Effectiveness of digital marketing and its value in new ventures

The degree of probability of users finding an online reference or a direct link to a website or social network account is called online visibility (Drèze & Zufryden, 2004). It can also be defined as the ease, measured in time and accessibility terms, with which potential clients contact a company's website on the Internet. Online visibility is the stage before accessing a website. Websites have different options to generate online visibility, such as paid advertising on high-traffic websites and social networks. Therefore, online visibility is considered a critical resource that cannot be directly controlled directly by organizations (Neirotti & Raguseo, 2021). It is also a resource that feeds back as increases with website growth, website content, usability and number of users (Pant & Pant, 2018). Online visibility is created through a digital marketing strategy by means of search engine optimization, search engine marketing or online advertising campaigns through different digital marketing tools. Online visibility is also generated by strategic efforts to develop brands through traditional marketing and its different tools. Hence a direct association exists among the company’s brand image, the quality of its products and services, and created client trust with online visibility (Pérez-Rodríguez et al., 2019). In general, brand recognition is also related to online visibility (Smithson et al., 2011).

Online visibility makes a clear difference between companies regarding the number of clients who access their products and services for the first time, and it is the first step to start building client trust (Popova et al., 2019), trust that is so important in electronic commerce (Khwaja et al., 2020).

Having good online visibility and recognition requires making high investments in time and resources. For this reason, it is necessary to establish a strategy that allows consistent and measurable objectives to be met over time. One of the current tools that generates online visibility and trust the most is search engines like Google (Smithson et al., 2011) because a large number of people around the world use them for all kinds of queries. A correct positioning strategy in Google with the most searched keywords, together with aggressive campaigns on all digital platforms, generates very high visibility on the digital market for obtaining first contact, brand recognition, trust and, finally, clientele.

Furthermore, the presence on highly recognized digital platforms, which allows a company's advertising to be visible, helps online visibility together with its level of trust (Wei, 2001). So, it is essential for companies to have a clear coordinated presence strategy on different platforms because this allows access to the target market with efficient resources use (Wong, 2005). Digital tools must be efficiently employed, and this is only possible if the digital marketing knowledge level is high. Experience and knowledge in digital marketing will allow any organization to improve its online visibility and to also provide market information and preferences, to help companies to stay ahead of constantly changing consumer preferences (Wiredu, 2022).

Currently, there is a large number of websites and social networks that allow online visibility to be developed (Pant & Pant, 2018). Online search engines like Google, Yahoo, Bing, among others, are those that best permit organizations to develop online visibility (Cizmeci & Ercan, 2015). Each search engine and social network has different methodologies to improve online visibility (Bala & Verma, 2018), which allows users to employ keywords to find the information they are looking for.

There are different ways for companies to improve their online visibility either organically or non-organically. The first is to generate content where the title contains keywords that are frequently typed in as part of network users’ searches (Ilfeld & Winer, 2002). This method is known as search engine optimization (SEO). This technique is also used on social networks, such as Instagram, Facebook and TikTok, where content search volumes have significantly increased in recent years (De Pelsmacker et al., 2018). In addition to this positioning technique, Google, the most important search engine today, has the Google AdWords tool that allows payments to be made to obtain the temporly positioning of a website within the Google search engine with keywords and phrases (Bala & Verma, 2018). This type of strategy is known as search engine marketing or SEM (Sen, 2005). Bing Ads in the Yahoo search engine (Yahoo Bing Network) also allows the same paid positioning strategy to be applied in the search engine.

Social networks like Instagram, Facebook and TikTok are tools that allow online visibility to develop (Ferreira & Serpa, 2018). Thanks to their algorithms, these platforms generate traffic through hashtags, keywords, phrases and the share button. In turn, these social networks allow the creation of paid advertising campaigns at affordable prices, with the possibility of effectively segmenting the target audience (Nishi et al., 2015).

