importance and sources of hypothesis in social research

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Q: Discuss the importance and sources of hypothesis in social research.

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Importance of Hypothesis in Social Research

Hypotheses are crucial in social research, guiding the research process and providing a framework for testing theories and drawing conclusions. This essay discusses the importance and sources of hypotheses in social research.

Importance of Hypotheses:

1. Guiding the research process: Hypotheses provide direction and focus, helping researchers design studies, select methods, and collect data. For example, a researcher studying education and income might hypothesize that higher education leads to higher income, guiding variable selection and data collection.

2. Facilitating theory testing: Hypotheses allow researchers to test theories by making predictions about variable relationships. Robert Merton’s theory of anomie suggests deviant behavior occurs when there is a discrepancy between goals and means, which can be tested through hypotheses.

3. Enabling empirical verification: Hypotheses are testable statements verified through observation and data collection, establishing validity and reliability. For example, a researcher can test the hypothesis that social media use decreases face-to-face interactions.

4. Promoting scientific inquiry: Hypotheses encourage critical thinking about social phenomena, generating new ideas. Émile Durkheim’s hypothesis about social integration and suicide rates led to insights into social factors influencing suicidal behavior.

Sources of Hypotheses:

1. Theories and literature: Existing theories and research serve as sources of hypotheses. Pierre Bourdieu’s theory of cultural capital might inspire a hypothesis about socioeconomic background and academic success.

2. Observations and experiences: Researchers’ observations can inspire hypotheses. Observing gender differences in classroom participation might lead to hypotheses about gender stereotypes and engagement.

3. Analogies and comparisons: Comparing social phenomena can generate hypotheses about underlying mechanisms. Comparing parenting styles and child development might yield hypotheses about parental control and warmth.

4. Collaborative discussions: Discussions with colleagues or stakeholders can stimulate hypothesis generation. Discussing immigrant challenges might lead to hypotheses about social support and integration.

5. Logical reasoning: Hypotheses can be derived through logical reasoning. Analyzing poverty and crime might lead to hypotheses about limited opportunities and social strain.

Conclusion: Hypotheses guide research, facilitate theory testing, enable verification, and promote inquiry. Researchers can generate hypotheses from theories, observations, analogies, discussions, and reasoning, contributing to the advancement of sociological knowledge.

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Developing a Research Question

18 Hypotheses

When researchers do not have predictions about what they will find, they conduct research to answer a question or questions, with an open-minded desire to know about a topic, or to help develop hypotheses for later testing. In other situations, the purpose of research is to test a specific hypothesis or hypotheses.  A hypothesis is a statement, sometimes but not always causal, describing a researcher’s expectations regarding anticipated finding. Often hypotheses are written to describe the expected relationship between two variables (though this is not a requirement). To develop a hypothesis, one needs to understand the differences between independent and dependent variables and between units of observation and units of analysis. Hypotheses are typically drawn from theories and usually describe how an independent variable is expected to affect some dependent variable or variables. Researchers following a deductive approach to their research will hypothesize about what they expect to find based on the theory or theories that frame their study. If the theory accurately reflects the phenomenon it is designed to explain, then the researcher’s hypotheses about what would be observed in the real world should bear out.

Sometimes researchers will hypothesize that a relationship will take a specific direction. As a result, an increase or decrease in one area might be said to cause an increase or decrease in another. For example, you might choose to study the relationship between age and legalization of marijuana. Perhaps you have done some reading in your spare time, or in another course you have taken.  Based on the theories you have read, you hypothesize that “age is negatively related to support for marijuana legalization.” What have you just hypothesized? You have hypothesized that as people get older, the likelihood of their support for marijuana legalization decreases. Thus, as age moves in one direction (up), support for marijuana legalization moves in another direction (down). If writing hypotheses feels tricky, it is sometimes helpful to draw them out. and depict each of the two hypotheses we have just discussed.

Note that you will almost never hear researchers say that they have proven their hypotheses. A statement that bold implies that a relationship has been shown to exist with absolute certainty and that there is no chance that there are conditions under which the hypothesis would not bear out. Instead, researchers tend to say that their hypotheses have been supported (or not) . This more cautious way of discussing findings allows for the possibility that new evidence or new ways of examining a relationship will be discovered. Researchers may also discuss a null hypothesis, one that predicts no relationship between the variables being studied. If a researcher rejects the null hypothesis, he or she is saying that the variables in question are somehow related to one another.

Quantitative and qualitative researchers tend to take different approaches when it comes to hypotheses. In quantitative research, the goal often is to empirically test hypotheses generated from theory. With a qualitative approach, on the other hand, a researcher may begin with some vague expectations about what he or she will find, but the aim is not to test one’s expectations against some empirical observations. Instead, theory development or construction is the goal. Qualitative researchers may develop theories from which hypotheses can be drawn and quantitative researchers may then test those hypotheses. Both types of research are crucial to understanding our social world, and both play an important role in the matter of hypothesis development and testing.  In the following section, we will look at qualitative and quantitative approaches to research, as well as mixed methods.

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• This chapter has been adapted from Chapter 5.2 in Principles of Sociological Inquiry , which was adapted by the Saylor Academy without attribution to the original authors or publisher, as requested by the licensor. © Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License .

An Introduction to Research Methods in Sociology Copyright © 2019 by Valerie A. Sheppard is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.

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2.1 Approaches to Sociological Research

Learning objectives.

By the end of this section, you should be able to:

• Define and describe the scientific method.
• Explain how the scientific method is used in sociological research.
• Describe the function and importance of an interpretive framework.
• Describe the differences in accuracy, reliability and validity in a research study.

When sociologists apply the sociological perspective and begin to ask questions, no topic is off limits. Every aspect of human behavior is a source of possible investigation. Sociologists question the world that humans have created and live in. They notice patterns of behavior as people move through that world. Using sociological methods and systematic research within the framework of the scientific method and a scholarly interpretive perspective, sociologists have discovered social patterns in the workplace that have transformed industries, in families that have enlightened family members, and in education that have aided structural changes in classrooms.

Sociologists often begin the research process by asking a question about how or why things happen in this world. It might be a unique question about a new trend or an old question about a common aspect of life. Once the question is formed, the sociologist proceeds through an in-depth process to answer it. In deciding how to design that process, the researcher may adopt a scientific approach or an interpretive framework. The following sections describe these approaches to knowledge.

The Scientific Method

Sociologists make use of tried and true methods of research, such as experiments, surveys, and field research. But humans and their social interactions are so diverse that these interactions can seem impossible to chart or explain. It might seem that science is about discoveries and chemical reactions or about proving ideas right or wrong rather than about exploring the nuances of human behavior.

However, this is exactly why scientific models work for studying human behavior. A scientific process of research establishes parameters that help make sure results are objective and accurate. Scientific methods provide limitations and boundaries that focus a study and organize its results.

The scientific method involves developing and testing theories about the social world based on empirical evidence. It is defined by its commitment to systematic observation of the empirical world and strives to be objective, critical, skeptical, and logical. It involves a series of six prescribed steps that have been established over centuries of scientific scholarship.

Sociological research does not reduce knowledge to right or wrong facts. Results of studies tend to provide people with insights they did not have before—explanations of human behaviors and social practices and access to knowledge of other cultures, rituals and beliefs, or trends and attitudes.

In general, sociologists tackle questions about the role of social characteristics in outcomes or results. For example, how do different communities fare in terms of psychological well-being, community cohesiveness, range of vocation, wealth, crime rates, and so on? Are communities functioning smoothly? Sociologists often look between the cracks to discover obstacles to meeting basic human needs. They might also study environmental influences and patterns of behavior that lead to crime, substance abuse, divorce, poverty, unplanned pregnancies, or illness. And, because sociological studies are not all focused on negative behaviors or challenging situations, social researchers might study vacation trends, healthy eating habits, neighborhood organizations, higher education patterns, games, parks, and exercise habits.

Sociologists can use the scientific method not only to collect but also to interpret and analyze data. They deliberately apply scientific logic and objectivity. They are interested in—but not attached to—the results. They work outside of their own political or social agendas. This does not mean researchers do not have their own personalities, complete with preferences and opinions. But sociologists deliberately use the scientific method to maintain as much objectivity, focus, and consistency as possible in collecting and analyzing data in research studies.

With its systematic approach, the scientific method has proven useful in shaping sociological studies. The scientific method provides a systematic, organized series of steps that help ensure objectivity and consistency in exploring a social problem. They provide the means for accuracy, reliability, and validity. In the end, the scientific method provides a shared basis for discussion and analysis (Merton 1963). Typically, the scientific method has 6 steps which are described below.

Step 1: Ask a Question or Find a Research Topic

The first step of the scientific method is to ask a question, select a problem, and identify the specific area of interest. The topic should be narrow enough to study within a geographic location and time frame. “Are societies capable of sustained happiness?” would be too vague. The question should also be broad enough to have universal merit. “What do personal hygiene habits reveal about the values of students at XYZ High School?” would be too narrow. Sociologists strive to frame questions that examine well-defined patterns and relationships.

In a hygiene study, for instance, hygiene could be defined as “personal habits to maintain physical appearance (as opposed to health),” and a researcher might ask, “How do differing personal hygiene habits reflect the cultural value placed on appearance?”

Step 2: Review the Literature/Research Existing Sources

The next step researchers undertake is to conduct background research through a literature review , which is a review of any existing similar or related studies. A visit to the library, a thorough online search, and a survey of academic journals will uncover existing research about the topic of study. This step helps researchers gain a broad understanding of work previously conducted, identify gaps in understanding of the topic, and position their own research to build on prior knowledge. Researchers—including student researchers—are responsible for correctly citing existing sources they use in a study or that inform their work. While it is fine to borrow previously published material (as long as it enhances a unique viewpoint), it must be referenced properly and never plagiarized.

To study crime, a researcher might also sort through existing data from the court system, police database, prison information, interviews with criminals, guards, wardens, etc. It’s important to examine this information in addition to existing research to determine how these resources might be used to fill holes in existing knowledge. Reviewing existing sources educates researchers and helps refine and improve a research study design.

Step 3: Formulate a Hypothesis

A hypothesis is an explanation for a phenomenon based on a conjecture about the relationship between the phenomenon and one or more causal factors. In sociology, the hypothesis will often predict how one form of human behavior influences another. For example, a hypothesis might be in the form of an “if, then statement.” Let’s relate this to our topic of crime: If unemployment increases, then the crime rate will increase.

In scientific research, we formulate hypotheses to include an independent variables (IV) , which are the cause of the change, and a dependent variable (DV) , which is the effect , or thing that is changed. In the example above, unemployment is the independent variable and the crime rate is the dependent variable.

