Scott Connor

Many trial sponsors have questions about the value and legality of reaching potential participants online. Social networks have already demonstrated the ability to generate targeted numbers of pre-qualified patient referrals as well as lower sponsors' overall cost per randomized patient. And whether recruitment happens online or through more traditional means, it doesn't matter; clinical trial sponsors are neither selling a product nor making promises or claims about treatment. They are simply presenting trials as an option to potential participants. As long as we utilize sponsor- and IRB-approved content, the mechanism should not matter.

As in other enterprises, fortune will favor the bold in this venture into online clinical trial recruitment. Social networks—including MySpace and Facebook as well as increasingly popular sites such as bebo, Hi5, and Ning—have already proven that they have a place in the modern clinical trial recruitment mix. Sponsors who hesitate to utilize them are missing opportunities to proactively and cost-effectively place trial information directly in front of potential participants.

Social networking provides a tremendous opportunity for clinical trial sponsors. According to a February 2010 report from the Pew Research Center, 52 percent of adults ages 18–64 now have a profile on at least one social networking site. And since individuals have actively opt-in to social networking services, they are more likely to receive and act upon messages delivered through those media than they to respond to unsolicited communications or even traditional advertising.

Social networking sites also provide the potential for peer-to-peer influence and referrals. The viral aspects of social networking sites and related activities mean that a message's reach can expand exponentially—without the accompanying exponential investment.

Let's be clear though: Social networking is not a trial recruitment panacea. It's highly unlikely that, by itself, a social networking campaign can fulfill the enrollment goal for any clinical study. However, assuming an understanding of the opportunities and limitations associated with social networking and e-recruitment, it can be a valuable part of the clinical trial marketing mix.

Define Audience, Identify Space

While the first foray into e-recruitment can be intimidating for clinical trial sponsors, social networking really isn't so different from other methods of trial recruitment. Establishing visibility in an online environment requires the same basic approach utilized in more traditional recruitment channels: Define and understand the target patient group, then structure a strategy that will motivate them to respond.

Social networking sites are already designed to help sponsors target advertising and content based on the patient population, disease state, and research sites. Facebook and MySpace, for example, have the ability to target advertisements to individual users' pages based on information in user profiles, including gender, birth date, and geographic location.

Given the fact that social networks reach people in nearly every major city in every country on the globe, the ability to target messaging geographically (geo-targeting) is critical, helping ensure the cost- and recruitment-effectiveness of online trial promotion. Both Facebook and MySpace allow advertisers to target messaging within a specific radius of a city or by ZIP code. It's best to stay within 30 miles of the site for most disease categories, as distance to a research site is still, by far, the number one factor in patients' choice to participate in a trial. Trials recruiting for serious indications such as cancer are the exception to this rule. These patients are willing to travel farther for treatment, so sponsors can usually extend the geographic recruitment radius.

Next, develop approved messaging for use in various formats. It's important to develop a full range of discrete messages in the form of online advertisements, canned tweet responses, and text-based hyperlinks. These are the most common formats that social and online health networks use throughout their distribution channels, and sponsors need regulatory approvals for all of them.

But the approval process doesn't stop there. Once a sponsor submits an IRB-approved message or advertisement for inclusion on Facebook or MySpace, an internal editorial committee at the respective social networking service reviews the content. If it's approved by this committee, the ad is displayed within specific sizing and placement parameters on the network. Edits to content must go back through the regulatory, sponsor, and social networking approval loop, but the online nature of the messaging makes this process much faster than editing and re-approving advertisements for traditional media like television.