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Cited by 937Media Influence and HealthBehavioral Health and InterventionsPatient-Provider Communication in Healthcare

Understanding tailoring in communicating about health

Open access
Hawkins, R. P., Kreuter, M., Resnicow, K., Fishbein, M., Dijkstra, A.·2008·Health Education Research
DOI 10.1093/her/cyn004PMC PMC3171505
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Abstract

'Tailoring' refers to any of a number of methods for creating communications individualized for their receivers, with the expectation that this individualization will lead to larger intended effects of these communications. Results so far have been generally positive but not consistently so, and this paper seeks to explicate tailoring to help focus future research. Tailoring involves either or both of two classes of goals (enhancing cognitive preconditions for message processing and enhancing message impact through modifying behavioral determinants of goal outcomes) and employs strategies of personalization, feedback and content matching. These goals and strategies intersect in a 2 x 3 matrix in which some strategies and their component tactics match better to some goals than to others. The paper illustrates how this framework can be systematically applied in generating research questions and identifying appropriate study designs for tailoring research.

AI snapshot

Written from the paper’s full text.

TL;DR

This conceptual paper argues that “tailoring” in health communication is not a unitary construct but involves two goal classes—enhancing message processing and modifying behavioral determinants—and three strategies: personalization, feedback, and content matching. It proposes a 2 × 3 goals-by-strategies matrix to guide more precise research on what aspects of tailoring work and how.

Key findings

  • Tailoring is better understood as continuous degrees of audience segmentation and message customization rather than as discrete categories of mass, targeted, and tailored communication.
  • The paper identifies two broad tailoring goals: enhancing cognitive preconditions for message processing/acceptance and enhancing message impact by modifying behavioral determinants of outcomes.
  • It proposes three tailoring strategies—personalization, feedback, and content matching—with personalization tactics including identification, raising expectation, and contextualization; feedback types including descriptive, comparative, and evaluative; and content matching directed at key theoretical determinants.
  • The paper notes that >100 tailoring studies have been published and that the National Cancer Institute alone invested ∼$130 million in tailored communication research for cancer prevention and control since 1999; it also cites a meta-analysis concluding tailored print interventions are more effective than non-tailored ones.

Methods

  • Conceptual/theoretical paper, described as a “white paper” from an NCI Centers of Excellence in Cancer Communication Research working group; it is not a systematic review or primary empirical study.
  • The authors synthesize existing tailoring research and theory, cite illustrative studies, and propose a framework linking tailoring goals, strategies, and tactics.
  • They recommend future designs including presence-versus-absence/dismantling designs, parametric or “dosing” designs, constructive designs, and designs comparing degrees of segmentation and customization.

Limitations

  • The authors state that a thorough review of tailoring research is not their purpose and that some parts of the framework have been taken for granted by researchers or represent suggestions and speculations by the authors.
  • They state that no research has tested the proposed effects and mechanisms of tailored feedback, nor compared effects of different types or combinations of feedback in tailored health communication programs.
  • They also state that research on dose as the number of tailored communications received has been limited and inconclusive; the text makes evident that the proposed 2 × 3 matrix is not empirically validated in this paper.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1093/her/cyn004

Cites

47 of 47 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 42 cited sources checked · 0 supported · 0 flagged

  • Findingcitation
    § Introduction

    The reference group used in comparative feedback can itself be tailored.

    “The reference group used in comparative feedback can itself be tailored.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [39] Kreuter MW, Steger-May K, Bobra S, et al. Sociocultural characteristics and responses to cancer education materials among African American women. Cancer Control. 2003;10(Suppl.):69–80. doi: 10.1177/107327480301005s10. [DOI] [PubMed] [Google Scholar]

      Not checked in the free run.

  • Findingown data
    § Introduction

    Most studies of tailored content matching (or of other methods of tailoring) compared the experimental group with a group that received a general audience or group-targeted communication.

    “Most studies of tailored content matching (or of other methods of tailoring) compared the experimental group with a group that received a general audience or group-targeted communication.”
    Quote in the paperSubstantial claim
  • Findingreasoning
    § Introduction

    Individual-based assessments are often integral to tailored interventions.

    “Because segmentation and customization rely on information about individuals and are arguably most effective when this information is detailed and relevant to targeted behaviors, individual-based assessments are often integral to tailored interventions.”
    Quote in the paperSubstantial claim
  • Premisecitation
    § Introduction

    Early studies showed that tailored messages were more likely than non-tailored messages to be read and remembered.

