Use of online promotion to encourage patient awareness of aspirin use to prevent heart attack and stroke

Brian G. Southwell, Milton Eder, John R Finnegan, Alan T. Hirsch, Russell V Luepker, Sue Duval, Carol Russell, Sam O'Byrne

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background Literature on health promotion evaluation and public understanding of health suggests the importance of investigating behaviour over time in conjunction with information environment trends as a way of understanding programme impact. We analysed population response to online promotion of an educational tool built by the Ask About Aspirin campaign in the USA to inform people about aspirin as a preventive aid. Methods We collected 156 weeks of time series data on audience behaviour, namely use of a self-Assessment tool. We then used the Autoregressive Integrated Moving Average (ARIMA) modelling to predict that outcome as a function of paid search engine advertising, paid social media promotion and general search interest in aspirin. Results Through ARIMA modelling of tool engagement data adjusted for outcome series autocorrelation, we found a significant effect of online promotional effort on audience behaviour. Total paid search advertising positively predicted weekly total of individuals who started using the self-Assessment tool, coefficient=0.023, t=3.28, p=0.001. This effect did not appear to be an artefact of broader secular trends, as Google search data on the topic of aspirin use did not add explanatory power in the final model nor did controlling for general search interest eliminate the significant coefficient for paid search promotion. Conclusion Results hold implications both for educational tool development and for understanding health promotion campaign effects. We witnessed substantial but ephemeral effects on tool use as a function of paid search efforts, suggesting prioritisation of efforts to affect search engine results as a dissemination tactic.

Original languageEnglish (US)
Pages (from-to)1059-1063
Number of pages5
JournalJournal of epidemiology and community health
Issue number11
StatePublished - Nov 1 2018

Bibliographical note

Funding Information:
ME, JF and RVL conceptualised the campaign and tool reported and assisted with the manuscript. ATH conceptualised the campaign and tool reported. SD helped to conceptualise the analysis and contributed to the manuscript. CR and SO’B organised data used in the manuscript and assisted with interpretation of that data. Funding This work was supported by the U.S. National Heart, Lung and Blood Institute (award no. 1R01HL126041).

Publisher Copyright:
© © Author(s) (or their employer(s)) 2018. No commercial re-use. See rights and permissions. Published by BMJ.


  • cardiovascular disease
  • health promotion
  • social science
  • time-series


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