{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:58:12Z","timestamp":1792807092011,"version":"4.5.0"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T00:00:00Z","timestamp":1756252800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T00:00:00Z","timestamp":1756252800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100000664","name":"Health Technology Assessment Programme","doi-asserted-by":"publisher","award":["16\/13\/02"],"award-info":[{"award-number":["16\/13\/02"]}],"id":[{"id":"10.13039\/501100000664","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Trials"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Recruitment and retention of participants remain critical challenges in clinical trials, often requiring innovative approaches to ensure sufficient enrolment and sustained engagement. Social media advertising offers the potential to reach target populations quickly by leveraging demographic, geographic and interest-based targeting. This mixed-methods observational study evaluates participant experiences and the effectiveness of various recruitment routes within a trial of a treatment for acne. Demographic variables, including age, ethnicity, acne severity and acne duration, were stratified primary care, secondary care, community and social media recruitment routes and 12 participant interviews were analysed using reflexive thematic analysis. Social media recruitment accounted for over half of participants (53.9%). It was particularly effective in recruiting individuals with higher acne severity (IGA\u2009\u2265\u20093; 57.5% of its recruits,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009127), longer duration of disease (&gt;\u20095\u00a0years history of acne; 60.2% of its recruits,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009133) and from ethnic minority groups (9.0% of its recruits,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200920), the latter being notably higher than the proportion recruited via primary care (1.5% of its recruits,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20091). Slight variations in retention by recruitment route were observed, with social media (85%) and primary care (84%) achieving the highest retention rate at the 12-week follow-up. All routes lost between 25 and 32% of participants by the 24-week follow-up, signifying the importance of implementing effective retention strategies to keep participants engaged. Overall, participants found targeted social media advertisements to be an acceptable and convenient recruitment approach; initial signals of trust were provided by high-quality graphics and recognisable NHS and university logos, which coupled with responsive trial staff, were suggested to provide a seamless enrolment experience. This study demonstrates that social media recruitment can be an effective and acceptable component of a multi-route strategy for clinical trial enrolment.\n                  <\/jats:p>","DOI":"10.1186\/s13063-025-08994-5","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T21:48:27Z","timestamp":1756331307000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Social media recruitment enhances participant diversity in dermatology clinical trial: findings from the SAFA trial"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7850-233X","authenticated-orcid":false,"given":"Cherish","family":"Boxall","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Renz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth","family":"Stuart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid","family":"Muller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Soulsby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Nuttall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim S.","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracey H.","family":"Sach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Lawrence","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Ridd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick","family":"Francis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Little","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zina","family":"Eminton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gareth","family":"Griffiths","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison M.","family":"Layton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Saji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Cluff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Santer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,27]]},"reference":[{"issue":"1","key":"8994_CR1","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1186\/1745-6215-7-9","volume":"7","author":"AM McDonald","year":"2006","unstructured":"McDonald AM, et al. What influences recruitment to randomised controlled trials? A review of trials funded by two UK funding agencies. Trials. 2006;7(1):9.","journal-title":"Trials"},{"issue":"3","key":"8994_CR2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-015276","volume":"7","author":"SJ Walters","year":"2017","unstructured":"Walters SJ, et al. Recruitment and retention of participants in randomised controlled trials: a review of trials funded and published by the United Kingdom health technology assessment programme. BMJ Open. 2017;7(3): e015276.","journal-title":"BMJ Open"},{"issue":"2","key":"8994_CR3","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-059230","volume":"12","author":"MJ Richard","year":"2022","unstructured":"Richard MJ, et al. Recruitment, consent and retention of participants in randomised controlled trials: a review of trials published in the National Institute for Health Research (NIHR) journals library (1997\u20132020). BMJ Open. 2022;12(2): e059230.","journal-title":"BMJ Open"},{"issue":"11","key":"8994_CR4","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.5698","volume":"18","author":"J Topolovec-Vranic","year":"2016","unstructured":"Topolovec-Vranic J, Natarajan K. The use of social media in recruitment for medical research studies: a scoping review. J Med Internet Res. 2016;18(11): e286.","journal-title":"J Med Internet Res"},{"issue":"10","key":"8994_CR5","doi-asserted-by":"publisher","DOI":"10.2196\/22810","volume":"22","author":"I Darmawan","year":"2020","unstructured":"Darmawan I, et al. The role of social media in enhancing clinical trial recruitment: scoping review. J Med Internet Res. 2020;22(10): e22810.","journal-title":"J Med Internet Res"},{"issue":"8","key":"8994_CR6","doi-asserted-by":"publisher","DOI":"10.2196\/38015","volume":"24","author":"EM Darko","year":"2022","unstructured":"Darko EM, Kleib M, Olson J. Social media use for research participant recruitment: integrative literature review. J Med Internet Res. 2022;24(8): e38015.","journal-title":"J Med Internet Res"},{"issue":"1","key":"8994_CR7","doi-asserted-by":"publisher","first-page":"476","DOI":"10.1186\/s13063-020-04361-8","volume":"21","author":"S Treweek","year":"2020","unstructured":"Treweek S, Briel M. Digital tools for trial recruitment and retention\u2014plenty of tools but rigorous evaluation is in short supply. Trials. 