One size does not fit allthe importance of tailoring health messages
Dr. Maddalena Fiordelli
UX Conference, October 26th 2013
Background
Health: the state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity (WHO)
•Rising cost of healthcare
•High predominance of preventable illnesses
Necessity for developing more effective health education and communication strategies
The evolution of health messagesDifferent concepts:
•Targeted (specific subgroups)
•Personalization (use some common personal identificators)
•Tailored combination of information and behavior change strategies intended to reach one specific person, based on his unique characteristics (individual assessment)
The evolution of health messages
The evolution of health messagesInformation customized or tailored to meet the unique needs, interests, and concerns of a specific individual
Tradition of health education: generic material aimed at providing as much info as possible within a single health communication (ALL THING TO ALL PEOPLE)
The idea of tailoring
The idea of tailoring
The tailor metaphor
•Take measurements
•Know preference of fabrics, color, style
•Create a product that fits the customer
Main characteristics:
-Assessment-based
-Individual-focused
The idea of tailoring• Personalizing information or tailoring messages for
each individual can be more effective for: engaging individuals, building their self-efficacy and improving health behaviors.– Self-efficacy: behavior change is more likely when an
individual learns to monitor his/her own motivations and behaviors, gain confidence in his/her ability to do the latter through the development of self-regulatory skills, and believe that engaging in these behaviors will lead to desirable outcomes
• Information perceived as personally relevant enhances an individual’s motivation to elaborate on the message, and consequently his/her receptivity to persuasion efforts (ELM)
How to tailor
Nine major steps for developing and implementing a tailored health communication program:
1.Analyzing the health problem
2.Developing a program framework
3.Developing tailoring assessment
4.Designing tailored feedback
5.Writing tailored message
6.Creating tailoring algoritm
7.Automating the tailoring process
8.Implementing the program
9.Evaluating the program
How to tailor
Hawkins et al. 2008
How to tailor
Hawkins et al. 2008
How to tailor
Lustria et al. 2009
How to tailor (what)
• Message
• Layout
• Feedback
• Channel
• Interaction
• Etc.
The impact of tailoring• Tailored printed material showed to be effective if:
– intervene on preventive screening behaviors; generated pamphlets, newsletter or maganizes; utilized more than one intervention contact; were conducted with non-US participats; had shorter period between intervention/follow-up; recruited participants from housholds; tailored on 4-5 theoretical concepts and behavior and demographics; used a behavioral theory (attitutes, self efficacy, stage of change, process of change and social influences)
• Computer-tailored online interventions: – utilized a greater variety of options for assessing individuals,
creating and delivering customized health messages, equipping individuals with the tools necessary to maintain or change their behaviors, and keeping them engaged in their own self-care
• Interventions using new technologies have the greatest chance of being effective
Tailoring mHealthEmerging tecnologies can enable to measure clients’ physical responses and quickly adapt content accordingly.
Mobile technologies enable interventions that are dynamically tailored «in the moment» as needed to be responsive to client’s state.
Health behavior models must not only guide tailoring at the start of an intervention but also the dynamic process of frequent adjustments during the course of an intervention.
Examples from ICH
Examples from ICH
Support of Patient Empowerment by an intelligent self-management pathway for patients
EMPOWER supports the self-management of diabetes patients through a modular and standards-based Patient Empowerment Framework. It helps sufferers of diabetes with observing daily patterns of living and with managing personalized action plans.
Open issues (Aronson et al. 2013)
Is tailoring limiting…
•the intervention’s reach?
•the intervention’s generalizability?
•the intervention’s cost effectiveness?
Thank you for your attention!