Maddalena Fiordelli @ICH - One size does not fit all: the importance of tailoring health messages

1. One size does not fit all
the importance of tailoring health
messages
UX Conference, October 26th 2013
Dr. Maddalena Fiordelli

2. 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

3. The evolution of health
messages
Different 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)

4. The evolution of health
messages

5. The evolution of health
messages
Information 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)

6. The idea of tailoring

7. 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

8. 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)

9. 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

10. How to tailor
Hawkins et al. 2008

11. How to tailor
Hawkins et al. 2008

12. How to tailor
Lustria et al. 2009

13. How to tailor (what)
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Message
Layout
Feedback
Channel
Interaction
Etc.

14. 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

15. Tailoring mHealth
Emerging 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.

16. Examples from ICH

17. 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.

18. Open issues (Aronson et al. 2013)
Is tailoring limiting…
•the intervention’s reach?
•the intervention’s generalizability?
•the intervention’s cost effectiveness?

19. Thank you for your
attention!