2020;21(1):476.","journal-title":"Trials"},{"issue":"1","key":"8994_CR8","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1186\/s13063-020-04234-0","volume":"21","author":"A Blatch-Jones","year":"2020","unstructured":"Blatch-Jones A, et al. Using digital tools in the recruitment and retention in randomised controlled trials: survey of UK clinical trial units and a qualitative study. Trials. 2020;21(1):304.","journal-title":"Trials"},{"issue":"1","key":"8994_CR9","doi-asserted-by":"publisher","DOI":"10.2196\/13424","volume":"3","author":"SH Nguyen","year":"2020","unstructured":"Nguyen SH, et al. Understanding social media use and engagement among dermatology patients to inform dermatological prevention and care in Vietnam: cross-sectional study. JMIR Dermatol. 2020;3(1): e13424.","journal-title":"JMIR Dermatol"},{"issue":"8","key":"8994_CR10","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-053876","volume":"11","author":"S Renz","year":"2021","unstructured":"Renz S, et al. Spironolactone for adult female acne (SAFA): protocol for a double-blind, placebo-controlled, phase III randomised study of spironolactone as systemic therapy for acne in adult women. BMJ Open. 2021;11(8): e053876.","journal-title":"BMJ Open"},{"key":"8994_CR11","doi-asserted-by":"publisher","first-page":"e074349","DOI":"10.1136\/bmj-2022-074349","volume":"381","author":"M Santer","year":"2023","unstructured":"Santer M, et al. Effectiveness of spironolactone for women with acne vulgaris (SAFA) in England and Wales: pragmatic, multicentre, phase 3, double blind, randomised controlled trial. BMJ. 2023;381:e074349.","journal-title":"BMJ"},{"key":"8994_CR12","first-page":"56","volume":"28","author":"M Santer","year":"2024","unstructured":"Santer M, et al. Clinical and cost-effectiveness of spironolactone in treating persistent facial acne in women: SAFA double-blinded RCT. Health Technol Assess. 2024;28:56.","journal-title":"Health Technol Assess"},{"issue":"1","key":"8994_CR13","doi-asserted-by":"publisher","first-page":"661","DOI":"10.1186\/s13063-023-07630-4","volume":"24","author":"C Boxall","year":"2023","unstructured":"Boxall C, et al. Factors that influence women\u2019s enrolment and ongoing participation in a partially decentralised randomised controlled dermatology trial: a qualitative interview study with participants in the SAFA (spironolactone for adult female acne) trial. Trials. 2023;24(1):661.","journal-title":"Trials"},{"issue":"4","key":"8994_CR14","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1080\/2159676X.2019.1628806","volume":"11","author":"V Braun","year":"2019","unstructured":"Braun V, Clarke V. Reflecting on reflexive thematic analysis. Qual Res Sport Exerc Health. 2019;11(4):589\u201397.","journal-title":"Qual Res Sport Exerc Health"},{"issue":"2","key":"8994_CR15","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","volume":"3","author":"V Braun","year":"2006","unstructured":"Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77\u2013101.","journal-title":"Qual Res Psychol"},{"key":"8994_CR16","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/j.ecns.2021.03.006","volume":"55","author":"K Leighton","year":"2021","unstructured":"Leighton K, et al. Using social media and snowball sampling as an alternative recruitment strategy for research. Clin Simul Nurs. 2021;55:37\u201342.","journal-title":"Clin Simul Nurs"},{"key":"8994_CR17","doi-asserted-by":"publisher","DOI":"10.1016\/j.conctc.2023.101245","volume":"37","author":"VK Ortner","year":"2024","unstructured":"Ortner VK, et al. Accelerating patient recruitment using social media: early adopter experience from a good clinical practice-monitored randomized controlled phase I\/IIa clinical trial on actinic keratosis. Contemp Clin Trials Commun. 2024;37: 101245.","journal-title":"Contemp Clin Trials Commun"},{"key":"8994_CR18","unstructured":"National Institute for Health and Care Research. Improving inclusion of under-served groups in clinical research: guidance from INCLUDE project. 2020. Available from: https:\/\/www.nihr.ac.uk\/improving-inclusion-under-served-groups-clinical-research-guidance-include-project. 31 October 2024."}],"container-title":["Trials"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13063-025-08994-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13063-025-08994-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13063-025-08994-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T06:23:51Z","timestamp":1757485431000},"score":1,"resource":{"primary":{"URL":"https:\/\/trialsjournal.biomedcentral.com\/articles\/10.1186\/s13063-025-08994-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,27]]},"references-count":18,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["8994"],"URL":"https:\/\/doi.org\/10.1186\/s13063-025-08994-5","relation":{},"ISSN":["1745-6215"],"issn-type":[{"value":"1745-6215","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,27]]},"assertion":[{"value":"22 January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 August 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The SAFA trial and qualitative sub-study received a favourable ethical opinion from the Wales Research Ethics Committee (18\/WA\/0420) and has Health Research Authority approval (IRAS 246637). All participants provided informed consent to participate in the qualitative interview.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported\u00a0in this paper.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"318"}}