    “early studies showed that tailored messages were more likely than non-tailored messages to be read and remembered [14, 15].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [14] Skinner C, Strecher V, Hospers H. Physicians' recommendations for mammography: do tailored messages make a difference? Am J Public Health. 1994;84:43–9. doi: 10.2105/ajph.84.1.43. [DOI] [PMC free article] [PubMed] [Google Scholar]

      Not checked in the free run.

    • cites [15] Campbell M, DeVellis B, Strecher VJ, et al. Improving dietary behavior: the effectiveness of tailored messages in primary care settings. Am J Public Health. 1994;84:783–7. doi: 10.2105/ajph.84.5.783. [DOI] [PMC free article] [PubMed] [Google Scholar]

      Not checked in the free run.

  • Interpretationreasoning
    § Introduction

    The three traditional types of health communication (mass, targeted, tailored) are not discrete categories, but overlapping segments of the continua of segmentation and customization.

    “Seen in this light, the three traditional types are not discrete categories, but overlapping segments of the continua.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim. 31
  • May combine two claims. 23

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation
    § Introduction

    Some tailoring studies have used dismantling designs.

    “Some tailoring studies have used such designs [19].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19] Kreuter MW, Bull F, Clark EM, et al. Understanding how people process health information: a comparison of tailored and untailored weight loss materials. Health Psychol. 1999;18:487–94. doi: 10.1037//0278-6133.18.5.487. [DOI] [PubMed] [Google Scholar]

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Findingnone given
    § Introduction

    No research has tested the proposed effects and mechanisms of effect of tailored feedback, nor compared effects of different types or combinations of feedback in tailored health communication programs.

    “We know of no research testing these proposed effects and mechanisms of effect of tailored feedback, nor of research comparing effects of different types or combinations of feedback in tailored health communication programs.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Findingnone given
    § Introduction

    The three tailoring strategies are frequently used in combination with each other and can even occur within a single message.

    “As noted at the outset of this section, the three tailoring strategies are frequently used in combination with each other and can even occur within a single message.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Findingnone given
    § Introduction

    Some research already exists comparing undifferentiated versus 'targeted' or 'targeted' versus 'tailored' messages.

    “Some such research already exists, labeled as comparing undifferentiated versus ‘targeted’ or ‘targeted’ versus ‘tailored’ messages.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Findingnone given
    § Introduction

    Differences between the three feedback tactics are subtle in practice.

    “Although differences between the three feedback tactics are subtle in practice, it seems possible that some might be more effective for certain individuals under certain circumstances.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation
    § Introduction

    Another comparative feedback tactic gathers data from the same individuals over time and messages report on progress over time (self-comparison).

    “Another comparative feedback tactic gathers data from the same individuals over time and messages report on progress over time (i.e. self-comparison) [40].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [40] Velicer W, Prochaska J, Fava JL, et al. Interactive versus noninteractive interventions and dose-response relationships for stage-matched smoking cessation programs in a managed care setting. Health Psychol. 1999;18:21–8. doi: 10.1037//0278-6133.18.1.21. [DOI] [PubMed] [Google Scholar]

      Not checked in the free run.

  • May combine two claims.

    Findingcitation
    § Introduction

    Research on the dose dimension of tailoring has been limited and inconclusive.

    “Research on this dimension of dose has been limited and inconclusive [40].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [40] Velicer W, Prochaska J, Fava JL, et al. Interactive versus noninteractive interventions and dose-response relationships for stage-matched smoking cessation programs in a managed care setting. Health Psychol. 1999;18:21–8. doi: 10.1037//0278-6133.18.1.21. [DOI] [PubMed] [Google Scholar]

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S4 (based).

    Findingnone given
    § Introduction

    Tailored evaluative feedback varies in the depth of inference made.

    “Tailored evaluative feedback varies in the depth of inference made.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationreasoning
    § Abstract

    Tailoring involves either or both of two classes of goals or mechanisms: enhancing cognitive preconditions for message processing or acceptance and enhancing message impact by modifying behavioral determinants of goal outcomes.

