Below are excerpts from this grantee’s quarterly reports.
Year 2 Quarter 2
Summarize what was accomplished with regard to these aims in the present quarter.
In Quarter 2, we continued to recruit adolescents through Instagram. From September 23 to November 30, we reached 283,853 teens (599,287 impressions). Among these, there were 3,208 link clicks and 873 completed surveys. A total of 185 teens completed the online assent form, and 30 teens completed the qualitative interview. We are excited to make such progress in only a month’s worth of recruitment! We plan to begin quantitative data analysis of the surveys as soon as we reach 1,000 (we anticipate by mid-December). With the qualitative interviews, we began completing “interview summaries” which we plan to use for qualitative analysis. Among the 30 completed, we are finding some content saturation, but we are continuing interviews to get a diverse (racial/ethnic/gender identify/geographic location) sample.
Briefly restate the specific aims or objectives associated with this project.
In the current study “Connect-19”, we aim to recruit 1,000 adolescents (ages 13-17) on Instagram to complete a survey assessing technology use patterns (e.g., duration, timing, activity, social reasons for use) before and after a pivotal COVID-19 related date for youth: the announcement of school closure. We will also assess a wide range of social and emotional wellbeing outcomes (stress, anxiety, depression, positive affect, social support) using validated measures. A purposefully sampled subset (n=50) will be assented for a video-based qualitative interview and direct download of social media content and meta-data 1 month prior and 1 month after school closure, to permit objective analysis of COVID-19’s impact on social media use. All aspects of the study will be guided by a Youth Advisory Team, made up of youth who have previously participated in our team’s research and are committed to advising on survey design, interview design, and data gathering and interpretation.
Year 2, Quarter 1
Summarize what was accomplished with regard to these aims in the present quarter.
In Quarter 1, we finalized the questions we will ask participants in the quantitative survey including: technology use and social media use before and after school closure; experience with cyber-victimization, dating violence, and in-person peer violence; mental health and wellbeing e.g. PROMIS, PANAS, WHO, and MSPSS; and the impact of COVID-19 on their daily lives. We programmed the questions into Qualtrics, as well as the e-assent / e-consent forms. We also designed the Instagram advertisements with feedback from a Youth Advisory Team: 1 member from the TAM YAB and 3 local Rhode Island youth who participated in past studies. We successfully obtained IRB approval for remote e-assenting of teens and e-consenting of parents.
On September 23, 2020, we started recruitment on Instagram. In 2 days, we were able to reach 19,044 teens (19,844 impressions). Among these, there were 137 link clicks, 47 completed surveys, and 13 teens completing e-assent for the qualitative interview. We still need to e-consent parents and schedule the first qualitative interview.
Briefly restate the specific aims or objectives associated with this project
The objective of IMPACT (Intervention Media to Prevent Adolescent Cyber-conflict through Technology) is to conduct a pilot randomized trial (N=50) of at-risk youth age 13-17 who endorse past-year online victimization. We aim to test the acceptability and feasibility of the IMPACT intervention (remote brief intervention delivered over the phone and 8 weeks of daily messages) recruiting teens online through social media.
In what way did your project provide opportunities for training or professional development?
One of this study’s activities is downloading teens’ social media data. We plan to conduct a sentiment analysis of posts, similar to what we completed in a previous text-based social media study. We are training a future PhD student (recently accepted to a program), a T32 recipient, and a current PhD student in the data analysis for this project; we are also expanding our network of collaborators in order to conduct more complex analyses of the data.
Tell us about your efforts to reach a range of audiences and maximize impact through dissemination and implementation.
A key part of our work is a focus on reaching vulnerable populations, and one of the promises of social media is the ability to reach adolescents who might not otherwise enroll in this type of study. Over the course of the study, we learned how to target advertisements to intentionally reach a more diverse sample. We are currently writing a “methods” paper that describes the challenges and successes of recruiting online through social media. To maximize dissemination, we are including a methods hub focused on social media and online recruitment within our new Center for Digital Health at Brown, and will highlight findings and lessons-learned from this study.
Tell us about key learnings you’ve uncovered over the course of your project, including advice you might give to investigators conducting similar work.
We have learned about the challenges and success of different ad campaigns through trial and error. We initially started with story ads (content that is ephemeral and disappears after 24 hours), based on research that adolescents utilize stories heavily. We found that “reach campaigns” using stories (ads sent to your target population e.g. 13-17 year olds) yielded few link clicks, and no one completed the screening survey. We then tried story ads using the “traffic campaigns,” which target people who tend to click on and engage with links, with higher overall number of link-clicks but a low proportion of youth completing the screening survey. We then changed from story ads to feed ads (i.e., content that permanently stays on a teen’s Instagram’s account, as they scroll through their feed). This strategy (feed ads, delivered using the traffic campaign) have gotten the greatest proportion of link clicks, screening completions, and enrollment of eligible youth. Moving forward, we will continue to assess whether traffic (feed) campaigns are the best way to advertise, and adjust as needed to meet our target enrollment goal of 50. We will also assess whether there are differences in those who complete the screening versus those who do not, and whether there are differences in eligible youth who enroll versus those who do not enroll.
Tell us about the anticipated or real-time impact of this project.
We anticipate that we will provide teens across the country access to cyberbullying resources. All teens who take the screener survey will be directed to a resource link, regardless if they met eligibility for the study. For those enrolled and who complete the study, we anticipate that teens will increase their knowledge of the impacts on cyber-conflict and steps to intervene.
Tell us about problems encountered, changes to your approach, and reasons behind these changes.
The biggest problem we’ve encountered was the development timeline with JourneyLabs. We used them for a previous study (delivering messages only), and the additional functions we requested for the present study IMPACT required more time than anticipated. We went back and forth with JourneyLabs to determine which functions were necessary (having the capability to video-call within the app) versus functions that would be nice to have (participants able to customize their profile with colors and avatars). Ultimately, due to JourneyLabs’ barriers, we could not do video-call within the app, and will now have to use a native phone app (e.g. Skype, Google Hangout, Face Time). We do not anticipate this being a barrier with participants, though we would have preferred a single app to conduct all parts of the study.
Tell us what excites you about the funded project.
Our team is most excited for the opportunity to reach youth across the country. Based on our prior work, we have expertise in in-person recruitment out of hospital settings. While we have reached hundreds of at-risk youth in Rhode Island, funding from TAM has allowed us to expand our reach. We are also excited about the possibility of creating and expanding our innovative methods for identifying wellness in real-time, using Instagram posts.
Tell us more about your team!
Our team consists of PI: Megan Ranney, Project Coordinator: John Patena, Research Assistant: Emily Kutok, and Co-Is: Nicole Nugent, Alison Riese, Shira Dunsiger, Rochelle Rosen, and Jeff Huang. The Emergency Digital Health Innovation program, affiliated with Brown University and Lifespan Health Systems, is a collaboration of practitioners, researchers, and experts in digital health and adolescent well-being. Our mission is to develop, test, and implement high-quality, evidence-based digital health tools for patients and providers. Currently, Dr. Ranney and John mentor a team of 25 research assistants and students.
Fun fact: Emily Kutok has a Snapchat streak with her sister of 1215 days!