A website is undoubtedly one of the most powerful tools for online visibility (Baloglu & Pekcan, 2006) and has the ability to provide company information and record interactions with potential clients to learn about their needs (Gretzel & Yoo, 2008). Having a well-designed reliable website builds trust with potential clients. This trust, which is generated through online reputation, is essential for deciding purchases, and it is the second necessary characteristic to gain consumers after being known by clients thanks to online visibility.

The Internet allows the proliferation of countless sources of information, but does not guarantee its veracity. This phenomenon has led to the development of different websites that have positioned themselves on the market for their level of veracity by generating trust among Internet users (De Pelsmacker et al., 2018). These trusted websites offer companies the possibility of generating traffic to their own sites (Zheng et al., 2021).

Online reputation is a mix of characteristics that comprise excellent reviews, good positioning in search engines, easy-to-use platforms for all types of audiences, high-quality pre-sales, sales and post-sale services, and support from the company that protects the client when making transactions with it (Cantallops & Salvi, 2014).

There are several strategies to achieve online reputation, but there must be solid products and services that support the strategy. The use of SEM strategies on digital search platforms, social networks, blogs and sites of interest on the Internet helps to build trust among users (Gangananda et al., 2022). With a constant strategic use of these tools, online visibility grows. However, this implies a bigger volume of users on the Internet and for the service provided to be publicly exposed. So any deception by the company would be quickly reflected and its online reputation could be quickly lost. Organizations are limited as regards the content of comments, and can only foster the presence of reviews. The different online platforms that serve as intermediaries between the user and the company have developed tools that allow customers to interact in order to disclose and learn about user experiences. Yet comments cannot be altered by the reviewed firm. Thanks to this, trust between service applicants and service providers is generated.

In addition, and as previously mentioned, the good positioning of websites in Internet search engines, together with positive comments, generate users perceived trust (Papathanassis & Knolle, 2011), a factor that helps to increase sales and, in turn, to improve online reputation (Ye et al., 2009).

Thus online reputation is extremely sensitive on the Internet and strongly influences electronic word of mouth (eWOM) (Chevalier & Mayzlin, 2006), which is an important factor for consumers of products or services. eWOM is a relevant factor in the purchase decision process when purchasing on the Internet (Levy et al., 2013). Having more visibility on the Internet, together with good comments about products and services, allows organizations to improve their volumes of visits, interest and sales (Ye et al., 2009).

Knowing what clients think about a company and what they have experienced with its products or services is essential for any organization. This knowledge helps to improve the product or service and to become more competitive. Digital marketing tools allow this basic marketing activity to be performed very efficiently (Peco-Torres et al., 2023). It is normal for platforms that offer directory services, such as hotel reservations, medical and dental appointments, purchases, among others, allow users to leave their comments and ratings of products and services in a visible way. This information is vital for companies to improve their products and services, but also for potential new users to obtain references about a specific product or service on the Internet. When a company has a competitive product or service, by properly utilizing digital marketing tools, a very high positioning on the Internet can be obtained, which is perceived as an indicator of reputation (Schultheiss et al., 2018).

Google is one of the most visited search engines in the world and builds Internet users’ trust. Google has different tools that allow it to generate online reputation, such as its Google My Business extension, in which companies create their profiles and generate visibility on international GPS, such as Google Maps and Waze. This tool allows users to give a rating from 1 to 5 stars and to leave a comment about their experience with the company, service or product. Companies, in turn, can upload photos of their products and relevant information about their businesses, which can dispel many doubts and misgivings among consumers.

The platforms to search and classify hotels and tourist plans, digital directories of doctors and dentists, among many other types of businesses, enable the companies in these directories and search engines to show the benefits of their products and services through the comments left on the platform. This information is vital to generate improvement plans (Devece et al., 2017). As we have seen, although there is a clear difference between the online visibility and online reputation concepts, most digital marketing tools develop and work with both factors at the same time. From an operational point of view and given the objectives of the present study, we measure the combined action of online visibility and online reputation (Habib et al., 2022) using the Internet brand image construct (Suryani et al., 2021). This is not the case for client contact tools which, for dental clinics, implies direct contact with professionals as well as negotiation to close sales (Saberian et al., 2020). Businesses should be more concerned about the large number of online reviews rather than the credibility of online reviews because a large amount of negative eWOM (electronic Word of Mouth) can even seriously weaken a strong brand image (Hoang & Tung, 2023).