    “Tailoring involves either or both of two classes of goals (enhancing cognitive preconditions for message processing and enhancing message impact through modifying behavioral determinants of goal outcomes) and employs strategies of personalization, feedback and content matching.”
    • Also stated in: § Introduction · plain
      “Claims about why and how tailoring enhances health communication fall into two distinct classes of mechanisms: (i) that tailoring enhances cognitive preconditions for message processing or acceptance and (ii) that it enhances message impact by selectively modifying initial behavioral determinants of desired outcomes.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationreasoning
    § Abstract

    These goals and strategies intersect in a 2 × 3 matrix in which some strategies and their component tactics match better to some goals than to others.

    “These goals and strategies intersect in a 2 × 3 matrix in which some strategies and their component tactics match better to some goals than to others.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning
    § Introduction

    Using information about particular individuals (tailoring) may customize to a more specific segment but is not a qualitatively different strategy from targeting.

    “Using information about particular individuals (tailoring in categorical terms) may customize to a yet more specific segment but is not a qualitatively different strategy.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation
    § Introduction

    There is a growing consensus that attitude, perceived norms, and self-efficacy serve as the principal determinants of intention to perform a given behavior and that each is based on underlying beliefs.

    “There is a growing consensus that these three constructs serve as the principal determinants of intention to perform a given behavior and that each is itself based on a set of underlying beliefs [9, 25, 26].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [9] Noar SM, Benac CN, Harris MS. Does tailoring matter? Meta-analytic review of tailored print health behavior change interventions. Psychol Bull. 2007;133:673–93. doi: 10.1037/0033-2909.133.4.673. [DOI] [PubMed] [Google Scholar]

      Not checked in the free run.

    • cites [25] Fishbein M, Triandis HC, Kanfer FH, et al. Factors influencing behavior and behavior change. In: Baum A, Revenson TR, Singer JE, editors. Handbook of Health Psychology. Mahwah, NJ: Lawrence Erlbaum Associates; 2001. pp. 3–17. [Google Scholar]

      Not checked in the free run.

    • cites [26] Speaking of Health: Assessing Health Communication Strategies for Diverse Populations. Washington, DC: National Academy Press; 2002. IOM Committee on Communication for Behavior Change in the 21st Century Improving the Health of Diverse Populations. [Google Scholar]

      Not checked in the free run.

  • May combine two claims.

    Premisecitation
    § Abstract

    Across studies of tailoring effects, tailored communications have typically been more effective than non-tailored (undifferentiated or group-targeted) messages, though some studies have found no differences.

    “Results so far have been generally positive but not consistently so, and this paper seeks to explicate tailoring to help focus future research.”
    • Also stated in: § Introduction · plain
      “typically showing tailoring to be more effective than undifferentiated messages, though some studies have found no differences [4–8].”
    Quote in the paperSubstantial claim0 of 5 sources checked
    • cites [4] Skinner CM, Campbell MK, Rimer BJ, et al. How effective is tailored print communication? Ann Behav Med. 1999;21:290–8. doi: 10.1007/BF02895960. [DOI] [PubMed] [Google Scholar]

      Not checked in the free run.

    • cites [5] Strecher V. Computer-tailored smoking cessation materials: a review and discussion. Patient Educ Couns. 1999;36:107–17. doi: 10.1016/s0738-3991(98)00128-1. [DOI] [PubMed] [Google Scholar]

      Not checked in the free run.

    • cites [6] Brug J. Dutch research into development and impact of computer-tailored nutrition education. Eur J Clin Nutr. 1999;53:S78–82. doi: 10.1038/sj.ejcn.1600808. [DOI] [PubMed] [Google Scholar]

      Not checked in the free run.

    • cites [7] Lancaster T, Stead L, Silagy C. Effectiveness of interventions to help people stop smoking: findings from the Cochrane Library. Br Med J. 2000;321:355–8. doi: 10.1136/bmj.321.7257.355. [DOI] [PMC free article] [PubMed] [Google Scholar]

      Not checked in the free run.

    • cites [8] Ryan P, Lauver D. The efficacy of tailored interventions. J Nurs Scholarsh. 2002;34:331–7. doi: 10.1111/j.1547-5069.2002.00331.x. [DOI] [PubMed] [Google Scholar]

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Interpretationreasoning
    § Abstract

    Tailoring employs strategies of personalization, feedback and content matching.