In a sociological study, the researcher would establish one form of human behavior as the independent variable and observe the influence it has on a dependent variable. How does gender (the independent variable) affect rate of income (the dependent variable)? How does one’s religion (the independent variable) affect family size (the dependent variable)? How is social class (the dependent variable) affected by level of education (the independent variable)?

Taking an example from Table 12.1, a researcher might hypothesize that teaching children proper hygiene (the independent variable) will boost their sense of self-esteem (the dependent variable). Note, however, this hypothesis can also work the other way around. A sociologist might predict that increasing a child’s sense of self-esteem (the independent variable) will increase or improve habits of hygiene (now the dependent variable). Identifying the independent and dependent variables is very important. As the hygiene example shows, simply identifying related two topics or variables is not enough. Their prospective relationship must be part of the hypothesis.

Step 4: Design and Conduct a Study

Researchers design studies to maximize reliability , which refers to how likely research results are to be replicated if the study is reproduced. Reliability increases the likelihood that what happens to one person will happen to all people in a group or what will happen in one situation will happen in another. Cooking is a science. When you follow a recipe and measure ingredients with a cooking tool, such as a measuring cup, the same results is obtained as long as the cook follows the same recipe and uses the same type of tool. The measuring cup introduces accuracy into the process. If a person uses a less accurate tool, such as their hand, to measure ingredients rather than a cup, the same result may not be replicated. Accurate tools and methods increase reliability.

Researchers also strive for validity , which refers to how well the study measures what it was designed to measure. To produce reliable and valid results, sociologists develop an operational definition , that is, they define each concept, or variable, in terms of the physical or concrete steps it takes to objectively measure it. The operational definition identifies an observable condition of the concept. By operationalizing the concept, all researchers can collect data in a systematic or replicable manner. Moreover, researchers can determine whether the experiment or method validly represent the phenomenon they intended to study.

A study asking how tutoring improves grades, for instance, might define “tutoring” as “one-on-one assistance by an expert in the field, hired by an educational institution.” However, one researcher might define a “good” grade as a C or better, while another uses a B+ as a starting point for “good.” For the results to be replicated and gain acceptance within the broader scientific community, researchers would have to use a standard operational definition. These definitions set limits and establish cut-off points that ensure consistency and replicability in a study.

We will explore research methods in greater detail in the next section of this chapter.

Step 5: Draw Conclusions

After constructing the research design, sociologists collect, tabulate or categorize, and analyze data to formulate conclusions. If the analysis supports the hypothesis, researchers can discuss the implications of the results for the theory or policy solution that they were addressing. If the analysis does not support the hypothesis, researchers may consider repeating the experiment or think of ways to improve their procedure.

However, even when results contradict a sociologist’s prediction of a study’s outcome, these results still contribute to sociological understanding. Sociologists analyze general patterns in response to a study, but they are equally interested in exceptions to patterns. In a study of education, a researcher might predict that high school dropouts have a hard time finding rewarding careers. While many assume that the higher the education, the higher the salary and degree of career happiness, there are certainly exceptions. People with little education have had stunning careers, and people with advanced degrees have had trouble finding work. A sociologist prepares a hypothesis knowing that results may substantiate or contradict it.

Sociologists carefully keep in mind how operational definitions and research designs impact the results as they draw conclusions. Consider the concept of “increase of crime,” which might be defined as the percent increase in crime from last week to this week, as in the study of Swedish crime discussed above. Yet the data used to evaluate “increase of crime” might be limited by many factors: who commits the crime, where the crimes are committed, or what type of crime is committed. If the data is gathered for “crimes committed in Houston, Texas in zip code 77021,” then it may not be generalizable to crimes committed in rural areas outside of major cities like Houston. If data is collected about vandalism, it may not be generalizable to assault.

Step 6: Report Results

Researchers report their results at conferences and in academic journals. These results are then subjected to the scrutiny of other sociologists in the field. Before the conclusions of a study become widely accepted, the studies are often repeated in the same or different environments. In this way, sociological theories and knowledge develops as the relationships between social phenomenon are established in broader contexts and different circumstances.

Interpretive Framework

While many sociologists rely on empirical data and the scientific method as a research approach, others operate from an interpretive framework . While systematic, this approach doesn’t follow the hypothesis-testing model that seeks to find generalizable results. Instead, an interpretive framework, sometimes referred to as an interpretive perspective , seeks to understand social worlds from the point of view of participants, which leads to in-depth knowledge or understanding about the human experience.

Interpretive research is generally more descriptive or narrative in its findings. Rather than formulating a hypothesis and method for testing it, an interpretive researcher will develop approaches to explore the topic at hand that may involve a significant amount of direct observation or interaction with subjects including storytelling. This type of researcher learns through the process and sometimes adjusts the research methods or processes midway to optimize findings as they evolve.

Critical Sociology

Critical sociology focuses on deconstruction of existing sociological research and theory. Informed by the work of Karl Marx, scholars known collectively as the Frankfurt School proposed that social science, as much as any academic pursuit, is embedded in the system of power constituted by the set of class, caste, race, gender, and other relationships that exist in the society. Consequently, it cannot be treated as purely objective. Critical sociologists view theories, methods, and the conclusions as serving one of two purposes: they can either legitimate and rationalize systems of social power and oppression or liberate humans from inequality and restriction on human freedom. Deconstruction can involve data collection, but the analysis of this data is not empirical or positivist.

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PSC/SOC 340/JS 504: Social Science Research Methods

• Getting Started
• The Scientific Method
• How to Read Scientific Articles
• Research vs Review Articles
• Quantitative vs Qualitative Research
• Books About Research Process
• Lit Review & Research Question

What is the difference between a theory & a hypothesis?

An example of how to write a hypothesis.

• Research Design
• Research Instrument
• Find Articles, Reports & Documents
• How do I find a Quantitative article?
• Find Statistics
• Find Poll & Survey Results
• Evaluate Your Sources
• Cite Your Sources

The terms theory and hypothesis are often used interchangeably in everyday use. However, the difference between them in scholarly research is important, particularly when using an experimental design. A theory is a well-established principle that has been developed to explain some aspect of the natural world. Theories arise from repeated observation and testing and incorporates facts, laws, predictions, and tested hypotheses that are widely accepted [e.g., rational choice theory; grounded theory].

A hypothesis is a specific, testable prediction about what you expect to happen in your study. For example, an experiment designed to look at the relationship between study habits and test anxiety might have a hypothesis that states, "We predict that students with better study habits will suffer less test anxiety." Unless your study is exploratory in nature, your hypothesis should always explain what you expect to happen during the course of your research.

The key distinctions are:

• A theory predicts events in a broad, general context;  a hypothesis makes a specific prediction about a specified set of circumstances.
• A theory has been extensively tested and is generally accepted among scholars; a hypothesis is a speculative guess that has yet to be tested.

Cherry, Kendra. Introduction to Research Methods: Theory and Hypothesis . About.com Psychology; Gezae, Michael et al. Welcome Presentation on Hypothesis . Slideshare presentation.

A worker on a fish-farm notices that his trout seem to have more fish lice in the summer, when the water levels are low, and wants to find out why. His research leads him to believe that the amount of oxygen is the reason - fish that are oxygen stressed tend to be more susceptible to disease and parasites.

He proposes a general hypothesis.

“Water levels affect the amount of lice suffered by rainbow trout.”

This is a good general hypothesis, but it gives no guide to how to design the research or experiment . The hypothesis must be refined to give a little direction.

“Rainbow trout suffer more lice when water levels are low.”

Now there is some directionality, but the hypothesis is not really testable , so the final stage is to design an experiment around which research can be designed, a testable hypothesis.

“Rainbow trout suffer more lice in low water conditions because there is less oxygen in the water.”

This is a testable hypothesis - he has established variables , and by measuring the amount of oxygen in the water, eliminating other controlled variables , such as temperature, he can see if there is a correlation against the number of lice on the fish.

This is an example of how a gradual focusing of research helps to define how to write a hypothesis .

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Practice  Questions  – Write short note on Importance and Sources of Hypothesis in Sociological Research. [ UPSC 2008]

Approach –  Introduction, What makes Hypothesis relevant in a sociological research?, What are the sources which aids us to derive hypothesis?, Conclusion

INTRODUCTION

A hypothesis is a prediction of what will be found at the outcome of a research project and is typically focused on the relationship between two different variables studied in the research. It is usually based on both theoretical expectations about how things work and already existing scientific evidence.

We know that research begins with a problem or a felt need or difficulty. The purpose of research is to find a solution to the difficulty. It is desirable that the researcher should propose a set of suggested solutions or explanations of the  difficulty which the research proposes to solve. Such tentative solutions formulated as a proposition are called hypotheses. The suggested solutions formulated as hypotheses may or may not be the real solutions to the problem. Whether they are or not is the task of research to test and establish.

DEFINTITIONS

• Lundberg- A Hypothesis is a tentative generalisation, the validity of which remains to be tested. In its most elementary stages, the hypothesis may be any hunch, guess imaginative idea or Intuition whatsoever which becomes the basis of action or Investigation.
• Bogardus- A Hypothesis is a proposition to be tested.
• Goode and Hatt- It is a proposition which can be put to test to determinants validity.
• P. V. Yaung- The idea of ​a temporary but central importance that becomes the basis of useful research is called a working hypothesis.

TYPES OF HYPOTHESIS

i)  Explanatory Hypothesis : The purpose of this hypothesis is to explain a certain fact. All hypotheses are in a way explanatory for a hypothesis is advanced only when we try to explain the observed fact. A large number of hypotheses are advanced to explain the individual facts in life. A theft, a murder, an accident are examples.

ii) Descriptive Hypothesis:  Some times a researcher comes across a complex phenomenon. He/ she does not understand the relations among the observed facts. But how to account for these facts? The answer is a descriptive hypothesis. A hypothesis is descriptive when it is based upon the points of resemblance of some thing. It describes the cause and effect relationship of a phenomenon e.g., the current unemployment rate of a state exceeds 25% of the work force. Similarly, the consumers of local made products constitute asignificant market segment.

iii) Analogical Hypothesis : When we formulate a hypothesis on the basis of similarities (analogy), it is called an analogical hypothesis e.g., families with higher earnings invest more surplus income on long term investments.

iv) Working hypothesis : Some times certain facts cannot be explained adequately by existing hypotheses, and no new hypothesis comes up. Thus, the investigation is held up. In this situation, a researcher formulates a hypothesis which enables to continue investigation. Such a hypothesis, though inadequate and formulated for the purpose of further investigation only, is called a working hypothesis. It is simply accepted as a starting point in the process of investigation.

v) Null Hypothesis:  It is an important concept that is used widely in the sampling theory. It forms the basis of many tests of significance. Under this type, the hypothesis is stated negatively. It is null because it may be nullified, if the evidence of a random sample is unfavourable to the hypothesis. It is a hypothesis being tested (H0). If the calculated value of the test is less than the permissible value, Null hypothesis is accepted, otherwise it is rejected. The rejection of a null hypothesis implies that the difference could not have arisen due to chance or sampling fluctuations.