As a summary of the ideas raised in the theoretical analysis, we propose the following hypotheses:

The use of digital tools would attract more clients, and this should be reflected in the clinic’s capacity use growing. It must be noted that as a service, one of the more important managerial aspects to be considered in dental clinic’s performance is the use of its capacity (Smith-Daniels et al., 2007). The measurement of using a dental clinic’s capacity is an essential dimension of its performance. Improving capacity use by digital marketing implies not only a good Internet brand image, but also the combination of other direct digital marketing capacities to inform the client and to close sales. Previous studies show that the more consumers recommend a product to other consumers through social networking sites (SNS), the more credibility of SNS to build, and recommendations have more significant impact on purchase decisions (Siddiqui et al., 2021). For a SNS to have an impact on clients, it must have a big volume of users´ interactions. Thus, only the most important SNS should be taken into account as brand image development tools, such as Instagram, TikTok and Facebook.

Then:

It is important to state that we consider not the simple use of the digital marketing, but its effective use. So, it is crucial for this research to define in the methodology section how to measure the effective use of different digital marketing tools. Khan et al. (2023) show that credibility and brand image in the social network marketing context to play a vital role in influencing consumers' online purchase intentions through certain characteristics like trustworthiness, information quality, professional value and influencer credibility. Digital tools are crucial for influencing consumers’ purchasing intentions. Digital marketing enables companies to segment and target their marketing efforts more effectively by analyzing data to identify the targeted customers with the right message. This can lead to higher sales and higher ROI (Jung & Shegai, 2023). Alwan and Alshurideh (2022) show that digital marketing positively and significantly affects the purchase intention variable.

Today, digital tools have enabled a large number of innovative businesses to be born and rapidly grow (Kraus et al., 2019). The big volume of Internet users and social networks around the world has favored the digitization of transactional processes and communication with end users in all organizations by generating entrepreneurship and new business development opportunities (Anisimova & Klyueva, 2019). Digital marketing, particularly the use of social networks, can facilitate entrepreneurship on new markets by increasing the company’s visibility (Vafeiadis & Skordoulis, 2020). Therefore, entrepreneurs can greatly benefit from digital marketing because it allows direct rapid business growth at a lower cost (Ratten, 2020). In addition, the analysis of social networks allows to discover clients’ needs by creating new services or adapting existing ones. In new ventures, maximum performance must be achieved if the aim is to correctly grow (Bala & Verma, 2018). Another advantage of digital marketing for entrepreneurs is that it allows scalable growth (Mohammad, 2022). As a business grows, it can increase its digital marketing efforts and reach an ever-widening audience without incurring significant costs.

Through digital marketing, companies can reach audiences with a high degree of segmentation and interest in the services or products they offer. Besides, digital marketing can meet marketing objectives with a lower budget than other advertising types, which allows access to new markets at a lower cost (Wegner et al., 2023).

For new entrepreneurs, digital marketing is a valuable tool that enables informed strategic marketing decisions (Marques et al., 2022). The different current digital tools provide entrepreneurs with the ability to measure Digital Marketing effectiveness in marketing and the effects of each campaign which, in turn, allows them to develop new and better. So, we can state:

In this case, and as a combination of the three previous hypotheses, we affirm that:

The success of employing marketing tools is based on a combination of profound knowledge of the sector and how the marketing tools can be applied specifically to it. In the present-day, the most spectacular and potentially powerful digital marketing uses go beyond non-technical people’s knowledge. Only professionals in digital marketing can make the best of deploying these tools. While early digital marketing uses attempted to promote online visibility to learn about the products and services offered by different companies, current advances address improvements in terms of detailed segmentation to achieve greater effectiveness in campaigns carried out through digital tools.

