Use of a Paid Digital Marketing Campaign to Promote a Mobile Health App to Encourage Parent-Engaged Developmental Monitoring: Implementation Study.

BACKGROUND: The internet has become an increasingly popular medium for parents to obtain health information. More studies investigating the impact of paid digital marketing campaigns for parents on promoting children's healthy development are needed. OBJECTIVE: This study aims to explore the outcomes of a paid digital marketing campaign, which occurred from 2018 to 2020, to promote messages about parent-engaged developmental monitoring and ultimately direct parents to the Centers for Disease Control and Prevention's (CDC's) Milestone Tracker app, a mobile health (mHealth) app developed by the CDC. METHODS: The paid digital marketing campaign occurred in 3 phases from 2018 to 2020. In each phase, 24 to 36 marketing messages, in English and Spanish, were created and disseminated using Google's Universal App Campaigns and Facebook Ads Manager. Outcomes were measured using impressions, clicks, and install data. Return on investment was measured using click-through rate (CTR), cost per click, and cost per install metrics. RESULTS: The Google-driven marketing messages garnered a total of 4,879,722 impressions (n=1,991,250, 40.81% for English and n=2,888,472, 59.19% for Spanish). The messages resulted in a total of 73,956 clicks (n=44,328, 59.94% for English and n=29,628, 40.06% for Spanish), with a total average CTR of 1.52% (2.22% for English and 1.03% for Spanish). From these clicks, there were 13,707 installs (n=9765, 71.24% for English and n=3942, 28.76% for Spanish) of the CDC's Milestone Tracker app on Google Play Store. The total average cost per install was US $0.93 across all phases. The phase 3 headline "Track your child's development" generated the highest CTR of 3.23% for both English and Spanish audiences. The Facebook-driven marketing messages garnered 2,434,320 impressions (n=1,612,934, 66.26% for English and n=821,386, 33.74% for Spanish). The messages resulted in 44,698 clicks (n=33,353, 74.62% for English and n=11,345, 25.38% for Spanish), with an average CTR of 1.84% (2.07% for English and 1.38% for Spanish). In all 3 phases, animated graphics generated the greatest number of clicks among both English and Spanish audiences on Facebook when compared with other types of images. CONCLUSIONS: These paid digital marketing campaigns can increase targeted message exposure about parent-engaged developmental monitoring and direct a parent audience to an mHealth app. Digital marketing platforms provide helpful metrics that can be used to assess the reach, engagement, and cost-effectiveness of this effort. The results from this study suggest that paid digital marketing can be an effective strategy and can inform future digital marketing activities to promote mHealth apps targeting parents of young children.

The association between racial and socioeconomic discrimination and two stages of alcohol use in blacks.

BACKGROUND: This study aimed to characterize the associations of racial and socioeconomic discrimination with timing of alcohol initiation and progression from initiation to problem drinking in Black youth. METHODS: Data were drawn from a high-risk family study of alcohol use disorder. Mothers and their offspring (N = 806; Mage = 17.87, SDage = 3.91; 50% female) were assessed via telephone interview. Cox proportional hazards regression analyses were used to examine associations between discrimination and timing of first drink and progression from first drink to problem drinking in two separate models. Predictor variables were considered in a step-wise fashion, starting with offspring racial and socioeconomic discrimination, then adding (2) maternal racial and/or socioeconomic discrimination experiences; (3) religious service attendance and social support as potential moderators; and (4) psychiatric and psychosocial risk factors and other substance use. RESULTS: Offspring racial discrimination (HR: 2.01, CI: 1.17-3.46 ≤ age 13) and maternal experiences of discrimination (HR: 0.79, CI: 0.67-0.93) were associated with timing of initiation in the unadjusted model only; offspring socioeconomic discrimination predicted timing of initiation among female offspring, even after adjusting for all covariates (HR: 1.49, CI: 1.14-1.93). Socioeconomic discrimination predicted a quicker transition from first use to problem drinking exclusively in the unadjusted model (HR: 1.70, CI: 1.12-2.58 ≤ age 18). No moderating effects of religious service attendance or social support were observed for either alcohol outcome. CONCLUSIONS: Findings suggest socioeconomic discrimination is a robust risk factor for initiating alcohol use in young Black female youth and should be considered in the development of targeted prevention programs.

The Association Between Racial Discrimination and Suicidality among African-American Adolescents and Young Adults.

This study assessed the association between racial discrimination and suicidality (ideation, plan, or attempt) in African-American adolescents and young adults (n = 806, mean age = 17.9 years). Structured psychiatric phone interviews were conducted in offspring and their mothers in a high-risk alcoholism family study. Logistic regression analyses using offspring's own racial discrimination as a predictor revealed elevated odds of suicidality, even after adjusting for correlated psychiatric conditions (OR = 1.76) but was reduced to non-significance after adjusting for maternal experiences of racial discrimination (OR = 3.19 in males), depression, and problem drinking. Findings support a link between racial discrimination and suicidality in African-American youth that, for males, is partially explained by maternal racial discrimination.