Recruitment and Retention of Rural-Dwelling Young Adults into a Digital Healthy Eating Intervention: Lessons Learned from a Randomized Controlled Trial of the Veg4Me Study

Background/objectives: The study aimed to identify the key methodological challenges and solutions related to recruitment and retention of rural-dwelling young adults into a randomized controlled trial that tests the feasibility of a digital healthy eating intervention (Veg4Me). Methods: Digital registration for a 12-week study was set up as a one-step process without researcher involvement. Participant registrations and recruitment rates were monitored daily using predetermined online preventative measures to identify fraudulent responses and to amend the digital registration process where necessary. Retention rates were monitored daily to identify any necessary amendments to the follow-up protocol. Results: During data collection, n = 279 fraudulent responses were identified from n = 536 total responses (52%). One month into recruitment, amendments were made to the registration process to reduce fraudulent responses. To address bot attacks, Qualtrics passwords and a two-factor authentication process were added to the Veg4Me landing page. Targeted recruitment strategies, such as unpaid social media posts, corresponded to peaks in recruitment. In the final recruitment month, a question was embedded within follow-up correspondence to encourage completion of the post-intervention survey. This resulted in an additional n = 8 (7%) participants completing the intervention. Conclusions: Empirical observations made in this study suggest that digital recruitment protocols without direct researcher involvement should consider multiple in-built strategies for identifying and preventing fraudulent responses. This includes a two-factor authentication process and minimizing the over-promotion of financial incentives in recruitment strategies. Recruitment strategies should consider the use of social media posts in local community groups, while the use of reminders and notifications could support retention.