Part Two: Engagement…or how to make it matter

For a long time cognitive scientists have been studying how we receive and process messages.   Petty and Cacioppo are the big names in this area of study, coming up with the Elaboration Likelihood Model or ELM to describe what they observed.  In a nutshell they found that we process messages in two ways, via  central or  peripheral processing.  As health communicators our goal is to engage indepth or central processing.  When people have little interest in a message, they tend to process it peripherally.  When processing peripherally, they don’t think about the arguments in the message but rather they  use cues like attractiveness, reputation or credibility to guide their decision to perform a behavior.  Alternatively, central processing is energy consuming.  It is only engaged in when a message is  very important and relevant to the person and when the person has the intellectual or technical ability to process a message centrally.    Processing centrally requires careful listening and evaluation of message content.  Whenever possible you want to promote central processing.   When you’ve thought about an issue and made a decision to perform a recommended behavior your’re more committed to really doing it.   Central processing is more likely to lead to long-term and stable change.

One of the best ways to engage the central processing route is to make your message relevant to the audience.  Tailoring achieves relevance. Studies have found that compared to non-tailored messages, tailored messages are more likely to be read and remembered, rated as attention getting, saved and discussed with others and perceived as personally relevant. Tailored messages are patient-centered.  Patient-centered messages are associated with better adherence to treatment than are topic-centered messages.  In particular, they can enhance self-efficacy, or the perceived ability to complete a specific task.Here is an example to illustrate the tailoring process.   Suppose we were to develop tailored messages to encourage an adult female to quit smoking, an interview or assessment survey would be used to query her about her life to better understand her smoking behavior.  The assessment would find that her name is Shelia Shephard, a cashier at a supermarket.  She identifies herself as an African American; she is 43 years old and has been smoking since she was 14.  Her smoking is done to relieve stress.  She has tried to quit before but has been unsuccessful.  She wants to try to quit again but can’t afford nicotine alternatives that can help her quit.  She socializes with other smokers during breaks.  Her main barrier to quitting is low self-esteem after having been previously unsuccessful in quitting; she believes that she will not reduce her risk of cancer by quitting.  A tailored message designer might create a message addressing her by name, acknowledging her long-time identification as a smoker and providing her feedback on ways to reduce stress without smoking.  The message would address her low self-esteem by providing supportive messaging to increase self-esteem.  It might provide her with coupons for nicotine gums and include a testimonial from a cashier who has quit.

The pace of interactivity has accelerated.   The opportunities for using tailoring have moved from print to Web to Blackberries.  Connection is just a text message away.  With the advent of tracking devices that can input data for real-time monitoring, the possibility of tailored texting to support behavioral change is not a pipe dream.  It is reality.  And that’s not all folks…stay tuned for more…

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