USES OF HYPOTHESIS

i) It is a starting point for many a research work. ii) It helps in deciding the direction in which to proceed. iii) It helps in selecting and collecting pertinent facts. iv) It is an aid to explanation. v) It helps in drawing specific conclusions. vi) It helps in testing theories. vii) It works as a basis for future knowledge.

ROLE  OF HYPOTHESIS

In any scientific investigation, the role of hypothesis is indispensable as it always guides and gives direction to scientific research. Research remains unfocused without a hypothesis. Without it, the scientist is not in position to decide as to what to observe and how to observe. He may at best beat around the bush. In the words of Northrop, “The function of hypothesis is to direct our search for order among facts, the suggestions formulated in any hypothesis may be solution to the problem, whether they are, is the task of the enquiry”.

First ,  it is an operating tool of theory. It can be deduced from other hypotheses and theories. If it is correctly drawn and scientifically formulated, it enables the researcher to proceed on correct line of study. Due to this progress, the investigator becomes capable of drawing proper conclusions. In the words of Goode and Hatt, “without hypothesis the research is unfocussed, a random empirical wandering. The results cannot be studied as facts with clear meaning. Hypothesis is a necessary link between theory and investigation which leads to discovery and addition to knowledge.

Secondly,  the hypothesis acts as a pointer to enquiry. Scientific research has to proceed in certain definite lines and through hypothesis the researcher becomes capable of knowing specifically what he has to find out by determining the direction provided by the hypothesis. Hypotheses acts like a pole star or a compass to a sailor with the help of which he is able to head in the proper direction.

Thirdly , the hypothesis enables us to select relevant and pertinent facts and makes our task easier. Once, the direction and points are identified, the researcher is in a position to eliminate the irrelevant facts and concentrate only on the relevant facts. Highlighting the role of hypothesis in providing pertinent facts, P.V. Young has stated, “The use of hypothesis prevents a blind research and indiscriminate gathering of masses of data which may later prove irrelevant to the problem under study”. For example, if the researcher is interested in examining the relationship between broken home and juvenile delinquency, he can easily proceed in the proper direction and collect pertinent information succeeded only when he has succeed in formulating a useful hypothesis.

Fourthly , the hypothesis provides guidance by way of providing the direction, pointing to enquiry, enabling to select pertinent facts and helping to draw specific conclusions. It saves the researcher from the botheration of ‘trial and error’ which causes loss of money, energy and time.

Finally,  the hypothesis plays a significant role in facilitating advancement of knowledge beyond one’s value and opinions. In real terms, the science is incomplete without hypotheses.

STAGES OF HYPOTHESIS TESTING

• EXPERIMENTATION   : Research study focuses its study which is manageable and approachable to it and where it can test its hypothesis. The study gradually becomes more focused on its variables and influences on variables so that hypothesis may be tested. In this process, hypothesis can be disproved.
• REHEARSAL TESTING :   The researcher should conduct a pre testing or rehearsal before going for field work or data collection.
• FIELD RESEARCH :  To test and investigate hypothesis, field work with predetermined research methodology tools is conducted in which interviews, observations with stakeholders, questionnaires, surveys etc are used to follow. The documentation study may also happens at this stage.
• PRIMARY & SECONDARY DATA/INFORMATION ANALYSIS :  The primary or secondary data and information’s available prior to hypothesis testing may be used to ascertain validity of hypothesis itself.

Formulating a hypothesis can take place at the very beginning of a research project, or after a bit of research has already been done. Sometimes a researcher knows right from the start which variables she is interested in studying, and she may already have a hunch about their relationships. Other times, a researcher may have an interest in ​a particular topic, trend, or phenomenon, but he may not know enough about it to identify variables or formulate a hypothesis. Whenever a hypothesis is formulated, the most important thing is to be precise about what one’s variables are, what the nature of the relationship between them might be, and how one can go about conducting a study of them.

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Scientific Hypotheses: Writing, Promoting, and Predicting Implications

Armen yuri gasparyan.

1 Departments of Rheumatology and Research and Development, Dudley Group NHS Foundation Trust (Teaching Trust of the University of Birmingham, UK), Russells Hall Hospital, Dudley, West Midlands, UK.

Lilit Ayvazyan

2 Department of Medical Chemistry, Yerevan State Medical University, Yerevan, Armenia.

Ulzhan Mukanova

3 Department of Surgical Disciplines, South Kazakhstan Medical Academy, Shymkent, Kazakhstan.

Marlen Yessirkepov

4 Department of Biology and Biochemistry, South Kazakhstan Medical Academy, Shymkent, Kazakhstan.

George D. Kitas

5 Arthritis Research UK Epidemiology Unit, University of Manchester, Manchester, UK.

Scientific hypotheses are essential for progress in rapidly developing academic disciplines. Proposing new ideas and hypotheses require thorough analyses of evidence-based data and predictions of the implications. One of the main concerns relates to the ethical implications of the generated hypotheses. The authors may need to outline potential benefits and limitations of their suggestions and target widely visible publication outlets to ignite discussion by experts and start testing the hypotheses. Not many publication outlets are currently welcoming hypotheses and unconventional ideas that may open gates to criticism and conservative remarks. A few scholarly journals guide the authors on how to structure hypotheses. Reflecting on general and specific issues around the subject matter is often recommended for drafting a well-structured hypothesis article. An analysis of influential hypotheses, presented in this article, particularly Strachan's hygiene hypothesis with global implications in the field of immunology and allergy, points to the need for properly interpreting and testing new suggestions. Envisaging the ethical implications of the hypotheses should be considered both by authors and journal editors during the writing and publishing process.

INTRODUCTION

We live in times of digitization that radically changes scientific research, reporting, and publishing strategies. Researchers all over the world are overwhelmed with processing large volumes of information and searching through numerous online platforms, all of which make the whole process of scholarly analysis and synthesis complex and sophisticated.

Current research activities are diversifying to combine scientific observations with analysis of facts recorded by scholars from various professional backgrounds. 1 Citation analyses and networking on social media are also becoming essential for shaping research and publishing strategies globally. 2 Learning specifics of increasingly interdisciplinary research studies and acquiring information facilitation skills aid researchers in formulating innovative ideas and predicting developments in interrelated scientific fields.

Arguably, researchers are currently offered more opportunities than in the past for generating new ideas by performing their routine laboratory activities, observing individual cases and unusual developments, and critically analyzing published scientific facts. What they need at the start of their research is to formulate a scientific hypothesis that revisits conventional theories, real-world processes, and related evidence to propose new studies and test ideas in an ethical way. 3 Such a hypothesis can be of most benefit if published in an ethical journal with wide visibility and exposure to relevant online databases and promotion platforms.

Although hypotheses are crucially important for the scientific progress, only few highly skilled researchers formulate and eventually publish their innovative ideas per se . Understandably, in an increasingly competitive research environment, most authors would prefer to prioritize their ideas by discussing and conducting tests in their own laboratories or clinical departments, and publishing research reports afterwards. However, there are instances when simple observations and research studies in a single center are not capable of explaining and testing new groundbreaking ideas. Formulating hypothesis articles first and calling for multicenter and interdisciplinary research can be a solution in such instances, potentially launching influential scientific directions, if not academic disciplines.

The aim of this article is to overview the importance and implications of infrequently published scientific hypotheses that may open new avenues of thinking and research.

Despite the seemingly established views on innovative ideas and hypotheses as essential research tools, no structured definition exists to tag the term and systematically track related articles. In 1973, the Medical Subject Heading (MeSH) of the U.S. National Library of Medicine introduced “Research Design” as a structured keyword that referred to the importance of collecting data and properly testing hypotheses, and indirectly linked the term to ethics, methods and standards, among many other subheadings.

One of the experts in the field defines “hypothesis” as a well-argued analysis of available evidence to provide a realistic (scientific) explanation of existing facts, fill gaps in public understanding of sophisticated processes, and propose a new theory or a test. 4 A hypothesis can be proven wrong partially or entirely. However, even such an erroneous hypothesis may influence progress in science by initiating professional debates that help generate more realistic ideas. The main ethical requirement for hypothesis authors is to be honest about the limitations of their suggestions. 5

EXAMPLES OF INFLUENTIAL SCIENTIFIC HYPOTHESES

Daily routine in a research laboratory may lead to groundbreaking discoveries provided the daily accounts are comprehensively analyzed and reproduced by peers. The discovery of penicillin by Sir Alexander Fleming (1928) can be viewed as a prime example of such discoveries that introduced therapies to treat staphylococcal and streptococcal infections and modulate blood coagulation. 6 , 7 Penicillin got worldwide recognition due to the inventor's seminal works published by highly prestigious and widely visible British journals, effective ‘real-world’ antibiotic therapy of pneumonia and wounds during World War II, and euphoric media coverage. 8 In 1945, Fleming, Florey and Chain got a much deserved Nobel Prize in Physiology or Medicine for the discovery that led to the mass production of the wonder drug in the U.S. and ‘real-world practice’ that tested the use of penicillin. What remained globally unnoticed is that Zinaida Yermolyeva, the outstanding Soviet microbiologist, created the Soviet penicillin, which turned out to be more effective than the Anglo-American penicillin and entered mass production in 1943; that year marked the turning of the tide of the Great Patriotic War. 9 One of the reasons of the widely unnoticed discovery of Zinaida Yermolyeva is that her works were published exclusively by local Russian (Soviet) journals.

