title: Marketing to increase participation in a Web-based continuing medical education cultural competence curriculum.
abstract: BACKGROUND
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: 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, USA. cestrada@uab.edu
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Estrada
authors.forename: Periyakaruppan
authors.initials: P
authors.lastname: Krishnamoorthy
authors.forename: Ann
authors.initials: A
authors.lastname: Smith
authors.forename: Lisa
authors.initials: L
authors.lastname: Staton
authors.forename: Michele J
authors.initials: MJ
authors.lastname: Korf
authors.forename: Jeroan J
authors.initials: JJ
authors.lastname: Allison
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Houston
mesh_terms: D000329:Advertising / Q000191:economics; D003256:Community Participation / Q000706:statistics & numerical data*; D054521:Cultural Competency / Q000193:education*; D003479:Curriculum; D004502:Education, Medical, Continuing; D006801:Humans; D033181:Information Dissemination; D020407:Internet / Q000191:economics / Q000458:organization & administration*; D008389:Marketing of Health Services / Q000379:methods*; D010865:Pilot Projects