title: Design and Conduct of an Internet-Based Preconception Cohort Study in North America: Pregnancy Study Online.
abstract: BACKGROUND
  We launched the Boston University Pregnancy Study Online (PRESTO) to assess the feasibility of carrying out an Internet-based preconception cohort study in the US and Canada.
  
  
  METHODS
  We recruited female participants age 21-45 and their male partners through Internet advertisements, word of mouth, and flyers. Female participants were randomised with 50% probability to receive a subscription to FertilityFriend.com (FF), a web-based programme that collects real-time data on menstrual characteristics. We compared recruitment methods within PRESTO, assessed the cost-efficiency of PRESTO relative to its Danish counterpart (Snart-Gravid), and validated retrospectively reported date of last menstrual period (LMP) against the FF data.
  
  
  RESULTS
  After 99 weeks of recruitment (2013-15), 2421 women enrolled; 1384 (57%) invited their male partners to participate, of whom 693 (50%) enrolled. Baseline characteristics were balanced across randomisation groups. Cohort retention was similar among those randomised vs. not randomised to FF (84% vs. 81%). At study enrollment, 56%, 22%, and 22% couples had been trying to conceive for < 3, 3-5, and ≥ 6 months, respectively. The cost per subject enrolled was $146 (2013 US$), which was similar to our companion Danish study and half that of a traditional cohort study. Among FF users who conceived, > 97% reported their LMP on the PRESTO questionnaire within 1 day of the LMP recorded via FF.
  
  
  CONCLUSIONS
  Use of the Internet as a method of recruitment and follow-up in a North American preconception cohort study was feasible and cost-effective.
authors.affiliation: Department of Epidemiology, Boston University School of Public Health, Boston, MA.|Slone Epidemiology Center, Boston University, Boston, MA.
authors.forename: Lauren A
authors.initials: LA
authors.lastname: Wise
authors.affiliation: Department of Epidemiology, Boston University School of Public Health, Boston, MA.|RTI Health Solutions, Research Triangle Park, NC.
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Rothman
authors.affiliation: Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Mikkelsen
authors.affiliation: Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT.
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Stanford
authors.affiliation: Department of Epidemiology, Boston University School of Public Health, Boston, MA.
authors.forename: Amelia K
authors.initials: AK
authors.lastname: Wesselink
authors.affiliation: Department of Epidemiology, Boston University School of Public Health, Boston, MA.
authors.forename: Craig
authors.initials: C
authors.lastname: McKinnon
authors.affiliation: Department of Epidemiology, Boston University School of Public Health, Boston, MA.|Slone Epidemiology Center, Boston University, Boston, MA.
authors.forename: Siobhan M
authors.initials: SM
authors.lastname: Gruschow
authors.affiliation: Department of Epidemiology, Boston University School of Public Health, Boston, MA.
authors.forename: Casie E
authors.initials: CE
authors.lastname: Horgan
authors.affiliation: Department of Epidemiology, Boston University School of Public Health, Boston, MA.
authors.forename: Aleta S
authors.initials: AS
authors.lastname: Wiley
authors.affiliation: Department of Epidemiology, Boston University School of Public Health, Boston, MA.
authors.forename: Kristen A
authors.initials: KA
authors.lastname: Hahn
authors.affiliation: Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Henrik Toft
authors.initials: HT
authors.lastname: Sørensen
authors.affiliation: Department of Epidemiology, Boston University School of Public Health, Boston, MA.
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Hatch
mesh_terms: D000328:Adult; D003268:Contraception Behavior; D003362:Cost-Benefit Analysis; D003718:Denmark / Q000453:epidemiology; D005240:Feasibility Studies; D005260:Female; D005306:Fertilization; D006801:Humans; D020407:Internet; D008297:Male; D009656:North America / Q000453:epidemiology; D010353:Patient Education as Topic; D018579:Patient Selection; D016742:Preconception Care / Q000379:methods / Q000706:statistics & numerical data*; D011247:Pregnancy; D011446:Prospective Studies; D012107:Research Design; D011795:Surveys and Questionnaires
keywords: Internet; fertility; methods; mobile apps; prospective studies