Engaging Urban American Indian/Alaska Native Emerging Adults in a Nationwide Substance Use Intervention Randomized Controlled Trial: A Story of Recruitment during the COVID-19 Pandemic

The majority of American Indian and Alaska Native (AI/AN) peoples reside in urban areas and experience significant health disparities relating to substance use. Nonetheless, very few randomized controlled trials (RCTs) have been conducted analyzing new substance use interventions for these populations, due, in part, to challenges with recruitment. This paper highlights recruitment strategies we employed from 2021-2023 in a study, Traditions, and Connections for Urban Native Americans (TACUNA), which analyzed the benefits of a new substance use intervention for urban AI/AN emerging adults (age 18 to 25). We navigated the COVID-19 pandemic by creating virtual platforms for the interventions used in our RCT and for our recruitment strategy. By utilizing algorithms identifying the interests of our recruitment audience and effective ad combinations on Facebook and Instagram, we were able to recruit 541 participants from 37 states. This study helps to identify recruitment strategies that may help to decrease health inequities as it relates to substance use research conducted among urban AI/AN peoples.