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Targeted and Tailored Health Messages: Whats the better value

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Predictors of Use of Hearing Protection Model. Sally L. Lusk PhD, RN, FAAN & team ... and non-tailored computer-based instruction (p=.51, Mann-Whitney U Test) ... – PowerPoint PPT presentation

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Title: Targeted and Tailored Health Messages: Whats the better value


1
Targeted and Tailored Health Messages Whats
the better value?
  • Madeleine J. Kerr, RN, PhD,
  • Karen A. Monsen, RN, PhD(c),
  • Kay Savik MS

School of Nursing
2
Acknowledgements
Predictors of Use of Hearing Protection Model
Sally L. Lusk PhD, RN, FAAN team University of
Michigan
National Institute for Occupational Safety and
Health (NIOSH RO1CCR 513049) M. Kerr, PI.
3
Purpose of follow-up study
  • To discover the better value between tailoring
    and targeting health messages.

4
Tailoring vs. Targeting
Customized to a population
Individually tailored
5
Specific Aims
  • Determine if content of tailored interventions
    differed from the targeted interventions
  • Describe unique characteristics of participants
    for whom the tailored intervention was effective
    in improving outcomes

6
Background for follow-up study
  • Study of construction workers use of hearing
    protection devices (HPD)
  • Randomized trial of tailored versus targeted
    computer-based educational messages.

7
Results
  • Overall participants improved use of HPD from
    baseline (42) to post-intervention (50),
    (plt.001)

8
Results
  • No significant difference in the effect of
    tailored and non-tailored computer-based
    instruction (p.51, Mann-Whitney U Test)
  • Tailored participants improved use of HPD by 8.3
    (30.2)
  • Non-tailored participants improved use of HPD by
    6.1 (29.8)

9
Intervention Description
Interactive multimedia game-like format
10
Intervention Description
  • Applied concepts from the Predictors of Use of
    Hearing Protection Model
  • e.g health messages designed to decrease
    perceptions of barriers to use, increase
    self-efficacy in using HPDs.

11
Intervention Description
  • Sequence
  • 8-minute introduction consent
  • 15-minute survey
  • 40- to 50- minute educational program
  • 11 tailoring points
  • 5 tailored vs. no message
  • 6 tailored vs targeted message

12
Tailored vs. no message
  • benefits of using HPDs
  • social models for HPD use
  • access to HPDs
  • noise annoyance
  • organizational support for HPD use
  • e.g. If perceived employer support is low.
  • View the agent hall of fame for finding ways to
    seek out support.

13
Tailored vs. targeted message
  • Noise exposure
  • Use of HPDs
  • Hearing ability
  • Comfort communicating while using HPDs
  • Barriers
  • Fit of HPDs (example follows)

14
Fit of HPDs example
  • Youre progressing very well, but…
  • (Tailored) …I see from your record that you are
    unhappy with the way your anti-noise weapon fits.
  • (Targeted) …you need some more details on getting
    the most out of your anti-noise weapon.
  • The computer will now guide you through some
    basic tips that will help you get the right fit.

15
Aim 1 Method
  • Tailored and targeted intervention content was
    matched, quantified and match scores described,
    following Ryan et al. methodology1.
  • 1. Ryan GL, Skinner CS, Farrell D, Champion VL.
    Examining the boundaries of tailoring the
    utility of tailoring versus targeting mammography
    interventions for two distinct populations.
    Health Educ.Res. 2001 Oct16(5)555-566.

16
Aim 1 Method
  • Match score sums were computed for each
    participant in the tailoring group (n163)
  • Match score sums represented the fit of their
    individually tailored message combination with
    the targeted message combination.

17
Aim 1 Match score method
  • Two content experts
  • independently compared messages at each of 11
    tailoring points to the corresponding targeted
    message
  • rated their judgments of similarity using a match
    score of 0 (poor fit), 0.5 (close fit), or 1point
    (nearly exact fit).
  • compared their ratings
  • reached consensus through discussion

18
Aim 1 Results
  • Match scores demonstrated that tailored
    interventions differed from the targeted
    intervention for this study.
  • The perfect match score was 11 scores for the
    tailored messages ranged from 2 to 9, with a mean
    of 5.5 (bar chart follows)

19
(No Transcript)
20
Aim 1 Results
  • Among tailoring group subjects, a higher match
    score correlated positively with a change in
    hearing protection use (r.17, p.03).
  • This suggests that the researchers successfully
    created an effective targeted message
    intervention for construction workers.

21
Aim 2 Method
  • Background data on subjects who improved their
    use of hearing protection were compared to those
    who did not.

22
Aim 2 Results
  • About half of subjects who received tailored
    interventions showed improvement in use of
    hearing protection.
  • These subjects were not significantly different
    in background characteristics from those not
    showing improvement in use of hearing protection.

23
Conclusions
  • The control intervention had been well-targeted
    to address the overall responses of construction
    workers
  • No differences were found between background
    characteristics of subjects related to the
    effectiveness of tailoring
  • Thus targeted interventions were the better value.

24
Discussion
  • Evidence is needed to promote optimal use of
    resources in health promotion.
  • Future studies should consider using tailoring as
    a tool to develop well-targeted interventions.

25
  • Our challenge is to be able to develop
    parsimonious theoretical models outlining what is
    worth tailoring for what types of people and in
    what sociocultural contexts (Ryan et al.,2001).
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