Using Tailored E-Mail Messages about Social Communication Milestones and Autism Spectrum Disorder to Engage Professionals in Autism Navigator® for Primary Care

Background: The AAP and other professional organizations maintain a strong commitment to screening all children for autism spectrum disorder (ASD) at 18-24 months; yet, a recent USPTF report found inconclusive evidence to support universal screening in primary care prior to parents’ expression of concerns. Pediatric healthcare professionals and families may be familiar with infants’ motor milestones, but less aware of early social communication milestones and red flags for ASD. Bridging this research-to-practice gap is more critical than ever, and important steps include training professionals about screening, diagnosis, and evidence-based treatment. Researchers have investigated the utility of academic detailing, or educational outreach through professional development, to encourage physicians to change screening and referral processes (Honigfield, Chandhok, & Spiegelman, 2011; Soumerai & Avorn, 1990). Engagement with course material may be enhanced through the use of web-based tools. There is a need for research on the effectiveness of media message framing in encouraging professionals to complete coursework and change their screening and referral practices.

Objectives: The purpose of this study was: 1) to examine the responses of professionals enrolled in Autism Navigator^® for Primary Care who received tailored e-mail messages about early social communication milestones and ASD; and 2) to characterize participants’ perceptions of the messages.

Methods: Engaging weekly e-mail messages were developed through extensive efforts of an interdisciplinary team of autism researchers and specialists in marketing and public relations, user interface, and graphic design (Figure 1). Messages were framed to encourage course completion and utilization of a parent portal with automated screening linked to family resources. Participants were randomly assigned to one of two conditions based on e-mail message type. Gain-framed message highlighted the benefits of screening and awareness of early social communication milestones. Loss-framed e-mails stressed the risks or costs of not being aware and not screening (Tversky & Kahneman, 1981). Website analytics were used as a metric to examine relations between click-through rates and course activity. Participants were invited to respond to a brief, online survey to explore their perceptions of the messages.

Results: Data collection is ongoing. The mean open rate for messages to date is 36%. The click-through rate was 16% for gain-framed and 15% for loss-framed messages. In the 5 weeks since the email campaign began, there has been a 54% increase in course activity completion. Professionals varied in their perceptions of messages and offered suggestions for refinement.

Conclusions: E-mail engagement was higher than rates reported in the education and training industry, where average open and click-through rates hover between 16-22% and 3-6%, respectively (Chaffey, 2016; Constant Contact, 2016). Receiving informative messages about ASD and social communication delays was associated with upward trends in users’ activity in a professional development course. This study demonstrates how media messaging and data analytics can be used to monitor and engage distance learners in course utilization and completion. These findings will inform further academic detailing efforts, and add to research on web-based tools and strategies for tailoring messages that encourage professionals to translate new knowledge into practice.