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2019 HSR&D/QUERI National Conference Abstract

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4007 — Reaching Veterans at Risk for Suicide and Psychiatric Disorders: Exploring Outreach Potential with Facebook Ads

Lead/Presenter: Alan Teo,  COIN - Portland
All Authors: Teo AR (VA Portland Health Care System, HSR&D Center to Improve Veteran Involvement in Care (CIVIC)), Chan B (Oregon Health & Science University and Portland State University, School of Public Health), Graham AL (Schroeder Institute for Tobacco Research & Policy Studies, Truth Initiative, Washington DC) Dobscha SK (VA Portland Health Care System, HSR&D Center to Improve Veteran Involvement in Care (CIVIC))

Objectives:
1.List headline, image, and related features of Facebook ads that appeal to military veterans. 2.Explain strengths as well as limitations of using Facebook ads to recruit research participants.

Methods:
Using a 3x5 factorial design, we designed 15 Facebook ads tailored to Veterans. Ads varied by imagery (person taking a survey; veteran with his family; soldiers marching) and headlines emphasizing different positively-framed messages (social norms; altruism; empowerment; incentive; and sharing). All ads were run under identical conditions with a "call to action" to complete an online health survey. Negative binomial models incorporating the full factorial design were used to compare image and headline main effects and interactions on each outcome.

Results:
Overall, advertisements produced 827,918 impressions (views), 9,527 clicks, and 587 survey respondents eligible for analysis. Lack of enrollment in VA health care (193/587, 33%) and positive screens for current mental health problems were common, including posttraumatic stress disorder (266/585, 45%), problematic drinking (243/584, 42%), major depression (164/586, 28%), and suicidality (132/585, 23%). Approximately half of the Veterans (285/587, 49%) were recruited with just 2 of the 15 ads, which showed soldiers marching tied to an "incentive" or "sharing" headline. These 2 ads were also the most cost-effective, at $4.88 and $5.90 per participant, respectively. Among Veterans with current suicidal ideation, the survey-taking image resulted in higher survey completion than the soldiers marching image (p = .007).

Implications:
Facebook ads can efficiently reach Veterans, including those at risk for suicidality and psychiatric disorders, and those not using VA services. Advertisement image and headlines may help optimize the effectiveness of advertisements for specific subgroups.

Impacts:
This study demonstrates the utility of Facebook advertisements as a recruitment method for research studies involving post-9/11 era veterans.