Targeting and Tailoring

Targeted Health Communicatio

The rationale for group-targeted health communication issummarizedinthreekeyassumptions:(1)thereis diversity among the members of any large population with respect to the determinants of a given health decision or behavior and also among the characteristics that affect exposure and attention to, processing of, and influence of health messages; (2) for any healthrelated behavior, homogeneous population subgroups can be defined based on shared patterns of these determinants and characteristics; and (3) different health communication strategies are needed to effectively reach different population subgroups. In health communication terminology, these population subgroups are called audience segments.

The concept of audience segmentation has its roots in marketing and advertising consumer products and services and is now widely accepted as a best practice in health communication. Historically, audience segmentation in public health has been driven by findings from disease surveillance and epidemiological studies that identified population subgroups with elevated risk or burden of disease. Because of the limited types of data typically collected in these surveillance and research activities, the resulting audience segments were often fairly unsophisticated, relying on only demographic variables (e.g., teenagers, African Americans), health status indicators (e.g., pregnancy, blood pressure), broad behavioral categories (e.g., smokers, men having sex with men), or sometimes simple combinations of the three (e.g., pregnant teenage girls who smoke). Boslaugh, Kreuter, Nicholson, and Naleid (2005) showed that simple segmentation strategies such as those relying on demographic variables alone provided little improvement over no segmentation at all in understanding physical activity behavior. Thus, while epidemiological data such as these are invaluable for identifying population subgroups with great need for risk reduction, they are of little use in helping health communication planners and developers [Page 1028]make critical decisions about effective message design or selection of interpersonal and media channels to reach members of those subgroups.

More sophisticated, multivariable approaches to audience analysis and segmentation consider demographic, psychographic, geographic, health status and behavioral characteristics, and the dynamic interplay among them. For example, Vladutiu, Nansel, Weaver, Jacobsen, and Kreuter (2006) observed that parents’ beliefs and behaviors related to child injury prevention varied significantly based on whether or not they were first-time parents and by the age of their oldest child. In short, beliefs about the effectiveness of injuryprevention measures and perceptions of how important injury prevention was to others in their lives were related to injury prevention behaviors among parents of preschool children, but not among parents of infants and toddlers. Attitudes about injury prevention (i.e., ‘injuries are normal part of childhood,’ ‘injuries can't be prevented’) predicted injury-prevention behaviors for first-time parents but not parents of multiple children. Thus, rather than promoting injury prevention by delivering the same information to all parents, these findings suggest that it may be more effective to segment the population of parents into multiple subgroups, for example, those with only one child versus those with two or more children. For parents with only one child, targeted communications would focus on changing specific beliefs that may undermine child injuryprevention behaviors.

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