What is tailoring?
Tailoring is a process of creating individualized communication. It is an assessment-based approach in which individuals provide personal data related to a given health outcome. Those data are used to determine the most appropriate information or strategies to meet each person's unique needs.
There are important differences between tailoring and other approaches to health communication. In order to clarify the differences, we use the following standardized terminology:
Generic materials
Probably the cheapest way to reach large audiences, generic materials aspire to be all things to all people by providing one comprehensive set of information about a topic. In using generic materials, it is not necessarily assumed that all people have the same informational needs, but rather that individuals can and will sift through the parts of these materials that don't apply to them to find and consume that which does.
Personalized generic materials
These materials use a person's name to draw attention to an otherwise generic message. This commonly-used direct mail approach (e.g., "Matthew W. Kreuter, you may have already won $1,500,000!") is designed to capture readers' attention so that even a modest response rate might generate a profit.
Targeted generic materials
These materials are developed for a specific population sub-group (e.g., a smoking cessation manual for African Americans, or breast and cervical cancer screening materials for mid-life and older women). Implicit in the use of targeted health messages is the assumption that sufficient homogeneity exists among members of a demographically-defined group to justify using one common approach to communicate with all its members.
Tailored materials
Tailored communication is intended to reach one specific person, based on characteristics that are unique to that person, related to the outcome of interest, and have been derived from an individual assessment. New communication technologies have made it not only possible but practical to collect individual-level data from large populations and use that information to customize educational and behavior change materials to individuals' unique needs.
Tailored health communication greatly reduces the burden of search and retrieval imposed by generic materials, and provides information that is truly individualized, not just superficially labeled with the recipient's name.
Tailoring is NOT, as mistaken by some researchers, the development of a single intervention approach that takes into account characteristics shared by a defined population. This is targeted communication, and although an improvement over generic materials, it still cannot address important factors that vary from person to person and affect individuals' health-related decisions and behaviors. In contrast to other communication approaches, tailored communication can identify and address the specific informational and behavioral needs of any one person.
The process of tailoring health messages is a lot like the process an actual tailor uses in making custom-fit clothing. A tailor takes a customer's measurements, asks about preferences for fabric, color, and style, and uses this information to create a suit to fit that one customer. Likewise, a tailored health communication program measures a participant's needs, interests, and concerns, and uses that information to create messages and materials to fit that one person.
Tailored materials address only those factors known to be important to an individual recipient. For example, most smoking cessation materials address the benefits of quitting in some way or another. These benefits may include improved health, reduced disease risk, saving money, gaining control over your life, and improved physical appearance. But not every smoker will value each of these benefits. For some, the sole motive for quitting may be financial. For others, improved appearance. And even for those motivated by health benefits, there will be some who want to quit because they have been diagnosed with a smoking-related condition, others who want to prevent such illness, and still others who want to quit to protect the health of non-smokers in their family. If it is indeed important to address the benefits of cessation in quitting materials, it makes sense to frame these benefits in the terms most salient to an individual smoker. Tailored materials can do this.
The tailoring approach of conducting individual assessments and providing individualized feedback is not new, nor is its use unique to health educators. It is commonly employed by successful real estate agents, physicians, teachers, brokers, and salespersons, all of whom identify a client's needs through observation and inquiry, and use that information to customize solutions. In cancer prevention, individual counseling for behavior modification such as improved nutrition, increased physical activity, and smoking cessation is also based on this approach. In many ways, the interpersonal contact, interactivity, and immediacy of feedback that can be provided in one-on-one counseling makes this approach more desirable than a computer tailored print communication program. But the impact of counseling on the health of populations can be limited by cost and by the relatively limited number of individuals who can be reached by a small cadre of trained professionals. A skilled counselor can do everything a tailored message program can do except be available at all times to simultaneously serve multiple and diverse members of mass populations.
Saint Louis University
Health Communication Research Laboratory
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