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The Sexunzipped trial: optimizing the design of online randomized controlled trials.
J Med Internet Res. 2013 Dec 11; 15(12):e278.JM

Abstract

BACKGROUND

Sexual health problems such as unwanted pregnancy and sexually transmitted infection are important public health concerns and there is huge potential for health promotion using digital interventions. Evaluations of digital interventions are increasingly conducted online. Trial administration and data collection online offers many advantages, but concerns remain over fraudulent registration to obtain compensation, the quality of self-reported data, and high attrition.

OBJECTIVE

This study addresses the feasibility of several dimensions of online trial design-recruitment, online consent, participant identity verification, randomization and concealment of allocation, online data collection, data quality, and retention at 3-month follow-up.

METHODS

Young people aged 16 to 20 years and resident in the United Kingdom were recruited to the "Sexunzipped" online trial between November 2010 and March 2011 (n=2036). Participants filled in baseline demographic and sexual health questionnaires online and were randomized to the Sexunzipped interactive intervention website or to an information-only control website. Participants were also randomly allocated to a postal request (or no request) for a urine sample for genital chlamydia testing and receipt of a lower (£10/US$16) or higher (£20/US$32) value shopping voucher compensation for 3-month outcome data.

RESULTS

The majority of the 2006 valid participants (90.98%, 1825/2006) were aged between 18 and 20 years at enrolment, from all four countries in the United Kingdom. Most were white (89.98%, 1805/2006), most were in school or training (77.48%, 1545/1994), and 62.81% (1260/2006) of the sample were female. In total, 3.88% (79/2036) of registrations appeared to be invalid and another 4.00% (81/2006) of participants gave inconsistent responses within the questionnaire. The higher value compensation (£20/US$32) increased response rates by 6-10%, boosting retention at 3 months to 77.2% (166/215) for submission of online self-reported sexual health outcomes and 47.4% (118/249) for return of chlamydia urine samples by post.

CONCLUSIONS

It was quick and efficient to recruit young people to this online trial. Our procedures for obtaining online consent, verifying participant identity, automated randomization, and concealment of allocation worked well. The optimal response rate for the online sexual health outcome measurement was comparable to face-to-face trials. Multiple methods of participant contact, requesting online data only, and higher value compensation increased trial retention at 3-month follow-up.

TRIAL REGISTRATION

International Standard Randomized Controlled Trial Number (ISRCTN): 55651027; http://www.controlled-trials.com/ISRCTN55651027 (Archived by WebCite at http://www.webcitation.org/6LbkxdPKf).

Authors+Show Affiliations

e-Health Unit, Research Department of Primary Care and Population Health, University College London, London, United Kingdom. julia.bailey@ucl.ac.uk.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24334216

Citation

Bailey, Julia V., et al. "The Sexunzipped Trial: Optimizing the Design of Online Randomized Controlled Trials." Journal of Medical Internet Research, vol. 15, no. 12, 2013, pp. e278.
Bailey JV, Pavlou M, Copas A, et al. The Sexunzipped trial: optimizing the design of online randomized controlled trials. J Med Internet Res. 2013;15(12):e278.
Bailey, J. V., Pavlou, M., Copas, A., McCarthy, O., Carswell, K., Rait, G., Hart, G., Nazareth, I., Free, C., French, R., & Murray, E. (2013). The Sexunzipped trial: optimizing the design of online randomized controlled trials. Journal of Medical Internet Research, 15(12), e278. https://doi.org/10.2196/jmir.2668
Bailey JV, et al. The Sexunzipped Trial: Optimizing the Design of Online Randomized Controlled Trials. J Med Internet Res. 2013 Dec 11;15(12):e278. PubMed PMID: 24334216.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Sexunzipped trial: optimizing the design of online randomized controlled trials. AU - Bailey,Julia V, AU - Pavlou,Menelaos, AU - Copas,Andrew, AU - McCarthy,Ona, AU - Carswell,Ken, AU - Rait,Greta, AU - Hart,Graham, AU - Nazareth,Irwin, AU - Free,Caroline, AU - French,Rebecca, AU - Murray,Elizabeth, Y1 - 2013/12/11/ PY - 2013/04/13/received PY - 2013/09/06/accepted PY - 2013/08/14/revised PY - 2013/12/17/entrez PY - 2013/12/18/pubmed PY - 2014/8/15/medline KW - Internet KW - behavioral research KW - outcome assessment (health care) KW - randomized controlled trials as topic KW - sexual health KW - sexually transmitted diseases SP - e278 EP - e278 JF - Journal of medical Internet research JO - J Med Internet Res VL - 15 IS - 12 N2 - BACKGROUND: Sexual health problems such as unwanted pregnancy and sexually transmitted infection are important public health concerns and there is huge potential for health promotion using digital interventions. Evaluations of digital interventions are increasingly conducted online. Trial administration and data collection online offers many advantages, but concerns remain over fraudulent registration to obtain compensation, the quality of self-reported data, and high attrition. OBJECTIVE: This study addresses the feasibility of several dimensions of online trial design-recruitment, online consent, participant identity verification, randomization and concealment of allocation, online data collection, data quality, and retention at 3-month follow-up. METHODS: Young people aged 16 to 20 years and resident in the United Kingdom were recruited to the "Sexunzipped" online trial between November 2010 and March 2011 (n=2036). Participants filled in baseline demographic and sexual health questionnaires online and were randomized to the Sexunzipped interactive intervention website or to an information-only control website. Participants were also randomly allocated to a postal request (or no request) for a urine sample for genital chlamydia testing and receipt of a lower (£10/US$16) or higher (£20/US$32) value shopping voucher compensation for 3-month outcome data. RESULTS: The majority of the 2006 valid participants (90.98%, 1825/2006) were aged between 18 and 20 years at enrolment, from all four countries in the United Kingdom. Most were white (89.98%, 1805/2006), most were in school or training (77.48%, 1545/1994), and 62.81% (1260/2006) of the sample were female. In total, 3.88% (79/2036) of registrations appeared to be invalid and another 4.00% (81/2006) of participants gave inconsistent responses within the questionnaire. The higher value compensation (£20/US$32) increased response rates by 6-10%, boosting retention at 3 months to 77.2% (166/215) for submission of online self-reported sexual health outcomes and 47.4% (118/249) for return of chlamydia urine samples by post. CONCLUSIONS: It was quick and efficient to recruit young people to this online trial. Our procedures for obtaining online consent, verifying participant identity, automated randomization, and concealment of allocation worked well. The optimal response rate for the online sexual health outcome measurement was comparable to face-to-face trials. Multiple methods of participant contact, requesting online data only, and higher value compensation increased trial retention at 3-month follow-up. TRIAL REGISTRATION: International Standard Randomized Controlled Trial Number (ISRCTN): 55651027; http://www.controlled-trials.com/ISRCTN55651027 (Archived by WebCite at http://www.webcitation.org/6LbkxdPKf). SN - 1438-8871 UR - https://www.unboundmedicine.com/medline/citation/24334216/The_Sexunzipped_trial:_optimizing_the_design_of_online_randomized_controlled_trials_ L2 - https://www.jmir.org/2013/12/e278/ DB - PRIME DP - Unbound Medicine ER -