The past decades have been marked by an unprecedented growth of multicenter and global research studies involving hundreds and thousands of human subjects. This trend is shaped by an increasing number of reports on clinical trials and large cohort studies that create a strong evidence base for practice recommendations. Mega-studies may help generate and test large-scale hypotheses aiming to solve health issues globally. Properly designed epidemiological studies, for example, may introduce clarity to the hygiene hypothesis that was originally proposed by David Strachan in 1989. 10 David Strachan studied the epidemiology of hay fever in a cohort of 17,414 British children and concluded that declining family size and improved personal hygiene had reduced the chances of cross infections in families, resulting in epidemics of atopic disease in post-industrial Britain. Over the past four decades, several related hypotheses have been proposed to expand the potential role of symbiotic microorganisms and parasites in the development of human physiological immune responses early in life and protection from allergic and autoimmune diseases later on. 11 , 12 Given the popularity and the scientific importance of the hygiene hypothesis, it was introduced as a MeSH term in 2012. 13

Hypotheses can be proposed based on an analysis of recorded historic events that resulted in mass migrations and spreading of certain genetic diseases. As a prime example, familial Mediterranean fever (FMF), the prototype periodic fever syndrome, is believed to spread from Mesopotamia to the Mediterranean region and all over Europe due to migrations and religious prosecutions millennia ago. 14 Genetic mutations spearing mild clinical forms of FMF are hypothesized to emerge and persist in the Mediterranean region as protective factors against more serious infectious diseases, particularly tuberculosis, historically common in that part of the world. 15 The speculations over the advantages of carrying the MEditerranean FeVer (MEFV) gene are further strengthened by recorded low mortality rates from tuberculosis among FMF patients of different nationalities living in Tunisia in the first half of the 20th century. 16

Diagnostic hypotheses shedding light on peculiarities of diseases throughout the history of mankind can be formulated using artefacts, particularly historic paintings. 17 Such paintings may reveal joint deformities and disfigurements due to rheumatic diseases in individual subjects. A series of paintings with similar signs of pathological conditions interpreted in a historic context may uncover mysteries of epidemics of certain diseases, which is the case with Ruben's paintings depicting signs of rheumatic hands and making some doctors to believe that rheumatoid arthritis was common in Europe in the 16th and 17th century. 18

WRITING SCIENTIFIC HYPOTHESES

There are author instructions of a few journals that specifically guide how to structure, format, and make submissions categorized as hypotheses attractive. One of the examples is presented by Med Hypotheses , the flagship journal in its field with more than four decades of publishing and influencing hypothesis authors globally. However, such guidance is not based on widely discussed, implemented, and approved reporting standards, which are becoming mandatory for all scholarly journals.

Generating new ideas and scientific hypotheses is a sophisticated task since not all researchers and authors are skilled to plan, conduct, and interpret various research studies. Some experience with formulating focused research questions and strong working hypotheses of original research studies is definitely helpful for advancing critical appraisal skills. However, aspiring authors of scientific hypotheses may need something different, which is more related to discerning scientific facts, pooling homogenous data from primary research works, and synthesizing new information in a systematic way by analyzing similar sets of articles. To some extent, this activity is reminiscent of writing narrative and systematic reviews. As in the case of reviews, scientific hypotheses need to be formulated on the basis of comprehensive search strategies to retrieve all available studies on the topics of interest and then synthesize new information selectively referring to the most relevant items. One of the main differences between scientific hypothesis and review articles relates to the volume of supportive literature sources ( Table 1 ). In fact, hypothesis is usually formulated by referring to a few scientific facts or compelling evidence derived from a handful of literature sources. 19 By contrast, reviews require analyses of a large number of published documents retrieved from several well-organized and evidence-based databases in accordance with predefined search strategies. 20 , 21 , 22

The format of hypotheses, especially the implications part, may vary widely across disciplines. Clinicians may limit their suggestions to the clinical manifestations of diseases, outcomes, and management strategies. Basic and laboratory scientists analysing genetic, molecular, and biochemical mechanisms may need to view beyond the frames of their narrow fields and predict social and population-based implications of the proposed ideas. 23

Advanced writing skills are essential for presenting an interesting theoretical article which appeals to the global readership. Merely listing opposing facts and ideas, without proper interpretation and analysis, may distract the experienced readers. The essence of a great hypothesis is a story behind the scientific facts and evidence-based data.

ETHICAL IMPLICATIONS

The authors of hypotheses substantiate their arguments by referring to and discerning rational points from published articles that might be overlooked by others. Their arguments may contradict the established theories and practices, and pose global ethical issues, particularly when more or less efficient medical technologies and public health interventions are devalued. The ethical issues may arise primarily because of the careless references to articles with low priorities, inadequate and apparently unethical methodologies, and concealed reporting of negative results. 24 , 25

Misinterpretation and misunderstanding of the published ideas and scientific hypotheses may complicate the issue further. For example, Alexander Fleming, whose innovative ideas of penicillin use to kill susceptible bacteria saved millions of lives, warned of the consequences of uncontrolled prescription of the drug. The issue of antibiotic resistance had emerged within the first ten years of penicillin use on a global scale due to the overprescription that affected the efficacy of antibiotic therapies, with undesirable consequences for millions. 26

The misunderstanding of the hygiene hypothesis that primarily aimed to shed light on the role of the microbiome in allergic and autoimmune diseases resulted in decline of public confidence in hygiene with dire societal implications, forcing some experts to abandon the original idea. 27 , 28 Although that hypothesis is unrelated to the issue of vaccinations, the public misunderstanding has resulted in decline of vaccinations at a time of upsurge of old and new infections.

A number of ethical issues are posed by the denial of the viral (human immunodeficiency viruses; HIV) hypothesis of acquired Immune deficiency Syndrome (AIDS) by Peter Duesberg, who overviewed the links between illicit recreational drugs and antiretroviral therapies with AIDS and refuted the etiological role of HIV. 29 That controversial hypothesis was rejected by several journals, but was eventually published without external peer review at Med Hypotheses in 2010. The publication itself raised concerns of the unconventional editorial policy of the journal, causing major perturbations and more scrutinized publishing policies by journals processing hypotheses.

WHERE TO PUBLISH HYPOTHESES

Although scientific authors are currently well informed and equipped with search tools to draft evidence-based hypotheses, there are still limited quality publication outlets calling for related articles. The journal editors may be hesitant to publish articles that do not adhere to any research reporting guidelines and open gates for harsh criticism of unconventional and untested ideas. Occasionally, the editors opting for open-access publishing and upgrading their ethics regulations launch a section to selectively publish scientific hypotheses attractive to the experienced readers. 30 However, the absence of approved standards for this article type, particularly no mandate for outlining potential ethical implications, may lead to publication of potentially harmful ideas in an attractive format.

A suggestion of simultaneously publishing multiple or alternative hypotheses to balance the reader views and feedback is a potential solution for the mainstream scholarly journals. 31 However, that option alone is hardly applicable to emerging journals with unconventional quality checks and peer review, accumulating papers with multiple rejections by established journals.

A large group of experts view hypotheses with improbable and controversial ideas publishable after formal editorial (in-house) checks to preserve the authors' genuine ideas and avoid conservative amendments imposed by external peer reviewers. 32 That approach may be acceptable for established publishers with large teams of experienced editors. However, the same approach can lead to dire consequences if employed by nonselective start-up, open-access journals processing all types of articles and primarily accepting those with charged publication fees. 33 In fact, pseudoscientific ideas arguing Newton's and Einstein's seminal works or those denying climate change that are hardly testable have already found their niche in substandard electronic journals with soft or nonexistent peer review. 34

CITATIONS AND SOCIAL MEDIA ATTENTION

The available preliminary evidence points to the attractiveness of hypothesis articles for readers, particularly those from research-intensive countries who actively download related documents. 35 However, citations of such articles are disproportionately low. Only a small proportion of top-downloaded hypotheses (13%) in the highly prestigious Med Hypotheses receive on average 5 citations per article within a two-year window. 36

With the exception of a few historic papers, the vast majority of hypotheses attract relatively small number of citations in a long term. 36 Plausible explanations are that these articles often contain a single or only a few citable points and that suggested research studies to test hypotheses are rarely conducted and reported, limiting chances of citing and crediting authors of genuine research ideas.

A snapshot analysis of citation activity of hypothesis articles may reveal interest of the global scientific community towards their implications across various disciplines and countries. As a prime example, Strachan's hygiene hypothesis, published in 1989, 10 is still attracting numerous citations on Scopus, the largest bibliographic database. As of August 28, 2019, the number of the linked citations in the database is 3,201. Of the citing articles, 160 are cited at least 160 times ( h -index of this research topic = 160). The first three citations are recorded in 1992 and followed by a rapid annual increase in citation activity and a peak of 212 in 2015 ( Fig. 1 ). The top 5 sources of the citations are Clin Exp Allergy (n = 136), J Allergy Clin Immunol (n = 119), Allergy (n = 81), Pediatr Allergy Immunol (n = 69), and PLOS One (n = 44). The top 5 citing authors are leading experts in pediatrics and allergology Erika von Mutius (Munich, Germany, number of publications with the index citation = 30), Erika Isolauri (Turku, Finland, n = 27), Patrick G Holt (Subiaco, Australia, n = 25), David P. Strachan (London, UK, n = 23), and Bengt Björksten (Stockholm, Sweden, n = 22). The U.S. is the leading country in terms of citation activity with 809 related documents, followed by the UK (n = 494), Germany (n = 314), Australia (n = 211), and the Netherlands (n = 177). The largest proportion of citing documents are articles (n = 1,726, 54%), followed by reviews (n = 950, 29.7%), and book chapters (n = 213, 6.7%). The main subject areas of the citing items are medicine (n = 2,581, 51.7%), immunology and microbiology (n = 1,179, 23.6%), and biochemistry, genetics and molecular biology (n = 415, 8.3%).

Interestingly, a recent analysis of 111 publications related to Strachan's hygiene hypothesis, stating that the lack of exposure to infections in early life increases the risk of rhinitis, revealed a selection bias of 5,551 citations on Web of Science. 37 The articles supportive of the hypothesis were cited more than nonsupportive ones (odds ratio adjusted for study design, 2.2; 95% confidence interval, 1.6–3.1). A similar conclusion pointing to a citation bias distorting bibliometrics of hypotheses was reached by an earlier analysis of a citation network linked to the idea that β-amyloid, which is involved in the pathogenesis of Alzheimer disease, is produced by skeletal muscle of patients with inclusion body myositis. 38 The results of both studies are in line with the notion that ‘positive’ citations are more frequent in the field of biomedicine than ‘negative’ ones, and that citations to articles with proven hypotheses are too common. 39

Social media channels are playing an increasingly active role in the generation and evaluation of scientific hypotheses. In fact, publicly discussing research questions on platforms of news outlets, such as Reddit, may shape hypotheses on health-related issues of global importance, such as obesity. 40 Analyzing Twitter comments, researchers may reveal both potentially valuable ideas and unfounded claims that surround groundbreaking research ideas. 41 Social media activities, however, are unevenly distributed across different research topics, journals and countries, and these are not always objective professional reflections of the breakthroughs in science. 2 , 42

Scientific hypotheses are essential for progress in science and advances in healthcare. Innovative ideas should be based on a critical overview of related scientific facts and evidence-based data, often overlooked by others. To generate realistic hypothetical theories, the authors should comprehensively analyze the literature and suggest relevant and ethically sound design for future studies. They should also consider their hypotheses in the context of research and publication ethics norms acceptable for their target journals. The journal editors aiming to diversify their portfolio by maintaining and introducing hypotheses section are in a position to upgrade guidelines for related articles by pointing to general and specific analyses of the subject, preferred study designs to test hypotheses, and ethical implications. The latter is closely related to specifics of hypotheses. For example, editorial recommendations to outline benefits and risks of a new laboratory test or therapy may result in a more balanced article and minimize associated risks afterwards.