    “and employs strategies of personalization, feedback and content matching.”
    • Also stated in: § Introduction · plain
      “We propose that ‘personalization’, ‘feedback’ and ‘content matching’ are three distinct strategies through which the above tailoring goals can be achieved.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationreasoning
    § Introduction

    Tailoring has encompassed a diverse set of both message construction methods and psychological and social processes by which enhanced communication effects are brought about.

    “But as one reads and thinks more about such tailoring, it becomes apparent that tailoring has encompassed a diverse set of both message construction methods and the psychological and social processes (generally assumed) by which enhanced communication effects are brought about.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation
    § Introduction

    Positive emotions tend to reduce effortful processing and negative emotions enhance it.

    “Since positive emotions tend to reduce effortful processing and negative emotions enhance it, emotion arousal could elicit varying cognitive processing [22].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [22] Forgas JP. Affect in social judgments and decisions: a multiprocess model. Adv Exp Psychol. 1992;25:227–75. [Google Scholar]

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

    Interpretationreasoning
    § Introduction

    Individualizing health communication involves two linked processes, segmentation and customization, each of which varies continuously.

    “it obscures the more useful idea that individualizing health communication involves two linked processes, segmentation and customization, each of which varies continuously (Fig. 1).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation
    § Introduction

    A recent meta-analysis of tailoring studies using print messages concluded that tailored interventions are more effective than non-tailored ones and explored moderators of these effects.

    “A recent meta-analysis of tailoring studies utilizing print messages also concluded that tailored interventions are more effective than non-tailored ones and further explored a useful range of moderators of these effects [9].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9] Noar SM, Benac CN, Harris MS. Does tailoring matter? Meta-analytic review of tailored print health behavior change interventions. Psychol Bull. 2007;133:673–93. doi: 10.1037/0033-2909.133.4.673. [DOI] [PubMed] [Google Scholar]

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing), S4 (based).

    Interpretationreasoning
    § Introduction

    The evaluation in feedback contains content information by giving meaning to the factual psychological or behavioral state, thereby changing relevant beliefs.

    “(ii) the evaluation contains content information in that it gives a meaning to the factual psychological or behavioral state, thereby changing relevant beliefs,”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Interpretationnone given
    § Introduction

    Feedback and content matching strategies are intended primarily to stimulate particular intermediate impacts, but they may also affect processing.

    “Feedback and content matching strategies are intended primarily to stimulate particular intermediate impacts, but they may also affect processing.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The more one knows about what influences performance of a given behavior, the more likely one can design an intervention to change or reinforce that behavior.

  • Probably not a substantial claim: may not pass S1 (asserted), S2 (checkable), S3 (load-bearing), S4 (based).

    Interpretationnone given
    § Introduction

    The whole feedback text may increase the sense of 'being acknowledged'.

    “and (iii) and the whole feedback text may increase the sense of ‘being acknowledged’.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation
    § Introduction

    One reason high-inference messages may be potent is that the receiver could perceive the tailoring agent to be highly insightful and skilled (credible) and perceives more presence from the communication.

    “One reason may be that the receiver could perceive the tailoring agent to be highly insightful and skilled (i.e. credible) and perceives more presence [37] from the communication, just as deeper level reflections build rapport and encourage change in psychological counseling [41, 42].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [37] Lee KM. Presence, explicated. Commun Theory. 2004;14:27–50. [Google Scholar]

      Not checked in the free run.

    • cites [41] Carkhauff RR, Cannon J, Pierce R, et al. The Skills of Helping: An Introduction to Counseling Skills. Amherst, MA: Human Resource Development Press; 1979. [Google Scholar]

      Not checked in the free run.

    • cites [42] Miller WR, Rollnick S. Motivational Interviewing: Preparing People for Change. 2nd. New York: Guilford Press; 2002. [Google Scholar]

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Interpretationreasoning
    § Introduction

    Such designs test whether some example of segmentation/customization (tailoring) is more effective than little or no segmentation and customization.

    “In effect, such designs test whether some example of segmentation/customization (tailoring) is more effective than little or no segmentation and customization.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S1 (asserted), S4 (based).

    Interpretationreasoning
    § Introduction

    Messages based on high-inference evaluative feedback may be especially potent in changing beliefs.

    “Such inferences, if correct, can yield new insights into a person's behavioral or psychological states, and we hypothesize that messages based on these inferences may be especially potent in changing beliefs.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation
    § Introduction

    Descriptive feedback may produce non-specific effects such as 'feeling acknowledged', 'feeling understood' or creating a sense of presence, which could build rapport and favorably influence interpretation of the tailoring agent's motives or lower resistance to persuasion.

