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!