Not all scientific hypotheses have immediate positive effects. Some, if not most, are never tested in properly designed research studies and never cited in credible and indexed publication outlets. Hypotheses in specialized scientific fields, particularly those hardly understandable for nonexperts, lose their attractiveness for increasingly interdisciplinary audience. The authors' honest analysis of the benefits and limitations of their hypotheses and concerted efforts of all stakeholders in science communication to initiate public discussion on widely visible platforms and social media may reveal rational points and caveats of the new ideas.

Disclosure: The authors have no potential conflicts of interest to disclose.

Author Contributions:

• Conceptualization: Gasparyan AY, Yessirkepov M, Kitas GD.
• Methodology: Gasparyan AY, Mukanova U, Ayvazyan L.
• Writing - original draft: Gasparyan AY, Ayvazyan L, Yessirkepov M.
• Writing - review & editing: Gasparyan AY, Yessirkepov M, Mukanova U, Kitas GD.

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Sources of hypothesis in social research: 4 sources.

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This article throws light on the four important sources of hypothesis in social research, i.e, (1) General Culture in which a Science Develops, (2) Scientific Theory, (3) Analogies, and (4) Consequences of Personal, Idiosyncratic Experience as the Sources of Hypothesis.

1. General Culture in which a Science Develops :

A cultural pattern influences the thinking process of the people and the hypothesis may be formulated to test one or more of these ideas. Cultural values serve to direct research interests. The function of culture has been responsible for developing today’s science to a great dimension. In the words of Goode and Hatt, “to say that the hypotheses are the product of the cultural values does not make them scientifically less important than others, but it does at least indicate that attention has been called to them by the culture itself.

For example in the Western society race is thought to be an important determinant of human behaviour. Such a proposition can be used to formulate a hypothesis. We may also cite metaphysical bias and metaphysical ideas of Indian culture to have been responsible for the formulation of certain types of hypotheses. It implies that cultural elements of common cultural pattern may form a source of the formulation of hypotheses.

2. Scientific Theory:

A major source of hypothesis is theory. A theory binds a large body of facts by positing a consistent and lawful relationship among a set of general concepts representing those facts. Further generalizations are formed on the basis of the knowledge of theory. Corollaries are drawn from the theories.

These generalizations or corollaries constitute a part of hypothesis. Since theories deal with abstractions which cannot be directly observed and can only remain in the thought process, a scientific hypothesis which is concerned with observable facts and observable relationship between facts can only be used for the purpose of selecting some of the facts as concrete instances of the concepts and for making a tentative statement about the existence of a relation among the selected facts with the purpose of subjecting the relation to an empirical test.”

A hypothesis emerges as a deduction from theory. Hence, hypotheses become “working instruments of theory” Every worthwhile theory provides for the formulation of additional hypothesis. “The hypothesis is the backbone of all scientific theory construction; without it, confirmation or rejection of theories would be impossible.”

The hypotheses when tested are “either proved or disproved and in turn constitute further tests of the original theory.” Thus the hypothetical type of verbal proposition forms the link between the empirical propositions or facts and the theories. The validity of a theory can be examined only by means of scientific predictions or experimental hypothesis.

3. Analogies:

Observation of a similarity between two phenomena may be a source of formation of a hypothesis aimed at testing similarity in any other respect. Julian Huxley has pointed out that “casual observation in nature or in the framework of another science may be a fertile source of hypothesis. The success of a system in one discipline can be used in other discipline also. The theory of ecology is based on the observation of certain plants in certain geographical conditions. As such, it remains in the domain of Botany. On the basis of that the hypothesis of human ecology could be conceived.

Hypothesis of social physics is also based on analogy. “When the hypothesis was born out by social observation, the same term was taken into sociology. It has become an important idea in sociological theory”. Although analogy is not always considered, at the time of formulation of hypothesis; it is generally satisfactory when it has some structural analogies to other well established theories. For the systematic simplicity of our knowledge, the analogy of a hypothesis becomes inversely helpful. Formulation of an analogous hypothesis is construed as an achievement because by doing so its interpretation is made easy.

4. Consequences of Personal, Idiosyncratic Experience as the Sources of Hypothesis:

Not only culture, scientific theory and analogies provide the sources of hypothesis, but also the way in which the individual reacts to each of these is also a factor in the statement of hypotheses. Certain facts are present, but every one of us is not able to observe them and formulate a hypothesis.

Referring to Fleming’s discovery of penicillin, Backrach has maintained that such discovery is possible only when the scientist is prepared to be impressed by the ‘unusual’. An unusual event struck Fleming when he noted that the dish containing bacteria had a green mould and the bacteria were dead. Usually he would have washed the dish and have attempted once again to culture the bacteria.

But normally, he was moved to bring the live bacteria in close contact with the green mould, resulting in the discovery of penicillin. The example of Sir Issac Newton, the discoverer of the theory of Gravitation, is another glaring example of this type of ‘personal experience’. Although prior to Newton’s observation, several persons had witnessed the falling of the apple, he was the right man to formulate the theory of gravitation on the basis of this phenomenon.

Thus emergence of a hypothesis is a creative manner. To quote Mc Guigan, “to formulate a useful and valuable hypothesis, a scientist needs first sufficient experience in that area, and second the quality of the genius.” In the field of social sciences, an illustration of individual perspective may be visualized in Veblen’s work. Thorstein Veblen’s own community background was replete with negative experiences concerning the functioning of economy and he was a ‘marginal man’, capable of looking at the capitalist system objectively.

Thus, he could be able to attack the fundamental concepts and postulates of classical economics and in real terms Veblen could experience differently to bear upon the economic world, resulting in the making of a penetrating analysis of our society. Such an excellent contribution of Veblen has, no doubt, influenced social science since those days.

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Published on 26.8.2024 in Vol 26 (2024)

Acceptance of Social Media Recruitment for Clinical Studies Among Patients With Hepatitis B: Mixed Methods Study

Authors of this article:

Original Paper

• Theresa Willem 1, 2, 3 * , MA   ; 
• Bettina M Zimmermann 1, 2, 4 * , PhD   ; 
• Nina Matthes 2   ; 
• Michael Rost 5 , PhD   ; 
• Alena Buyx 2 , Prof Dr Med  

1 Institute of Molecular Immunology, Klinikum Rechts der Isar, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany

2 Institute of History and Ethics in Medicine, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany

3 Department of Science, Technology and Society (STS), School of Social Sciences and Technology, Technical University of Munich, Munich, Germany

4 Institute of Philosophy, Multidisciplinary Center for Infectious Diseases, University of Bern, Bern, Switzerland

5 Institute for Biomedical Ethics, University of Basel, Basel, Switzerland

*these authors contributed equally

Corresponding Author:

Bettina M Zimmermann, PhD

Institute of History and Ethics in Medicine

TUM School of Medicine and Health

Technical University of Munich

Ismaninger Str. 22

Munich, 81675

Phone: 49 89 4140 4041

Email: [email protected]

Background: Social media platforms are increasingly used to recruit patients for clinical studies. Yet, patients’ attitudes regarding social media recruitment are underexplored.

Objective: This mixed methods study aims to assess predictors of the acceptance of social media recruitment among patients with hepatitis B, a patient population that is considered particularly vulnerable in this context.

Methods: Using a mixed methods approach, the hypotheses for our survey were developed based on a qualitative interview study with 6 patients with hepatitis B and 30 multidisciplinary experts. Thematic analysis was applied to qualitative interview analysis. For the cross-sectional survey, we additionally recruited 195 patients with hepatitis B from 3 clinical centers in Germany. Adult patients capable of judgment with a hepatitis B diagnosis who understood German and visited 1 of the 3 study centers during the data collection period were eligible to participate. Data analysis was conducted using SPSS (version 28; IBM Corp), including descriptive statistics and regression analysis.

Results: On the basis of the qualitative interview analysis, we hypothesized that 6 factors were associated with acceptance of social media recruitment: using social media in the context of hepatitis B (hypothesis 1), digital literacy (hypothesis 2), interest in clinical studies (hypothesis 3), trust in nonmedical (hypothesis 4a) and medical (hypothesis 4b) information sources, perceiving the hepatitis B diagnosis as a secret (hypothesis 5a), attitudes toward data privacy in the social media context (hypothesis 5b), and perceived stigma (hypothesis 6). Regression analysis revealed that the higher the social media use for hepatitis B (hypothesis 1), the higher the interest in clinical studies (hypothesis 3), the more trust in nonmedical information sources (hypothesis 4a), and the less secrecy around a hepatitis B diagnosis (hypothesis 5a), the higher the acceptance of social media as a recruitment tool for clinical hepatitis B studies.

Conclusions: This mixed methods study provides the first quantitative insights into social media acceptance for clinical study recruitment among patients with hepatitis B. The study was limited to patients with hepatitis B in Germany but sets out to be a reference point for future studies assessing the attitudes toward and acceptance of social media recruitment for clinical studies. Such empirical inquiries can facilitate the work of researchers designing clinical studies as well as ethics review boards in balancing the risks and benefits of social media recruitment in a context-specific manner.

Introduction

Benefits and risks of using social media recruitment for clinical studies.

Recruiting clinical study participants through social media has the potential to increase the recruitment accrual in a cost-effective way [ 1 ]. Consequently, social media recruitment has been increasingly applied for clinical studies, often in parallel with other recruitment strategies. However, social media recruitment still bears a host of challenges. First, maintaining a social media presence and community management can be resource intensive. Second, when used as a stand-alone recruiting method, it might yield a cohort of limited demographic representativeness. Finally, social media recruitment comes with ethical issues, particularly when used to recruit for clinical studies [ 2 ]. Because social media recruitment includes reaching potential research participants outside a clinical setting and in a public online space without direct personal contact, risks related to social stigma, privacy infringement, loss of trust, and psychological harm have been discussed [ 3 ]. To mitigate some of these risks, prioritizing investigator transparency and obtaining explicit consent when recruiting from others’ social network was suggested [ 4 ]. Yet, because the activities of social media platforms are primarily unregulated and partly belong to large global technology companies, activities conducted on social media, including study recruitment, can never be fully controlled by researchers or institutions. Remaining privacy-infringing risks include hidden data collection and profiling, particularly problematic for patients carrying vulnerable characteristics [ 5 ].

Early studies assessing social media recruitment for clinical studies focused on the effectiveness of the method. For example, Frandsen et al [ 3 ] used social media recruitment for a smoking cessation trial and compared their cohort recruited from a Facebook-based approach to cohorts resulting from other recruitment methods. They found no differences between the cohorts regarding socioeconomic or smoking characteristics, except that participants recruited via Facebook were significantly younger. Wisk et al [ 4 ] recruited college students with type 1 diabetes, a hard-to-reach population, using a variety of outreach channels, including social media. They found that Facebook was the most successful recruitment method. Guthrie et al [ 5 ] found that Facebook advertising was significantly cheaper than recruiting via mail. While these studies allow insights into the utility of social media recruitment from the perspective of researchers, studies assessing patients’ perspectives and attitudes toward social media for clinical study recruitment are lacking. This study aims to deliver first evidence on patient attitudes toward social media recruitment, focusing on patients with hepatitis B.