    “It may also produce non-specific effects such as ‘feeling acknowledged’, ‘feeling understood’ or creating a sense of presence [37, 38], which could build rapport and favorably influence interpretation of the tailoring agent's motives or lower resistance to persuasion.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [37] Lee KM. Presence, explicated. Commun Theory. 2004;14:27–50. [Google Scholar]

      Not checked in the free run.

    • cites [38] Walther JB, Pingree S, Hawkins RP, et al. Attributes of online interactive health information systems. J Med Internet Res. 2005;7:e33. doi: 10.2196/jmir.7.3.e33. [DOI] [PMC free article] [PubMed] [Google Scholar]

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationreasoning
    § Introduction

    Comparative feedback may be especially effective among individuals for whom normative beliefs are important determinants of a given behavior.

    “Comparative feedback may be especially effective among individuals for whom normative beliefs are important determinants of a given behavior.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation
    § Introduction

    Tailoring on contextual variables alone may not be sufficient to bring about changes in behavior but might enhance the effects of other tailoring strategies on impact variables.

    “Tailoring on contextual variables alone may not be sufficient to bring about changes in behavior but might enhance the effects of other tailoring strategies on impact variables.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [36] Kreuter MW, Skinner C, Holt CL, et al. Cultural tailoring for mammography and fruit and vegetable intake among low-income African American women in urban public health centers. Prev Med. 2005;41:53–62. doi: 10.1016/j.ypmed.2004.10.013. [DOI] [PubMed] [Google Scholar]

      Not checked in the free run.

  • May combine two claims.

    Premisecitation
    § Introduction

    Identification has increased effects in some studies but had no effects in others.

    “Identification has increased effects in some studies [29] but had no effects in others [33].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [29] Dijkstra A. Working mechanisms of computer-tailored health education: evidence from smoking cessation. Health Educ Res. 2005;20:527–39. doi: 10.1093/her/cyh014. [DOI] [PubMed] [Google Scholar]

      Not checked in the free run.

    • cites [33] Bull F, Kreuter MW, Scharff DP, et al. Effects of tailored, personalized, and general materials on physical activity. Patient Educ Coun. 1999;36:181–92. doi: 10.1016/s0738-3991(98)00134-7. [DOI] [PubMed] [Google Scholar]

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing), S4 (based). May combine two claims.

    Interpretationreasoning
    § Introduction

    Personalization might lead to more positive thoughts but only when arguments are strong.

    “For example, personalization might lead to more positive thoughts but only when arguments are strong.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation
    § Introduction

    Women who received magazines tailored on both behavior and culture were most likely to report getting mammograms and to have increased fruit and vegetable consumption.

    “Women who received magazines tailored on both constructs were most likely to report getting mammograms and to have increased fruit and vegetable consumption [36].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [36] Kreuter MW, Skinner C, Holt CL, et al. Cultural tailoring for mammography and fruit and vegetable intake among low-income African American women in urban public health centers. Prev Med. 2005;41:53–62. doi: 10.1016/j.ypmed.2004.10.013. [DOI] [PubMed] [Google Scholar]

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning
    § Introduction

    Overreaching in evaluative feedback may undermine tailoring by yielding less relevant messages based on erroneous conclusions about the individual and by compromising the credibility of the tailoring program.

    “Such overreaching may then undermine tailoring not only by yielding less relevant messages based on erroneous conclusions about the individual but also by compromising the credibility of the tailoring program.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing), S4 (based).

    Interpretationreasoning
    § Introduction

    Factual feedback links the information to the individual, thereby increasing involvement.

    “‘Feedback with evaluation’ would seem to have at least three potential effects: (i) the factual feedback links the information to the individual, thereby increasing involvement;”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S1 (asserted). May combine two claims.

    Interpretationcitation
    § Introduction

    Personalization and feedback might lead to greater personal relevance, attention to messages, and greater elaboration.

    “For example, personalization and feedback might be hypothesized to lead to greater personal relevance, attention to messages, and greater elaboration [44].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [44] Kreuter MW, Skinner C, Steger-May K, et al. Responses to behaviorally vs. culturally tailored cancer communication for African American women. Am J Health Behav. 2004;28:195–207. doi: 10.5993/ajhb.28.3.1. [DOI] [PubMed] [Google Scholar]

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationnone given
    § Introduction

    Descriptive feedback ranges from simply restating or acknowledging information to providing information based on more complex processing of responses.

