Part One: Targeting and Tailoring Messages: What’s the difference and why should I care?

Think about doing a little target practice.  Imagine the target board…concentric rings coming to a small bull’s-eye in the center. What kind of gun would you choose to hit the mark?  A sawed off shotgun or a rifle with a scope?  The choice is obvious. Airing PSAs or producing health websites with messages crafted for a “general audience” is like shooting a target with a sawed-off shotgun.  The buckshot may or may not hit the paper marker, some may hit the bull’s-eye but a lot of the shot will miss the mark.  One way to achieve more accuracy is to direct your message at a smaller audience.
Targeting refers to the process of segmenting a general, heterogeneous audience into smaller more homogeneous groups. Targeting is based on the advertising principle of market segmentation.Factors that are generally used to segment a population are age, sex, race, income, ethnicity, location and diagnosis.It involves developing a single intervention approach for the subgroup. The subgroup can be very well defined, for example, Chinese-American men, aged 50 to 60 who frequent a certain health center.Targeted materials are based on an aggregate profile of a specific population subgroup.  The focus is on characteristics that are assumed to be shared within the group, hopefully based on formative research.  For example a heart healthy cookbook might be created for a group of Latina mothers in San Antonio. It might be written in Spanish at a sixth grade reading level, use Latina models to explain messages and include testimonials from members of the Latina community about the importance of heart healthy nutrition.

Targeting and tailoring are not the same thing.  To carry the target practice analogy to its conclusion, if you use a rifle with a scope you are extremely likely to hit the bulls-eye.  Tailoring is like hitting the bull’s-eye.    Tailored messages or strategies are not for a group of people but are created for one particular individual.   The process of tailoring segments your target audience to its smallest unit, one person.   Messages, derived from an assessment answered by that individual,  are crafted to address individual level factors that relate to the health or behavioral outcome of interest.  Psychosocial behavioral determinants, like perceived barriers, or perceived self-efficacy to engage in behavior change, are collected in survey format.   Given the capabilities of computers and software, crafting a message specific to one recipient is possible.  In fact it is possible to create tailored message programs to maximize individuality by producing thousands to millions of combinations of tailored messages.So, why should I, as a health communicator, care about targeting and tailoring?  Stay tuned to find out.

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Just The Fats (whoops, I mean Facts) Ma’am

“How about super-sizing that?” commercials on TV taught us. Guess what? We’re the ones who have been super-sized. Adult obesity rates are increasing across the United States. In fact 16 states increased over the past year and not one experienced a decrease.

Obesity rates have grown fastest in Oklahoma, Alabama, and Tennessee, and slowest in Washington, D.C., Colorado, and Connecticut. The South continues to experience the most increases with nine of the 10 states having the highest adult obesity rates. States in the Northeast and West tend to have lower rates. Mississippi maintained the highest adult obesity rate for the seventh year in a row, and Colorado has the lowest obesity rate and is the only state with a rate under 20 percent.

Just as adult obesity rates have grown, childhood obesity rates are lumbering ever upward. The highest rates (20 to 25%) are in eight states, Texas, Louisiana, Illinois, Georgia, Kentucky, Tennessee, Arkansas and Mississippi. Just out from the CDC is a study of 17,000 Americans conducted between 2005 and 2008. It found that half of all Americans drink a sugared beverage each day. Males are more likely to consume the sugary drinks than females, especially teenage boys. Again, lower income adults are more likely to drink sugary drinks than more affluent. Portion size seems to be a factor. For example, regular Coca-Cola’s come in a 12-once can that has 140 calories. According to CDC and others, to be healthy, people should limit their intake of sugary beverages to 64 calories per day. How many people do you know drink only half a can of Coke? No one…there’s no way to save the rest of the can…it will go flat.

A link has been found between sweetened drinks and the increasing obesity rate in the US.   With the increase in obesity rates comes an increase in diabetes rates. Only 15 years ago the highest state-wide rated was just under 20%; now 20% s is the lowest obesity rate. In that short amount of time, the number of states with over 7% diabetes rates has increased from 4 to 43. Hypertension rates have also shot up, every state reports rates above 20% and nine report rates of 30%.

The BBC reported Sept 1 that there has been a 30% increase in strokes between 1995 and 2008 in people ages 5 to 44.

The cost of obesity is hefty too. Obese individuals spend an average of $1500 more annually on health care and consume 30% more of health care costs than healthy weight individuals. That’s one beefy price tag.

So, what’s to be done? Stay tuned…same Fat time…same Fat station!

(This information is a short summary of a 2011 report by the Robert Wood Johnson Foundation (RWJF).The map by the Trust for America’s Health (TFAH) can be found on healthyamericans.org as an interactive map. Two versions are available, one for adult obesity rates and the other for childhood obesity rates by state. To see an interactive map of obesity rates by gender in see the Kaiser Family Foundation website.