Patients With Hepatitis B and Social Media

Patients with hepatitis B are a particularly interesting cohort to study acceptance for social media recruitment as the particularities of the disease exhibit potentially confounding factors for their attitudes toward social media recruitment. First, there is robust empirical evidence that patients with hepatitis B can be subject to social stigma [ 6 - 10 ]. Therefore, the risk of public exposure to hepatitis B diagnosis on social media renders them—and patients with other stigmatized traits and conditions—particularly vulnerable in the context of social media recruitment [ 11 ]. Second, hepatitis B in Europe is particularly prevalent in certain immigrant populations, which are at risk of being neglected for clinical studies due to language barriers and lack of health care access. Social media recruitment can help include patient populations who otherwise would be disregarded for clinical studies or are hard to reach [ 12 - 14 ].

Study Rationale and Objectives

However, the effectiveness of social media recruitment crucially hinges on technology acceptance. To date, the attitudes of patients regarding social media recruitment are underexplored. Addressing this gap, this mixed methods study assesses factors predicting the acceptance of social media recruitment among patients with hepatitis B. On the basis of qualitative individual interviews with 6 patients with hepatitis B and 30 multidisciplinary experts and a literature review, we hypothesized that general social media use (hypothesis 1), social media literacy (hypothesis 2), interest in clinical studies (hypothesis 3), trust (hypothesis 4), privacy needs (hypothesis 5), and perceived stigma (hypothesis 6) are associated with acceptance of social media recruitment.

Study Design

This study is part of the European Union–funded international research consortium “TherVacB—A Therapeutic Vaccine to Cure Hepatitis B,” work package 6 (ethical, legal, and social aspects of social media recruitment). Using a mixed methods design, we first conducted an explorative qualitative multistakeholder interview study assessing the ethical, legal, social, and practical implications of social media recruitment for clinical studies [ 2 ]. The hypotheses investigated in this paper are based on these interviews and a conceptual literature review mapping the ethical implications of social media recruitment [ 11 ]. The reporting of this study followed the Strengthening the Reporting of Observational Studies in Epidemiology guidelines [ 15 ].

Survey Recruitment

On the basis of preliminary statistical power analysis and pragmatic considerations of available study participants, we aimed for 200 responses in a recruitment period of 7 months. Due to administrative constraints, including the COVID-19 pandemic, the overall recruitment period was prolonged by 5 months (total recruitment period 12 months, June 4, 2022, to May 31, 2023), and the recruitment period varied among the recruiting clinics ( Multimedia Appendix 1 ).

Adult, German-speaking patients diagnosed with acute or chronic viral hepatitis B were recruited from 3 large university hospitals in Germany. We chose such a venue-based recruitment methodology because it is considered one of the best options to recruit representative samples from hard-to-reach populations [ 16 ]. The clinical staff was instructed to distribute the study information leaflet to every eligible patient in the study period, explaining the implications of the study and inviting them to fill out the questionnaire. To limit recruitment bias and enhance sample representativeness, study nurses were briefed to avoid self-selected restrictions in recruitment and, if possible, to give a questionnaire to every incoming patient with hepatitis B who understood German sufficiently well. However, because of the administrative burden of the clinical staff, only 30.4% (285/939) of the estimated eligible incoming patients received the questionnaire ( Multimedia Appendix 1 ). Because this low distribution number results from administrative burden in the clinic, we do not expect this to have a relevant impact on representativeness (refer to the Limitations subsection under the Discussion section). Completed questionnaires (207/285, 72.6% of the distributed questionnaires; Multimedia Appendix 1 ) were collected in the recruiting hospital and sent to the authors via mail.

Survey Construction

The dependent variable (acceptance of social media recruitment) was constructed based on the Technology Acceptance Model [ 17 , 18 ], involving the dimensions of perceived usefulness; perceived ease of use, intentions, and problem awareness; and proved good internal consistency (Cronbach α=0.863). Possible predictors for social media recruitment acceptance were identified based on the abovementioned hypotheses and operationalized by, if possible, existing validated questionnaires. For 3 (33%) of the 9 independent variables, we used existing validated questionnaires that were found to be of excellent reliability: the social media literacy scale (14 items, Cronbach α=0.947) [ 19 ], the Berger HIV Stigma Scale for use among patients with hepatitis C virus (6 items, Cronbach α=0.931) [ 20 ], and the Privacy Attitude Questionnaire [ 21 ]. For the latter, we included a shortened version that covered the dimensions developed in the Privacy Attitude Questionnaire but targeted it toward the hepatitis B context. From these dimensions, 2 subscales were created: secrecy of hepatitis B diagnosis (2 items, Cronbach α=0.623) and data privacy needs regarding hepatitis B diagnosis (2 items, Cronbach α=0.587).

For the remaining variables, no validated tools existed. Hence, we developed new scales for each variable of interest. As indicated by internal consistency, these were of moderate, good, or excellent reliability: general social media use (8 items, Cronbach α=0.676), hepatitis B–related social media use (6 items, Cronbach α=0.906), interest in clinical studies (2 items, Cronbach α=0.895), and trust in information sources regarding hepatitis B (11 items, Cronbach α=0.905; 2 subscales were created: trust in medical information sources—4 items, Cronbach α=0.784 and trust in nonmedical information sources, ie, traditional media, social media, other patients, poster advertisements, etc—7 items, Cronbach α=0.881). In addition to these adapted and self-developed scales, we included 4 demographic variables in the regression model (age, gender, education, and mother tongue as an indicator of migration background). A preliminary version of the questionnaire was discussed with 3 experts from the fields of infectiology and bioethics and then adapted and shortened based on their comments. We then performed cognitive pretesting [ 22 ] with 6 patients with hepatitis B, leading to minor changes. The full questionnaire is provided in Multimedia Appendix 2 .

Statistical Analysis

Using SPSS (version 28.0; IBM Corp), we (1) performed descriptive analyses, (2) determined independent factors associated with participants’ acceptance of social media as a recruitment tool for clinical hepatitis B studies through multiple linear regression analysis, and (3) performed additional exploratory bivariate analyses of hepatitis B–related stigma (ie, correlation, independent 2-tailed t test). The statistical significance level was set at P <.05. For multiple linear regression analysis, assumption checks were performed before the interpretation of the model ( Multimedia Appendix 3 ). For the scale measuring the frequency of social media use, missing values were replaced by “0” (ie, “never”), assuming that participants did not tick a box, as they did not know the respective social media platform. Overall, 71.3% (139/195) of the participants completed all items, resulting in 3.66% (478/13,065) missing values and 81% (54/67) incomplete variables.

For the linear regression analysis, theoretical considerations and hypotheses derived from our previous qualitative study determined predictor selection. In addition, the sample size or predictor ratio a priori determines variable selection for regression modeling. According to Harrell [ 23 ], a fitted regression model is likely to be reliable when p<m/10 or p<m/20 (average requirement: p<m/15), where p is the number of predictors and m is the sample size. Applying this requirement to our sample size (N=195) and having missing data, we preliminarily limited the number of included predictors to 11. The following 11 predictors were included in the regression model: general social media use, social media literacy, hepatitis B–related social media use, interest in clinical studies, trust in medical information sources regarding hepatitis B (dichotomized to meet assumption of linearity), trust in nonmedical information sources regarding hepatitis B, secrecy of hepatitis B (dichotomized to meet assumption of linearity), data privacy needs regarding hepatitis B (dichotomized to meet assumption of linearity), perceived stigma, age, and education. Assumptions checks for regression analyses are presented in Multimedia Appendix 3 .

Ethical Considerations

For study consent, participants were asked to confirm having read and understood the study information and to consent to the study participation by checking a consent box at the beginning of the questionnaire. Only questionnaires with this box checked were included in the analysis (12/207, 5.8% of the questionnaires were excluded for that reason; Multimedia Appendix 1 ). The ethics committees from the Technical University of Munich (12/22-S-NP), Hannover Medical School (10368_BO_K_2022), and University Clinic Leipzig (189/22-lk) approved the study.

Deriving Hypotheses

After conducting an in-depth literature review on the ethical and social challenges surrounding social media recruitment for clinical studies [ 11 ], we developed 2 semistructured interview guides, one targeted at patients with hepatitis B and the other targeted at multidisciplinary experts. On the basis of interviews with 6 patients that were triangulated with findings from 30 interviews with experts, we qualitatively assessed what factors could be associated with the acceptance of social media recruitment for clinical hepatitis B studies. On the basis of these findings, we derived hypotheses to be tested quantitatively in a survey among patients with hepatitis B in Germany ( Textbox 1 ).

• Hypothesis 1: The more patients use social media for hepatitis B, the higher their acceptance of using social media as a recruitment tool for clinical hepatitis B studies.
• Hypothesis 2: Digital literacy is associated with social media acceptance.
• Hypothesis 3: The higher the general interest in clinical study participation, the higher the acceptance of social media recruitment for clinical studies.
• Hypothesis 4: The more patients trust information sources for hepatitis B, the higher their acceptance of social media recruitment.
• Hypothesis 5: The more patients value privacy, the lower their acceptance of using social media as a recruitment tool for clinical hepatitis B studies.
• Hypothesis 6: The higher the perceived stigma of patients with hepatitis B, the lower their acceptance of social media as a recruitment tool for clinical studies.

Intensity of Using Social Media in the Context of Hepatitis B

Most of the patients we talked with were rejecting the idea of being recruited for a clinical hepatitis B study via social media. However, patients who were more actively involved in their own recruitment tended to have more accepting attitudes. For example, patients who described using social media as a tool for informing themselves about potential clinical studies related to their disease were less opposed to being recruited via the same channel. One patient included search engines in their definition of social media and mentioned the following:

You can also advertise on Google. That is quasi/I think it’s better if I [as a patient] search for a study. For example, I search for a study related to psoriasis and enter that term in Google—when the advertisement for a psoriasis study is then made so that it shows up as the first suggestion...I think that’s better because in these instances I’m already searching, so I take the first step, I search for the study. And then the study, or the advertisement must be done in such a way that I can find it. So, I take the first step and then I land on the study. [Patient 3]

Similarly, patients who joined shared interest groups, such as patient groups on Facebook, which gather people who deliberately want to share their own experiences with the disease and learn from others’ experiences, were more open toward the idea of being approached and recruited within such groups.