    “Descriptive feedback ranges from simply restating or acknowledging information (e.g. ‘You said you smoke a pack of cigarettes per day.’) to providing information based on more complex processing of their responses (e.g. ‘Based on your answers, we determined that you eat 24 grams of fat per day.’).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationnone given
    § Introduction

    Some feedback tactics might be more effective for certain individuals under certain circumstances.

    “Although differences between the three feedback tactics are subtle in practice, it seems possible that some might be more effective for certain individuals under certain circumstances.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning
    § Introduction

    In the case of weak arguments, personalization might lead to more counterargumentation and less desired effects.

    “In the case of weak arguments, personalization might lead to more counterargumentation and less desired effects.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation
    § Introduction

    Personalization strategies are generally used to enhance message processing, though there is some evidence that they may also affect behavior directly.

    “Personalization strategies are generally used to enhance message processing, though there is some evidence that they may also affect behavior directly [29].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [29] Dijkstra A. Working mechanisms of computer-tailored health education: evidence from smoking cessation. Health Educ Res. 2005;20:527–39. doi: 10.1093/her/cyh014. [DOI] [PubMed] [Google Scholar]

      Not checked in the free run.

    • Rests on an assumption: A message not attended to can have little or no effect.

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Interpretationnone given
    § Conclusions

    Strategies and goals are often linked, with personalization more often affecting processing goals and feedback and content matching more related to outcomes.

    “As a final step in this explication, we suggested that strategies and goals are often linked, with personalization more often affecting processing goals and feedback and content matching more related to outcomes.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Interpretationnone given
    § Conclusions

    Claims and evidence of tailoring's effectiveness are based on a variety of goals, both to alter message processing and to directly impact useful intermediate outcomes.

    “Furthermore, claims and evidence of tailoring's effectiveness are based on a variety of goals, both to alter message processing and to directly impact useful intermediate outcomes.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Premisenone given
    § Introduction

    Segmentation and customization rely on information about individuals.

    “Because segmentation and customization rely on information about individuals and are arguably most effective when this information is detailed and relevant to targeted behaviors, individual-based assessments are often integral to tailored interventions.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given
    § Conclusions

    All tailoring employs one or more of three basic strategies, which subsume further distinctions of tactics.

    “Beyond this, we have argued that all tailoring employs one or more of three basic strategies, which subsume further distinctions of tactics.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning
    § Conclusions

    Tailoring is not unitary; it results from dual continua of audience segmentation and message customization, both matters of degree, not categorical, and tailoring in practice varies continuously and relies on the linkage of the two.

    “The first argument that tailoring is not unitary results from the dual continua of audience segmentation and message customization: both are matters of degree, not categorical, and tailoring in practice thus varies continuously and relies on the linkage of the two.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given
    § Introduction

    Segmentation and customization are arguably most effective when information about individuals is detailed and relevant to targeted behaviors.

    “Because segmentation and customization rely on information about individuals and are arguably most effective when this information is detailed and relevant to targeted behaviors, individual-based assessments are often integral to tailored interventions.”
    Quote in the paperNot a substantial claim
43 of 43

  • The paper relies on this without support.

    A message not attended to can have little or no effect.

    “Obviously, a message not attended to can have little or no effect, so it should be no surprise that a common aim of tailoring is simply to increase attention (either the likelihood of processing the message at all or how far through the communication the receiver persists [13]), thus presumably increasing comprehension, itself necessary to effects.”

  • The paper relies on this without support.

    Greater degrees of segmentation and customization increase cost and effort.

    “Also, greater degrees of segmentation and customization increase cost and effort.”

  • The paper relies on this without support.

    The more one knows about what influences performance of a given behavior, the more likely one can design an intervention to change or reinforce that behavior.

    “Clearly, the more one knows about what influences performance of a given behavior, the more likely one can design an intervention to change or reinforce that behavior.”

  • The paper relies on this without support.

    In practice, personalization, feedback and content matching are almost always combined.

    “Although we describe the three strategies separately for conceptual clarity and those planning tailored communications should consider their separate advantages and disadvantages, in practice they are almost always combined.”

