Leveraging Social Media and Crowdsourcing to Recruit and Retain Military Veterans With Posttraumatic Stress Disorder or Experience of Harmful Gambling ...
Abstract
Background: Military veterans may be at increased risk of posttraumatic stress disorder (PTSD) compared to the general population. PTSD is often comorbid with harmful and problematic patterns of gambling. Behavioral therapies such as acceptance and commitment therapy have shown promise in treating these co-occurring disorders, especially if combined with mobile health (mHealth) interventions to circumvent known help-seeking barriers faced by veterans. However, to date, recruitment for mHealth interventions has been challenging and may impact intervention feasibility. Objective: In this paper, our objectives were to describe the strategies used to recruit UK military veterans with PTSD or experience of harmful gambling to a pilot study of a smartphone-based digital intervention, ACT Vet. Methods: We used several recruitment strategies, such as direct mailing, paid study advertising on social media (Facebook) and an online research platform (Prolific), study-specific website management, in-person event hosting with veterans' charities, snowball sampling, and incentives for completion. Results: Results showed that, over 27 days, recruitment through Facebook accounted for 21 eligible veterans (n=7, 33% through unpaid advertising and n=14, 67% through paid advertising), whereas Prolific accounted for 50 veterans. Additional strategies recruited 8 eligible veterans. In total, 79 eligible military veterans were recruited for ACT Vet, with 24 (30%) completing the final steps of the study. Conclusions: Difficulties such as low advertisement conversion rate and participant and data attrition arose throughout this study. Our findings illustrate the relative effectiveness of social media- and online platform-based initiatives in recruiting veterans with PTSD or harmful gambling. Future research should consider establishing an online presence for effective digital intervention recruitment with diverse branding to attract representative samples of veterans for mHealth research.
Study specs
Multiple recruitment strategies were used, including paid and unpaid advertisements on Facebook, Prolific, direct mailing, event hosting with veterans' charities, snowball sampling, and incentives.
- Authors
- C Heath,JM Williams,D Leightley
- Discipline
- Digital Health,Mental Health Research
- Sample Size
- N=79
- Study Type
- Recruitment Study
- Year
- 2025
- Human Data Platform
- Prolific
- Source
- View Source Google Scholar
Measured Outcomes
The effectiveness of different recruitment strategies for enrolling military veterans with PTSD or harmful gambling into a digital intervention study.
Peer Review & Critical Discussion
Potential Selection Bias in 2023 Cohort
The participant pool shows a concerning overrepresentation of users from high-income demographics. Looking at Table 3, we can see that 78% of respondents had annual incomes above $75k, which significantly limits the generalizability of these findings to broader populations.
Non-naive Participants Issue
I've noticed a methodological concern regarding participant naivety. Given that Prolific users often complete multiple studies, there's a real risk that participants had prior exposure to similar experimental paradigms, which could confound the results.
RLHF Applicability to This Study Design
The implications for RLHF training pipelines are understated. If we accept the authors' conclusions about preference stability, this has direct consequences for how we should structure reward model training. The temporal decay effect described in Section 4.2 is particularly relevant.
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