These insights indicate that patients who were already active on social media and found it useful for their personal disease management were more open to being recruited via social media. This led us to the following hypothesis: (H1) The more patients use social media (for hepatitis B), the higher their acceptance of using social media as a recruitment tool for clinical (hepatitis B) studies.

Digital Literacy

The patients we interviewed represented a variety of levels regarding social media literacy. While some patients have had very limited contact with social media, others were very active on social media. One patient even described social media content management as part of their daily job. Another had conducted a research web-based questionnaire for which they were recruiting on the web. Analyzing the interviewees’ accounts about their experience with social media, and partially their use habits, we found a scattered connection to social media recruitment acceptance: those who were considered to have higher digital literacy skills were, in some instances, likely to accept social media as a recruitment tool for clinical hepatitis B studies because they perceived other forms of recruitment as outdated:

I think we are living in a time that you have to use social media because if you don’t use it...sending a letter or put[ting it] in the newspaper, will not help you. [Patient 6]

On the other end of the spectrum, however, patients with very low digital literacy skills and relatedly very little reported use of social media, or digital media in general, in some instances had difficulties delimiting the concept of social media as such. Presumably, their less nuanced understanding of social media as a concept makes them less strictly opposed to being recruited for a clinical study via social media. One patient, for example, favored personal contact for study recruitment at first but then revised their statement and reported that being helped was even more important than personal contact:

Yes definitely. If it was something important it would be best if we met at a clinic, or I don’t know where this study is being done.... But even via Facebook or Messenger.... Yeah, actually never mind, I don’t care actually. [Patient 2]

While the interviews suggested a connection between the acceptance of social media recruitment for clinical hepatitis B studies and digital literacy, it remained unclear whether acceptance was higher with high or low digital literacy. Consequently, we formulated the nondirectional hypothesis that (H2) digital literacy is associated with social media acceptance (SMA).

Interest in Clinical Studies

Some participating patients expressed particularly high interest in participating in clinical studies about hepatitis B. One patient explained to us that they were “very, very happy to support studies” (patient 5), and another patient told us the following: “I actually want to help. So, that’s why I get in” (patient 6). Patients like this, who reported an increased willingness to participate in clinical studies in general, seemed more susceptible to social media as a recruitment tool, too.

Another patient perceived it as beneficial that online recruitment made them less dependent on their physician to refer them to the study:

I don’t know if my physician is even internet-savvy, he’s a bit older. And well, then I thought, I have to see for myself because I’m not sure how competent he is with such things. What I mean is, it would be nicer if I...could google for [a clinical trial], land on a platform, search for [relevant studies], see all the information and can get in touch right away and say: “Hey, I am interested in your study. I would like to participate.” Because in my case, the...specialists didn’t even know that this [study] existed.... That’s stupid and got me pretty upset.” [Patient 3]

None of the patients interviewed reported that they were generally against participation in clinical studies. This is likely a recruitment bias of this qualitative interview study, which made it difficult to interrogate if patients who are less accepting of clinical studies are also less accepting of social media recruitment. Yet, based on the apparent influence of this aspect in 2 (33%) of 6 patient interviews, we formulated the following hypothesis: (H3) The more patients are interested in clinical studies, the more they accept social media as a recruitment tool for clinical hepatitis B studies.

The role of trust in health care professionals, social media platforms, and other recruitment channels was a very salient aspect of all interviews. Illustrating this, one participating patient with hepatitis B stated the following as a reason for being against social media recruitment:

I just feel such a distrust of social media. Any information I share there, I’m not completely comfortable with/It’s just not a safe way for me to share information. [Patient 4]

Other patients were more open to social media recruitment if they knew the source of the advertisement and assigned relevant expertise to them:

It would be okay for me [if someone would contact me on social media to ask whether I would like to meet for a clinical study, as long as] the person is qualified in that direction and is well versed in this expertise. [Patient 2]

[R]ecruiting is normally working if the person that suggests it is a person that you trust or you know. So because she was a person I knew from [redacted], then I clicked the link and I got in. Normally we know, of course, that social media is also a trap for many, I don’t know, viruses and this kind of thing. So you don’t open everything if you don’t trust the link.... If I would see it on, I don’t know, social media and as we know, because you have these cookies that you accept, then immediately, they know that you have something or you are looking for some article. Then this kind of things will pop up. Again, it’s all about trusting links. I’m not sure how much I will get in something that is suggesting from just because I click on a link. [Patient 6]

More implicitly, another patient emphasized that the clinical setting was the place for them to discuss things in the context of hepatitis B, not social media:

This channel through the [clinic in Germany]... I have a very good opinion of the hospital and I have always been well taken care of there. That is the only channel through which I would talk about my condition and about my/yes. [Patient 1]

We analyze the aspect of trust in a separate publication (Willem, T, et al, unpublished data, January 2024) in detail and hypothesize the following: (H4) The more patients trust information sources, the higher their acceptance of social media recruitment. The hypothesis was operationalized for trust in medical information sources (H4a) and trust in nonmedical information sources (H4b).

A particular concern of most patients we spoke with was their privacy. Privacy is a multifaceted and complex concept, and we found that participants referred to different dimensions of privacy: (1) data privacy, defined as the general attitude toward protective measures that empower patients or users to make their own decisions about who can process their data for which purpose; and (2) privacy related to the perceived secrecy of the hepatitis B diagnosis.

First, regarding data privacy, several patients perceived recruitment via social media as dubious and suspected some form of data leakage or malicious data collection goals behind the reach outs. This view applied irrespectively to how they would be approached on social media (eg, advertisement banners in their social media timelines or personal contact requests via social media messengers by health care professionals). For example, a patient who reported on being in the process of decreasing their social media use to protect their privacy also said that if someone contacted them on social media regarding clinical study participation, they would “find that very strange, because [I] would ask [my]self, where did they get this information?” and reported that they would feel that this “would rob quite a lot of privacy” (patient 5). Another patient, who reported using WhatsApp as their only social media, explained that by saying that they “consider social media to be useful in some instances;” however, they continued, “It’s too risky for me with my private data and so much advertising. This, for me, trumps all advantages of social media recruitment” (patient 4).

Regarding the second privacy dimension, secrecy, several patients commented on their hepatitis B diagnosis being a very private, intimate matter:

This condition is in my most private, intimate sphere…. And you might be right, I never thought about it in this way, but [my avoiding engaging on social media regarding hepatitis B] may be related to the fact that content I pass on via WhatsApp can be passed on thousands of times with one click. [Patient 1]

One patient replied to a question regarding their attitude toward being contacted by a study center via social media that they “would find that difficult”. As a reason, this patient explained the following:

[T]hat’s just the problem: it ends up on social media. See, if someone writes: “Hey, I would like to ask you about your hepatitis B, whether you would participate in a study?” Then this information is out there on social media.... That’s why I had a very, very good feeling when my doctor approached me about [this interview study] and that it just went through the clinic. If she had said, “Look, someone is approaching you via social media,” or something, then I would have said no, right? Because I wouldn’t have wanted to, because these data/social media make money because they have data. They run the ads based on your data and what you type in there or what you say or whatever. And I don’t want that associated with my disease. [Patient 5]

These findings led us to the following hypothesis: (H5) The more patients value privacy, the lower their acceptance of using social media as a recruitment tool for clinical hepatitis B studies. The hypothesis was operationalized for secrecy (H5a) and data privacy (H5b).

Perceived Stigma

Several interviewed patients with hepatitis B reported fear of being stigmatized if their social environment found out about their diagnosis as an important reason against social media recruitment. One patient, who mentioned that only their closest family members knew about their diagnosis, expressed fear that other people learning the diagnosis would lead to social exclusion:

A broken leg or surgery on the knee or hip. This is apparent to everyone. And everyone assumes that it will heal at some point and that there is no potential infectious danger from these people. Whereas in the case of infectious diseases, no one can assess that, and people get socially excluded very quickly.... And this is why I am so cautious with my data. [Patient 1]

A similar view was shared by patient 5. Another patient added that perception of stigma differed depending on the context:

I come from [Eastern European country], I have moved to Germany. So here the mentality is a little bit different. If you say to someone, I have Hepatitis, he is okay with it. He says: “Oh, is not a problem. Normally here we are vaccinated against it.” If you are going to [Eastern European country] and say: “I have Hepatitis B,” it’s like you have a huge disease that can just be taken by a handshake [laughs]. And so I think that’s why I’m going on the conservative site. [Patient 6]

The connection between the stigma connected to hepatitis B and the social media–connected perceived privacy risks established by several interview participants led us to the following hypothesis: (H6) The higher the perceived stigma of patients, the lower their acceptance of social media as a recruitment tool for clinical hepatitis B studies.

Survey Results

Participant characteristics.

A total number of 195 eligible questionnaires were included in the statistical analysis of the survey study. Table 1 displays the characteristics of the patients with hepatitis B who participated in the study: more than half of the participants (108/195, 55.4%) were aged between 30 and 49 years. Just above half (110/195, 56.4%) reported having lower educational degrees than Abitur (German equivalent to a high school degree). More than half of the participants (111/195, 56.9%) had another mother tongue than German (only). All participants had a chronic hepatitis B infection, as per the inclusion criterion of this study.

Description of Scales

The questionnaire included 7 scales that were measured through several items ( Table 2 and Multimedia Appendices 1 and 4 ).

The level of acceptance for social media recruitment was measured through the SMA scale, which was calculated based on 4 questionnaire items (P6.01 to P6.04; Multimedia Appendix 4 ). Each item was measured by a 5-point Likert scale, ranging from 0 (completely disagree) to 4 (completely agree). Items P6.01 (“Social media are well suited to make patients aware of studies on new hepatitis B treatments”) and P6.02 (“Social media increase the likelihood of success in hepatitis B clinical trials”) formed the subscale of the perceived usefulness of social media recruitment and received moderate agreement (P6.01: mean 1.99, SD 1.23; P6.02: mean 1.81, SD 1.12). Items P6.03 and P6.04 formed the SMA subscale on the perceived usefulness of social media recruitment. Item P6.03 (“I would be recruited via social media for a hepatitis B clinical trial”) received particularly low acceptance (mean 1.13, SD 1.13; Multimedia Appendix 4 ). P6.04 (I would use social media to learn about hepatitis B clinical trials) received a higher mean acceptance score than P6.03 (mean 1.58, SD 1.23; Multimedia Appendix 4 ).

The overall SMA score was calculated by summarizing the scores from items 6.01 to 6.04 and ranged from 0 (no acceptance) to 16 (full acceptance; mean 6.48, SD 3.03; Table 2 ). While 28.7% (56/195) of the respondents rejected social media recruitment with an SMA score of <5, only 10.2% (20/195) of the respondents accepted social media recruitment with an SMA score of >11 ( Table 3 ).

a Items were measured through a 5-point Likert scale, ranging from 0 (completely disagree) to 4 (completely agree).