  • The paper relies on this without support.

    We are currently quite far from the fully individualized tailoring ideal and approaching it will be difficult.

    “We recognize that we are currently quite far from that ideal and also that approaching it will be difficult (note that Fig. 1 places tailoring as now practiced more or less at the center of both continua).”

  • The paper relies on this without support.

    If someone has a strong intention to perform a given behavior and has the necessary skills and abilities, and if there are no environmental constraints to prevent behavioral performance, then the probability of the behavior is high.

    “Ideally, if someone has a strong intention to perform a given behavior and has the necessary skills and abilities, and if there are no environmental constraints to prevent behavioral performance, then the probability of the behavior is high.”

  • The authors state this as an assumption.

    Tailored feedback is generally assumed to provide social comparison information that may focus effortful processing on self-evaluation and normative comparison to stimulate changes in perceived norms, attitudes or beliefs.

    “By comparing a person's attitudes, beliefs or behaviors to those of others, tailored feedback is generally assumed to provide social comparison information that may focus effortful processing on self-evaluation and normative comparison to stimulate changes in perceived norms, attitudes or beliefs.”
7 of 7

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Studies of personalization in health care and medicine have been increasing in number since the early 2000s, with growing evidence showing their effectiveness.

    “Studies of personalization in health care and medicine have been increasing in number since the early 2000s [22], with growing evidence showing their effectiveness [23-26].”

    From The Personalization of Conversational Agents in Health Care: Systematic Review (2019) · cites this paper as [24]

    The Introduction reports more than 100 published studies of tailored health communication since its introduction in the early 1990s, supporting substantial research activity. It does not establish that the number of studies specifically on personalization increased year by year since the early 2000s. The effectiveness clause is attached to other citations, not this source. (LLM, conf=0.78)

    Experimental — accuracy not yet measured

  • Conveying health information without considering individual differences may inhibit behavior change.

    “Experts in health behavior change have shown that conveying health information without considering individual differences may inhibit behavior change [20-26].”

    From Tailored web-based interventions for pain: Systematic review and meta-analysis (2017) · cites this paper as [21]

  • Content matching is thought to be the essence of tailored approaches.

    “which is thought to be the essence of tailored approaches [21]”

    From Tailored web-based interventions for pain: Systematic review and meta-analysis (2017) · cites this paper as [21]

Cites

Flagged first, then by citations

Research works printed but not linked: 2

  1. [30]Geller L. Customer retention begins with basics. Direct Mark. 1997;60:58–62. [Google Scholar]
  2. [37]Lee KM. Presence, explicated. Commun Theory. 2004;14:27–50. [Google Scholar]

Cited by

Sorted by citations

Related

Authors
Hawkins, R. P., Kreuter, M., Resnicow, K., Fishbein, M., & Dijkstra, A.
Affiliations
  • University of Wisconsin–Madison (US)
  • Saint Louis University (US)
  • University of Michigan (US)
  • University of Pennsylvania (US)
  • University of Groningen (NL)
Corresponding author
Hawkins, R. P.
ORCID
Venue
Health Education Research
Publisher
Oxford University Press (OUP)
Published
2008-06-01
Volume
23
Issue
3
Pages
454-466
ISSN
  • 0268-1153 (ISSN-L)
  • 1465-3648
DOI
10.1093/her/cyn004
PMC
PMC3171505
OpenAlex
W2162486273
Semantic Scholar
2726edb4ea8a922748ad9c8aeb548785670e22fe
Cited by
934
References
47
Citations by year
2026: 38 · 2025: 48 · 2024: 42 · 2023: 42 · 2022: 67 · 2021: 72 · 2020: 85 · 2019: 61 · 2018: 66 · 2017: 54 · 2016: 55 · 2015: 77 · 2014: 56 · 2013: 58 · 2012: 32
FWCI
667.05
Type
journal article
Language
en
Open access
Locations
  • Health Education Research (publishedVersion)
  • PubMed (publishedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
Funders
National Cancer Institute (R01CA114539)
Topics
  • Social Sciences › Arts and Humanities › Literature and Literary Theory › Media Influence and Health
  • Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
  • Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
Keywords
tailoring, health communication, personalized communication, personalization, feedback, content matching, behavioral factors
MeSH terms
Attention, Cognition, Communication, Goals, Health Education, Health Services Research, Humans, Patient Education as Topic

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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