Most studies have focused on the impact of digital marketing on sales, Internet brand image and the ability to achieve competitive advantages. So, the real value of horizontal cooperation among firms, as in dental clinic clusters, depends on the good practices and knowledge developed by digital marketing experts and the industry firms in close collaboration (Tarazona-Montoya et al., 2020). Small- and medium-sized enterprises (SMEs) do not usually have specialized resources on the digital market, and they are not even able to follow the technologic dynamic environment (Centobelli et al., 2016).

The impact of marketing tools on an organization’s activities can vary depending on the characteristics of the sector in which the organization operates. The health industry, like many service industries, is considered to be strongly influenced by digital marketing (Swan et al., 2019). This is usually attributed to the fact that health is an information-intensive industry (Yague-Perales & March-Chorda, 2013). Patients' information needs vary and are sometimes complex, including diagnosis, treatment and follow-up, but sometimes transport and accommodation. The variety of information needed by clients to select a dental clinic means that the support in marketing tools afforded by the cluster alliance could play a moderating role in the clinic’s performance (Felzensztein et al., 2014; Karakayaci & Dincer, 2018). Therefore, we can state:

The theoretical model of the five hypotheses can be summarized as shown in Fig. 1.

Research was conducted from June 2021 to May 2022 in cities of Colombia: Bogotá, Cali, Medellín, Bucaramanga, Barranquilla, Manizales, Pereira, Armenia, Pasto, Cartagena and Santa Marta. These are the largest cities in Colombia in size and population density terms.

Measurements were taken with surveys by telephone calls and video calls by Zoom, Skype, Teams and WhatsApp videos to each dentist and manager of dental clinics, who collaborated to collect data. Three hundred surveys were obtained from 300 dentists, dental centers or dental clinics to evaluate 16 variables, divided as follows:

Despite the widespread use of the digital marketing tools considered in this study (included Internet brand image), there were no validated scales to measure their effective use in marketing initiatives that adjust to the research set out in the previous sections. Thus, specific new scales were created. The procedure followed to develop them was based on three steps (Dubey & Sangle, 2019): first, item generation and selection using literature reviews and interviews with three professional experts in digital marketing; second, scale refinement involving focus groups for content validity and a final pilot study; third, scale validation (see the Analysis and Results section) by checking that scales fulfilled the psychometric properties of the measurement scales (). The digital marketing tools (independent variables) used in each dental clinic were assessed by the authors. Seven characteristics or items were assessed dichotomously with one or zero points for each tool. Each of these characteristics contributes to the final score of the variable, with a maximum of seven for each digital marketing tool. The characteristics assessed for each tool are as follows:

Table 1 presents the mean, standard deviation and correlation coefficients between variables.

The main limitation of this study is it was confined to a single country and sector, which makes it difficult to extrapolate the obtained results. The dental health sector has its own characteristics in both the structure of the sector, made up mostly of micro-enterprises, and in digital marketing tools use. For instance, the tools that deal with client trust play a fundamental role. In addition, the characteristics of a service require paying special attention to capacity use as a measure of performance. The Colombian dental health market also has its own characteristics, but the most differentiating feature is that dental health in Colombia is very competitive in quality and price termss, and this internal competition makes some clinics’ internationalization possible (Estrada-Cruz et al., 2022).

Regarding the study limitations, we indicate the drawbacks of using a survey. Nevertheless, the digital tools used by the clinics were directly assessed by researchers, then reducing the respondents’ subjective self-assessment to only the variables related to the clinic performance.

Thus, future research should confirm the results obtained in other countries and sectors. In addition to the aforementioned question of sector and country, future research could take a narrower, but deeper, scope by adding organizational and managerial variables to the model and separately analyzing the effects of digital marketing tools on entrepreneurial initiatives and the importance of clusters on mastering digital marketing. Another important aspect to be developed by future research would be to employ automated scales to measure companies’ digital tools use. The inclusion of strategies in SEO use in different digital marketing tools should be considered in future research works.