential task. Social media platforms, such as Facebook, offer the opportunity to recruit participants through paid advertisements. These ad campaigns may be a cost-effective approach to reaching and recruiting participants who meet specific study criteria. However, little is known about the extent to which clicks on social media advertisements translate to the actual consent and enrollment of participants who meet the study criteria. Understanding this is especially important for clinical trials conducted remotely, such as telehealth-based studies, which open the possibility to recruit over large geographical areas and are becoming more common for the treatment of chronic health conditions, such as osteoarthritis (OA). OBJECTIVE: The aim of this study was to report on the conversion of clicks on a Facebook advertisement campaign to consent to enrollment in an ongoing telehealth physical therapy study for adults with knee OA, and the costs associated with recruitment. METHODS: This was a secondary analysis using data collected over the first 5 months of an ongoing study of adults with knee OA. The Delaware Physical Exercise and Activity for Knee Osteoarthritis program compares a virtually delivered exercise program to a control group receiving web-based resources among adults with knee OA. Advertisement campaigns were configured on Facebook to reach an audience who could be potentially eligible. Clicking on the advertisement directed potential participants to a web-based screening form to answer 6 brief questions related to the study criteria. Next, a research team member called individuals who met the criteria from the screening form and verbally asked additional questions related to the study criteria. Once considered eligible, an electronic informed consent form (ICF) was sent. We described the number of potential study participants who made it through each of these steps and then calculated the cost per participant who signed the ICF. RESULTS: In sum, between July and November 2021, a total of 33,319 unique users saw at least one advertisement, 9879 clicks were made, 423 web-based screening forms were completed, 132 participants were successfully contacted, 70 were considered eligible, and 32 signed the ICF. Recruitment costed an average of US $51.94 per participant. CONCLUSIONS: While there was a low conversion from clicks to actual consent, 32% (32/100) of the total sample required for the study were expeditiously consented over 5 months with a per-subject cost well below traditional means of recruitment, which ranges from US $90 to US $1000 per participant. TRIAL REGISTRATION: Clinicaltrails.gov NCT04980300; https://clinicaltrials.gov/ct2/show/NCT04980300.

A qualitative investigation of Orthorexia Nervosa among U.S. college students: Characteristics and sociocultural influences.

BACKGROUND: Current studies on Orthorexia Nervosa (ON) are predominantly correlational and have largely been conducted outside of the U.S. with little attention to cultural aspects. This study aimed to qualitatively examine ON-related attitudes and behaviors among U.S. college students, with a particular focus on exploring concerns related to healthy eating and diet quality as defined by proposed diagnostic criteria, body image concerns and disordered eating, and sociocultural influences. METHOD: Eighteen women and 3 men, aged 18-23 years (M = 19.5, SD = 1.6), who had reported high levels of ON symptoms participated in individual interviews. Interviews were transcribed verbatim and examined for evidence of the proposed diagnostic criteria of ON. In addition, thematic analysis was conducted to examine concurrent body image and eating concerns, as well as sociocultural influences. RESULTS: The patterns of the presence of diagnostic criteria varied, with the importance of food quality, and associated severely restricted eating patterns emerging as some of the most common elements. Six themes emerged from the thematic analysis: healthy eating concerns and diet quality, frequency and nature of food-related thoughts, definitions of healthy eating and healthy foods, disordered eating and body image, interpersonal social influence, and media and other influence from the broader social context. DISCUSSION: The findings suggest that ON symptoms may be concurrent with, or an evolution of other eating disorder presentations. In addition, our results highlight the role of family and sociocultural factors in ON, pointing to the usefulness of examining these behaviors within sociocultural frameworks that have been successfully applied to other types of disordered eating.

Orthorexia nervosa, intuitive eating, and eating competence in female and male college students.

Orthorexia nervosa (ON) has emerged as a new pattern of disordered eating behaviors characterized by preoccupations related to diet quality and health concerns, rather than driven by weight and shape concerns. A growing body of cross-sectional empirical data has documented associations between orthorexia nervosa symptoms and other indicators of disordered eating. However, little attention has been paid to the potential relationship between ON symptoms and indicators of healthy eating or positive eating behaviors. The aim of the present study was therefore to evaluate the relationships between ON symptomatology and the different facets of intuitive eating and eating competence. A sample of n = 605, 19% male, college students from the USA completed an online survey assessing orthorexia nervosa behaviors, the four facets of intuitive eating, and eating competence. Overall, orthorexia nervosa behaviors were found to be associated with lower levels of positive eating attitudes and behaviors. However, among men, curvilinear convex relationships emerged for two facets of intuitive eating, Body-Food Choice Congruence and Reliance on Hunger and Satiety Cues, such that the highest levels of intuitive eating were reported by those with mid-range levels of orthorexia nervosa behaviors. Taken together, these findings suggest that broadly, patterns of eating characterized by restriction, albeit for health reasons, are associated with less positive eating behaviors particularly among women. Further work focused on evaluating how drive for a healthy diet can be associated with flexible and positive eating patterns is warranted.Level of evidence Level V descriptive cross-sectional study.

Body image and body change behaviors associated with orthorexia symptoms in males.

In recent years, Orthorexia Nervosa has received increasing attention as a form of restrictive disordered eating driven by concerns related to "healthy eating" as opposed to weight and shape concerns. To date, however, data on the correlates of orthorexia in men are lacking, particularly pertaining to the relationship between orthorexia and muscularity-related dimensions. A sample of 103 (Mage = 19.84) male college students completed an online questionnaire reporting on orthorexia symptoms, eating pathology, drive for muscularity, exercise dependence, and internalization of the thin and athletic ideals. Correlational analyses and linear regression models were used to explore relationships between orthorexia and variables of interest. Findings revealed positive relationships between high levels of orthorexia symptoms and eating pathology, exercise dependence, thin and athletic internalization, and behavioral dimensions of drive for muscularity. The results of this study extend our understanding of the correlates of orthorexia symptoms among young men and highlight their association with other dimensions of eating pathology as well as dysfunctional exercise. In addition, concerns related to healthiness may overlap with muscularity-related concerns, perhaps due to the conflation between health and muscular appearance in social constructions of male body ideals.