Association of Social Media Recruitment and Depression Among Racially and Ethnically Diverse Metabolic and Bariatric Surgery Candidates: A Prospective Cohort Study (Preprint)

BACKGROUND In today's connected world, marked by the widespread use of social media and the internet, obesity and depression rates are increasing concurrently on a global scale. This study investigated the complex dynamics involving social media recruitment for scientific research, race, ethnicity, and depression among metabolic and bariatric surgery (MBS) candidates. OBJECTIVE The research aimed to determine (1) the association between social media recruitment and depression among MBS candidates and (2) racial and ethnic differences in social media recruitment engagement. METHODS The analysis included data from 380 adult MBS candidates enrolled in a prospective cohort study from July 2019 to December 2022. Race/ethnicity, recruitment method (social media Y/N), and depression status were evaluated using chi-square tests and logistic regression models. Age, sex, and ethnicity were adjusted in multivariable logistic regression models. RESULTS Our sample mean (standard deviation) age was 47.35 (11.6) years old, with a range from 18 to 78 years old. Participants recruited through social media were more likely to report past or current episodes of depression (38.32% social media vs. 27.11% non-social media, P=0.032), with a 67% increased likelihood (OR=1.67, 95% CI 1.04–2.68, P=0.033) compared to non-social media recruits. Further analysis showed that participants with a history of depression who were below the mean sample age were 2.31 times more likely to be recruited via social media (aOR=2.31, 95% CI 1.10–4.84, P=0.027) compared to those aged above the sample mean. Hispanic and non-Hispanic White participants were significantly more likely to be recruited via social media than non-Hispanic Black participants (38.81% vs. 35.10% vs. 18.37%, respectively, P<0.001). After adjusting for age and sex, non-Hispanic Black participants were 57% less likely than non-Hispanic white participants to be recruited via social media (aOR=0.43, 95% CI 0.24–0.76, P=0.003). CONCLUSIONS We found that individuals recruited through social media channels were more likely to report past or current episodes of depression compared to those recruited through non-social media means, especially in younger participants. Results also showed that non-Hispanic blacks are less likely to engage in social media recruitment for scientific research versus other race/ethnic groups. Future mental health-related studies should consider strategies to mitigate potential biases introduced by recruitment methods, ensuring the validity and generalizability of research findings.