ADAPTING TO POLITICAL BARRIERS IN CONDUCTING TEEN PREGNANCY PREVENTION RESEARCH: USE OF SOCIAL MEDIA AS AN EXPEDITED RECRUITMENT STRATEGY

Purpose: This study describes an innovative approach to recruit adolescent and young adult females who use long acting reversible contraceptives (LARCs) for a teen pregnancy prevention (TPP) intervention. This was one of 62 TPP, Office of Adolescent Health (OAH) grantees initially funded in 2016, then terminated by the Trump administration in 2017. After a class action lawsuit (and six different lawsuits), funding was re-instated toward the end of 2018. This caused significant disruption to the study timeline and staffing. To achieve our objectives, we adapted our in-person methodology to an on-line recruitment approach. Methods: This study is part of a cluster randomized control trial to test the effectiveness of a social network intervention designed to facilitate communication about highly effective contraceptive methods between adolescent users of these methods and their peers. Study recruitment was conducted using a social network approach. Eligible participants were female, 14-19 years old and a current LARC user. Primary participants provided lists of friends who might be willing to participate (secondary participants). Recruitment was originally planned to take place in-person at seven Planned Parenthood clinics in Northern California, November 2016. Following the Trump administration's actions and resulting study delays, we modified our methods to online recruitment. After obtaining OAH and IRB approval, social media ads were launched on February 4, 2019. Online recruitment enabled us to expand our geographic reach to 21 states and the District of Columbia (only states that allow adolescents to consent for reproductive health services were included). The first advertisements (Ads) were monitored for two weeks. Ad1 included a realistic photo of an adolescent female. Ad2 was comprised of animations. Ad1 yielded a greater number of clicks to the study link, so a 3rd ad was created, similar to Ad1, but included a photo of three adolescent female friends. Results: In-person recruitment occurred for 308 days and enrolled 118 primary participants and 80 secondaries. Online recruitment occurred for147 days and enrolled 502 primary and 542 secondaries. Ad1 reached 267,012 users, resulted in 4,188 clicks on the recruitment link, Ad2 reached 176,760, resulted in 2,946 clicks and Ad3 (ran for a shorter time) reached101,897, resulted in 1,437 clicks. Cost ranged from $.43-.63 per click. Conclusions: Despite political setbacks to TPP programs, we successfully a