Marketing to increase participation in a Web-based continuing medical education cultural competence curriculum

Authors

  • Carlos A. Estrada MD, MS,

    Corresponding author
    1. Director, VA National Quality Scholars Program, Scientist, Deep South Center on Effectiveness (DSCE), REAP Center for Surgical, Medical Acute Care Research & Transitions (C-SMART), Birmingham VA Medical Center, and professor of medicine and director of the Division of General Internal Medicine, University of Alabama at Birmingham
    • Birmingham Veterans Affairs Medical Center, University of Alabama at Birmingham, Division of General Internal Medicine, 732 Faculty Office Tower, 510 20th Street South, Birmingham, AL 35294-3407
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  • Periyakaruppan Krishnamoorthy,

    1. Senior Systems Analyst, Division of Continuing Medical Education, University of Alabama at Birmingham
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  • Ann Smith MPH,

    1. Executive Director, Distance Learning and Outreach, University of Alabama
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  • Lisa Staton MD,

    1. Program manager, UAB Minority Health & Health Disparities Research Center, Division of Preventive Medicine, University of Alabama at Birmingham
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  • Michele J. Korf MA,

    1. Program Director and Outpatient Clinic Director, Department of Internal Medicine and Associate Professor, University of Tennessee College of Medicine Chattanooga
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  • Jeroan J. Allison MD, MSc,

    1. Vice Chair, Department of Quantitative Health Sciences, Associate Vice Provost for Health Disparities, and Professor of Quantitative Health Sciences, University of Massachusetts Medical School
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  • Thomas K. Houston MD, MPH

    1. Scientist, Center for Health Quality, Outcomes & Economic Research (CHQOER), Bedford VAMC, Professor, Quantitative Health Sciences and Medicine, Chief, Division of Health Informatics and Implementation Science, and Assistant Dean for Continuing Medical Education/Medical Education Research, University of Massachusetts Medical School
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  • Disclosures: This study was funded by a grant from the National Heart, Lung, and Blood Institute (K07 HL081373-01) to Dr. Estrada; approved by the institutional review boards of the University of Alabama at Birmingham; and presented in part at the 2009 and 2010 Southern Society of General Internal Medicine Annual Meetings, New Orleans, Louisiana. The authors report no conflict of interest.

    Disclaimer: The opinions expressed in this article are those of the authors alone and do not reflect the views of the Department of Veterans Affairs.

  • This work was presented in part at the 2009 and 2010 Southern Society of General Internal Medicine Annual Meetings, New Orleans, Louisiana.

Abstract

Introduction

CME providers may be interested in identifying effective marketing strategies to direct users to specific content. Online advertisements for recruiting participants into activities such as clinical trials, public health programs, and continuing medical education (CME) have been effective in some but not all studies. The purpose of this study was to compare the impact of 2 marketing strategies in the context of an online CME cultural competence curriculum (www.c-comp.org).

Methods

In an interrupted time-series quasi-experimental design, 2 marketing strategies were tested: (1) wide dissemination to relevant organizations over a period of approximately 4 months, and (2) Internet paid search using Google Ads (5 consecutive 8-week periods—control 1, cultural/CME advertisement, control 2, hypertension/ content advertisement, control 3). Outcome measures were CME credit requests, Web traffic (visits per day, page views, pages viewed per visit), and cost.

Results

Overall, the site was visited 19,156 times and 78,160 pages were viewed. During the wide dissemination phase, the proportion of visits requesting CME credit decreased between the first (5.3%) and second (3.3%) halves of this phase (p = .04). During the Internet paid search phase, the proportion of visits requesting CME credit was highest during the cultural/CME advertisement period (control 1, 1.4%; cultural/CME ad, 4.3%; control 2, 1.5%; hypertension/content ad, 0.6%; control 3, 0.8%; p < .001). All measures of Web traffic changed during the Internet paid search phase (p < .01); however, changes were independent of the advertisement periods. The incremental cost for the cultural advertisement per CME credit requested was US $0.64.

Discussion

Internet advertisement focusing on cultural competence and CME was associated with about a threefold increase in requests for CME credit at an incremental cost of under US $1; however, Web traffic changes were independent of the advertisement strategy.

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