Rajani Shankar Sadasivam*, University of Massachusetts Medical School, Worcester, United States Sarah L Cutrona, University of Massachusetts Medical School, Worcester, United States Tana M Luger, VA eHealth Quality Enhancement Research Initiative, Bedford VAMC, BEDFORD, MA, United States Erik M Volz, Imperial College London, London, United Kingdom Rebecca Kinney, University of Massachusetts Medical School, Worcester MA, United States Jeroan J Allison, University of Massachusetts Medical School, Worcester MA, United States Thomas K Houston, University of Massachusetts Medical School, Worcester MA, United States Track: Research Presentation Topic: Building virtual communities and social networking applications for patients and consumers Presentation Type: Oral presentation Submission Type: Single Presentation Building: Sheraton Maui Resort Room: B - Kapalua Date: 2014-11-13 11:00 AM – 11:45 AM Last modified: 2014-09-04

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Background: Smoking cessation rates have plateaued in the last 15 years. New methods to engage smokers are needed. Online social networks offer a new opportunity to spread public health interventions, but questions remain on how to do this effectively. Peer-to-peer recruitment has quickly become the method of choice to recruit customers to online commercial systems, but has not been evaluated for public health. Peer recruitment might be particularly suited to recruit smokers as they tend to be networked together. In the Share2Quit study, we developed a set of peer-recruitment tools on Facebook to test whether smokers will recruit other smokers on Facebook to an online smoking cessation intervention (Decide2Quit.org or D2Q).

Objectives: To measure predictors of successful peer recruitment (smoker-to-smoker) on Facebook.

Methods: The Share2Quit toolset included a Facebook app that allowed smokers to directly recruit their friends and family from D2Q, an online training video, and a recruitment tracker. Smokers were also sent a weekly recruitment report via email. To start the recruitment, an initial set of smokers were directly recruited using Facebook ads (direct recruits). These and subsequent recruits (peer recruits) were given access to the toolset for 30 days to recruit their friends and family current smokers to D2Q. We enforced a quota of 7 recruitment per smoker. We provided smokers with a $15 incentive for each recruitment from their referred network. We compared direct and peer recruits using the CHI2 statistic. Using a negative binomial regression, we assessed predictors of peer recruitment success.

Results: 106 smokers were directly recruited; 240 smokers were peer recruited. Compared to direct recruits, more peer recruited smokers were male (56.7 to 37.7), younger between ages 19-24 (50.8 to 17.7), and less motivated to quit (90.4 to 68.9) (all P<.01). We found an interaction between smoking status and proportion of close ties (family/close friends) in the social network. Current smokers were more successful if they reported a higher proportion of close ties, compared with those that reported a lower number of close ties (P for trend across quartiles .017). Inversely, among former smokers, higher close tie proportion was associated with lower rates of successful peer recruitment (P for trend across quartiles .05).

Conclusions: Peer recruited smokers were different from direct recruits. Differences in successful peer recruitment by smoking status and close ties may have new and important implications on how role modeling and relatedness influences spread through social networks.