Expanding the reach of research: Using remote research technologies to engage people who hear voices (Preprint)

BACKGROUND Similar to other populations with highly stigmatized medical or psychiatric conditions, people who hear voices (i.e., experience auditory verbal hallucinations or AVH) are often hard to identify and reach for research. Technology-assisted remote research strategies reduce barriers to research recruitment; however, few studies have reported on the efficiency and effectiveness of these approaches. OBJECTIVE The present study introduces and evaluates the efficacy of technology-assisted remote research designed for people who experience AVH. METHODS Our group developed an integrated, automated/human complementary online recruitment and enrollment apparatus which incorporated Google Ads, online screening, identification verification, and hybrid automation and interaction with live staff. We examined the efficacy of that apparatus by examining (1) the number of online ad impressions (i.e. number of times the online ad was viewed), (2) clicks on that ad, (3) engagement with online research materials, as well as the extent to which it succeeded at representing a broad sample of individuals with AVH, assessed through the self-reported AVH symptom severity and demographic representativeness (relative to the U.S. population) of the sample recruited. RESULTS Over an 18-month period, our Google Ads were viewed 872,496 times and was clicked on 11,183 times. A total amount of $4,429.25 was spent on Google Ads, resulting in 772 individuals who experience AVH providing consent to participate in an entirely remote research study ($0.40 per click on the ad, and $5.73 per consented participant) after verifying their phone number, passing a competency screening questionnaire, and providing consent. These participants reported high levels of AVH frequency (88.1% daily or more), distress (91.3%) and functional interference (92.4%). They also represented a broad sample of diversity that mirrored U.S. population demographics. Approximately a third (34.9%) of participants had never received treatment for their AVH and, therefore, were unlikely to be identified via traditional clinic-based research recruitment strategies. CONCLUSIONS Online procedures allow for time-saving, cost-efficient, and representative recruitment of individuals with AVH, and can serve as a model for future studies focusing on hard-to-reach populations. CLINICALTRIAL N/A