A Whole New World: Overcoming Methodological Challenges in the Post-Pandemic Recruitment of Pregnant Women at Risk of...

The impact of the COVID-19 pandemic on recruitment has been significant, including the recruitment of pregnant individuals with behavioral health risk factors. The objective of this manuscript is to highlight our response to the methodological challenges created by the pandemic and how we leveraged technology to adapt and expand our recruitment procedures for the Health Check-up for Expectant Moms, a technology-delivered behavioral skills intervention aimed at empowering and motivating pregnant women engaging in substance use and sexual health risks (e.g., condomless sex, multiple partners) to reduce their likelihood of STIs and substance use during pregnancy. After the onset of the pandemic, we transitioned from in-person recruitment to remote clinic recruitment (e.g., by phone, text messaging, and e-mail) as well as social media campaigns via Facebook® and Instagram® with a confidential web-based screening questionnaire for our study targeting pregnant women in 27 counties of Michigan. For remote recruitment, we contacted 6238 women; 1360 completed the study screening questionnaire (mean age = 31.5; SD = 4.6), 90 were eligible, and 73 were enrolled (6% eligibility). For social media recruitment, we had 2512 completing the pre-screening questionnaire. Of these, 501 (mean age = 31.9; SD = 4.6) went on to complete the full study screening questionnaire, 25 women were eligible, and 20 were enrolled (5%). Our 5% eligibility rate from our social media campaign is on par with our remote and in-clinic recruitment methods yet took far less time (15 weeks vs. 150 weeks vs. 48 weeks, respectively). Despite study recruitment challenges related to the pandemic, remote recruitment-particularly social media-was found to be a successful approach, may have a broader reach, and a cost-effective alternative to active recruitment.