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Background Influencer-based social media marketing campaigns are a popular strategy to engage customers in many non-research industries (e.g., retail), but have been increasingly used in public health campaigns to reach and engage specific populations. However, few studies have directly compared the performance of influencer-based marketing with other ad strategies (e.g., paid ads) in achieving these goals. Methods From March to September 2023, we conducted an influencer-focused marketing campaign in which we identified and partnered with predominantly Black LGBTQ + influencers in the United States South to promote engagement in our ongoing research. We then used web analytics and interest form data to compare performance of influencer posts versus paid ads over the same time period. Results We contacted a total of 358 influencers, 20 of whom ultimately agreed to post (85% Black/African American) and made a total of 28 posts on our behalf. A significantly higher percentage of users who clicked through influencer posts were Black (40% vs. 15%), were not currently using pre-exposure prophylaxis (PrEP) (67% vs. 62%), had no history of PrEP use (78% vs. 72%), and reported higher medical mistrust (12% vs. 8%) compared to those who clicked through paid ads. The percentage of Black men who have sex with men who were at high HIV risk, who were not taking PrEP, had no history of PrEP, or were high in mistrust, were all 2–3 times higher among those who clicked through influencer posts relative to paid ads. Conclusions Influencer-focused marketing may be a powerful tool to efficiently reach and engage high-priority and hard to reach populations.

Background Online advertisements on social media platforms are an important tool for engaging relevant populations in public health research. However, little is known about what platforms and ad characteristics are most effective in engaging high-priority HIV populations, including racial/ethnic and sexual minority individuals. Methods Data from this study were drawn from advertising campaigns conducted on popular websites and social media platforms that recruited for several nationwide randomized controlled trials of various HIV prevention and testing strategies among sexual minority men (SMM) from December 2019 until March 2022. Descriptive statistics and LASSO regression models were used to determine which platforms and ad characteristics were associated with significantly higher odds of engagement. Results Ads on Google search, Facebook, and Instagram yielded the most cost-effective engagement, while gay-oriented dating platforms and TrafficJunky yielded the highest percentage of users who appeared to meet basic eligibility criteria. The highest percentages of Black users were screened through ads on Jack’d, TrafficJunky, and Google search; for Hispanic/Latino users, Google search, Grindr, Facebook, and Instagram. Analyzing ad characteristics, we found ads that used suggestive content, animation, and included study or institution logos were associated with greater engagement. Ads that emphasized convenience of the research (e.g. mentioned participating “from home”) and that depicted people of similar races/ethnicities were also associated with greater engagement among Black and Hispanic/Latino sexual minority men. Conclusions We found that advertisements on mainstream social media sites are most cost effective. Although gay-oriented dating platforms were much more effective at reaching the target population, they were considerably more expensive. We also identified ad characteristics that were particularly effective in engaging users. These results could inform the design of online public health outreach campaigns for similar populations to improve their engagement and reach. Findings also demonstrated the value of conducting focused research on the effectiveness of various online marketing strategies.

One of the hallmarks of human cognition is cognitive flexibility, the ability to adapt thoughts and behaviors according to changing task demands. Previous research has suggested that the number of different exemplars that must be processed within a task (the set size) can influence an individual’s ability to switch flexibly between different tasks. This paper provides evidence that when tasks have a small set size, children’s cognitive flexibility is impaired compared to when tasks have a large set size. This paper also offers insights into the mechanism by which this effect comes about. Understanding how set size interacts with task-switching informs the debate regarding the relative contributions of bottom-up priming and top-down control processes in the development of cognitive flexibility. We tested two accounts for the relationship between set size and cognitive flexibility: the (bottom-up) Stimulus-Task Priming account and the (top-down) Rule Representation account. Our findings offered support for the Stimulus-Task Priming account, but not for the Rule Representation account. They suggest that children are susceptible to bottom-up priming caused by stimulus repetition, and that this priming can impair their ability to switch between tasks. These findings make important theoretical and practical contributions to the executive function literature: Theoretically, they show that the basic features of a task exert a significant influence on children’s ability to flexibly shift between tasks through bottom-up priming effects. Practically, they suggest that children’s cognitive flexibility may have been underestimated relative to adults’, as paradigms used with children typically have a smaller set size than those used with adults. These findings also have applications in education, where they have the potential to inform teaching in key areas where cognitive flexibility is required, such as mathematics and literacy.

Abstract Introduction Past research shows that HIV self‐testing (HIVST) can increase testing and facilitate more HIV diagnoses relative to clinic testing. However, in the United States, the use of HIVSTs is limited due to concerns that those who use HIVST could be less likely to be linked to care. Methods From January 2019 to April 2022, we recruited 811 men who have sex with men (MSM) in the United States who tested infrequently using an online marketing campaign and randomized them 1:1:1 to receive one of the following every 3 months for a year: (1) text message reminders to get tested at a local clinic (control); (2) mailed HIVST kits with access to a free helpline (standard HIVST); and (3) mailed HIVST kits with counselling provided within 24 hours of opening a kit (eTest). Quarterly follow‐up surveys assessed HIV testing, sexually transmitted infection (STI) testing, pre‐exposure prophylaxis (PrEP) use and sexual risk behaviour. Findings Eight participants were diagnosed with HIV, and all but one were through HIVST. Participants in either HIVST condition, standard or eTest, had significantly higher odds of any testing (OR = 7.9, 95% CI = 4.9−12.9 and OR = 6.6, 95% CI = 4.2−10.5) and repeat testing (>1 test; OR = 8.5, 95% CI = 5.7−12.6; OR = 8.9, 95% CI = 6.1−13.4) over 12 months relative to the control group. Rates of STI testing and PrEP uptake did not differ across study condition, but those in the eTest condition reported 27% fewer sexual risk events across the study period relative to other groups. Conclusions HIVST vastly increased testing, encouraged more regular testing among MSM, and identified nearly all new cases, suggesting that HIVST could diagnose HIV acquisition earlier. Providing timely follow‐up counselling after HIVST did not increase rates of STI testing or PrEP use, but some evidence suggested that counselling may have reduced sexual risk behaviour. To encourage more optimal testing, programmes should incorporate HIVST and ship kits directly to recipients at regular intervals.