Regression Analysis

Using multiple linear regression analyses, we evaluated the predictors of participants’ acceptance of social media as a recruitment tool for clinical hepatitis B studies. Testing the statistical significance of the overall model fit, the F test indicated that the predictors included in the model substantially contributed to the explanation of the dependent variable ( Table 4 ). Regression analysis revealed that social media use for hepatitis B, interest in clinical studies, trust in nonmedical information sources, and hepatitis B secrecy independently predicted acceptance of social media as a recruitment tool for clinical hepatitis B studies. More precisely, the higher the social media use for hepatitis B, the higher the interest in clinical studies, the more trust in nonmedical information sources, and the less secret hepatitis B, the higher the acceptance of social media as a recruitment tool for clinical hepatitis B studies ( Table 4 ).

a Overall model fit: F 11,127 =9.221, P <.001; R 2 =0.444; N=139.

b VIF: variance inflation factor.

c Not applicable.

Principal Findings

We present the first empirical study investigating how adult patients with hepatitis B accept social media recruitment for clinical studies. Social media have been suggested to increase recruitment accrual, particularly for hard-to-reach populations [ 13 , 14 , 24 ]. Our study provides a more fine-grained contextualization of this potential. We find that acceptance of social media recruitment among patients with hepatitis B is associated with higher ongoing activity on social media with regard to hepatitis B (confirming H1), a generally high interest in participating in clinical studies for hepatitis B (confirming H3), and high trust recruitment channels outside the clinical setting (confirming H4a). Patients with these characteristics are, consequently, recruitable via social media under the assumptions that (1) patients are most effectively recruited via social media if they accept this channel as a recruitment method and (2) people who do not accept this recruitment channel should also not be recruited in this way.

Yet, 54 (27.7%) out of 195 participants reported an acceptance score of <5 and, thus, rejected being recruited via social media. Moreover, only 20 (10.3%) out of 195 participants reported an acceptance score >11, indicating high acceptance. These findings indicate that recruitment success via social media might be limited among patients with hepatitis B in Germany and underline the importance of using multiple recruitment channels to facilitate diversity and equitable health care access, particularly for patient groups considered vulnerable [ 11 ].

Contrary to what we had hypothesized, SMA was not associated with digital literacy (rejecting H2), data privacy needs (rejecting H5b), and perceived hepatitis B–related stigma (rejecting H6), although reported secrecy around hepatitis B diagnosis was a predictor (confirming H5a). Moreover, trust in medical information sources and demographic variables (age and education) as well as the overall frequency of using social media were not associated with SMA. The results for H2 and H4b are not surprising, as the preceding qualitative interviews did not explicitly indicate a linear connection between digital literacy and social media recruitment acceptance. Our study cannot exclude the possibility that there might be a potential nonlinear association, but another survey study also found that digital literacy did not directly affect the intention to use digital technology [ 25 ]. Furthermore, trust is a multifaceted concept [ 26 , 27 ], which is why the subjects of trust were split into medical information sources and other advertisement channels. Hence, it is not unexpected that trust in medical information sources is not associated with SMA.

The rejection of H5b (data privacy) was more surprising, particularly because the qualitative interviews indicated strong connections between data privacy and SMA. In addition, the scholarly debate around data privacy issues has been very salient: data ethicists have repeatedly emphasized the issues related to data privacy and transparency in the context of social media use in the research context [ 12 , 28 , 29 ]. In addition, the European General Data Protection Regulation emphasizes the transparent use of data and the rights of data subjects [ 30 ]. Moreover, various scandals (eg, related to the US presidential election in 2016 and the UK Brexit referendum) diminished users’ trust in social media platforms and increased awareness of data privacy in that context [ 31 , 32 ]. A recent population survey conducted in Germany, the United Kingdom, and the United States confirmed high levels of concern regarding data privacy in all included countries [ 33 ]. Given these public discussions about social media activities being problematic for data privacy, it is particularly astonishing that data privacy concerns (as operationalized in our study) were not predicting SMA. The findings align with discussions around the privacy paradox. It was confirmed in numerous studies that social media users display limited data protection behavior despite being concerned about their privacy [ 34 - 36 ]. In line with this, the aforementioned scandals have not resulted in a decline in Facebook users [ 37 , 38 ]. Other studies suggest a poor user awareness of online privacy [ 39 ] and fatigue in engaging with privacy-related risks [ 40 ]. It seems that the surveyed population with hepatitis B in Germany are also affected by this privacy paradox.

The rejection of H6 (association of stigma) was surprising, too, particularly because of the strong association between hepatitis B and stigma in other studies. An Indian survey study found that most surveyed patients with hepatitis B were subject to severe stigma and moderate to severe discrimination, with gender identification as men, unemployment, and illiteracy being predictors of discrimination [ 6 ]. Other survey studies from Australia, Turkey, and Serbia confirmed the presence of self-reported perception of stigma in 35% to 47% of patients with hepatitis B and 60% to 65% of patients with hepatitis C [ 10 , 41 , 42 ]. An Iranian qualitative study found that patients with hepatitis B conceptualized stigma as both extrinsic (eg, discrimination, public embarrassment, or blame) and intrinsic (eg, perceived rejection, social isolation, and frustration) [ 8 ]. Although this empirical evidence illustrates the relative importance of stigma in the context of hepatitis B, this did not predict patients’ acceptance of social media recruitment in our study. Instead, our findings suggest that the perceived secrecy of a hepatitis B diagnosis, which seems to be unrelated to the perception of stigma, is informative on social media recruitment acceptance. This indicates that perceptions of stigma in other stigmatized diseases (eg, sexually transmitted diseases, and psychiatric disorders) might not influence patient acceptance to be recruited via social media for clinical studies. However, empirical studies within these populations need to confirm this.

Limitations and Further Research

Our survey showed a relatively balanced representation of genders. This aligns with a German serological study from 2011, which indicated no statistically significant difference in the prevalence of acute or chronic hepatitis B infection in men and women [ 43 ]. In terms of age distribution, the survey study covered a diverse range of age groups, mirroring the distribution found in the German serological study [ 43 ]. On the basis of these observations, the survey sample overall is representative of the population with hepatitis B in Germany regarding gender and age.

However, it is essential to consider potential limitations and sources of bias. The recruitment strategy used, primarily relying on venue-based recruitment within a clinical setting, might introduce selection bias, as it may not fully capture the diverse population that may exist outside such settings. In addition, only 30.4% (285/939) of estimated incoming patients received the questionnaire, which might introduce an additional selection bias. We attempted to mitigate this by explicitly briefing the study nurses to avoid self-selection when distributing the survey. The low distribution rate has been mainly caused by administrative burden, resulting in weeks during which no questionnaires were distributed. Thus, we do not expect this to have a large impact on selection bias.

In addition, the study’s restriction to the German language may have impaired the accessibility of the questionnaire for participants who do not have German as their mother tongue. In addition, the exclusive focus on a German setting may limit the generalizability of the findings to a broader international context, potentially impacting the study’s external validity. Finally, it is important to note that we have shortened the questionnaire in comparison to its original length after discussion with clinical colleagues, who provided the feedback that the questionnaire was too long. As part of this shortening, some validated scales were replaced by self-developed scales, which may have implications for the comprehensiveness and depth of the data collected.

Consequently, the attitudes of patients in other medical conditions toward social media recruitment, and a comparison to the attitudes of patients with hepatitis B assessed in this study, should be subject to further research. Similarly, it will be important to study how the different social media platforms, their underlying logic, use patterns, and other factors might influence patients’ acceptance of social media recruitment over time.

Conclusions

This study provides the first quantitative data on the acceptance of social media as a recruitment channel for clinical studies. In the context of hepatitis B in Germany, acceptance of being recruited via social media was very limited. More than 1 (28.7%) in 4 participants rejected this recruitment channel. The study sets out to be a reference point for future studies assessing the attitudes and acceptance of social media recruitment for clinical studies. Such empirical inquiries can facilitate the work of researchers designing clinical studies as well as ethics review boards in balancing the risks and benefits of social media recruitment in a context-specific manner. Moreover, this study provides guidance for researchers considering using social media recruitment and ethics review boards judging such undertakings, by cautioning against the potentially low acceptance rates social media–based recruitment might yield for some patient populations. These should be weighed against the risks of social media recruitment for the target populations.

Similarly relevant for practice, the findings indicate that social media recruitment is particularly accepted in patient populations with high interest in participating in clinical studies. This is particularly the case for diseases with insufficient treatment options and historically neglected diseases with high unmet needs [ 44 ]. Using social media as a recruitment channel for studies targeting these patient groups might thus encounter higher acceptance levels than in this study. There was no statistically significant role associated with perceived stigma and data privacy needs among patients, suggesting that these concerns are unrelated to social media recruitment acceptance.

Acknowledgments

This study received funding from the European Union’s Horizon 2020 research and innovation program (848223; TherVacB). This publication reflects only the authors’ views, and the European Commission is not liable for any use that may be made of the information contained therein. The authors would like to thank all TherVacB clinical project partners who helped recruit for this study and provided feedback on the questionnaire for their kind collaboration. The authors would also like to thank all patients with hepatitis B who took the time to participate in the survey.

Conflicts of Interest

None declared.

Response rate information.

Questionnaire.

Assumptions checks for regression analyses.

Description of each item of the questionnaire.

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Abbreviations

Edited by A Mavragani; submitted 27.10.23; peer-reviewed by D Kukadiya, WB Lee; comments to author 26.02.24; revised version received 08.03.24; accepted 03.06.24; published 26.08.24.

©Theresa Willem, Bettina M Zimmermann, Nina Matthes, Michael Rost, Alena Buyx. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 26.08.2024.

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Research: Meaning and Purpose

• First Online: 27 October 2022

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• Kazi Abusaleh 4 &
• Akib Bin Anwar 5  

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The objective of the chapter is to provide the conceptual framework of the research and research process and draw the importance of research in social sciences. Various books and research papers were reviewed to write the chapter. The chapter defines ‘research’ as a deliberate and systematic scientific investigation into a phenomenon to explore, analyse, and predict about the issues or circumstances, and characterizes ‘research’ as a systematic and scientific mode of inquiry, a way to testify the existing knowledge and theories, and a well-designed process to answer questions in a reliable and unbiased way. This chapter, however, categorizes research into eight types under four headings, explains six steps to carry out a research work scientifically, and finally sketches the importance of research in social sciences.

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Research Design and Methodology

Research Questions and Research Design

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Abusaleh, K., Anwar, A.B. (2022). Research: Meaning and Purpose. In: Islam, M.R., Khan, N.A., Baikady, R. (eds) Principles of Social Research Methodology. Springer, Singapore. https://doi.org/10.1007/978-981-19-5441-2_2

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