Building a Better Message: The 10 Variables That Really Matter (The Research)

Theoretical Background and research questions/hypothesis: There is growing realization in the field of health communications that health messages must be tailored to specific audience segments (Andresan, 2006). However, there is no general guide for how to design these segment-focused health communications (Abrams, Miller, and Bulger, 1999). To address this need, Drs. Keller and Lehmann systematically examined the role of message tactics and individual differences on intentions to comply with health recommendations.

Methods and Results (informing the conceptual analysis):, A meta-analysis of 60 experimental studies, involving 584 health message conditions and 22,500 participants, was conducted to examine main and interaction effects of 22 message tactics (e.g. gain/loss framing, vividness, self/other referencing, emotion) and six individual characteristics (e.g. gender, age, race, involvement) on intentions to comply with health recommendations (Keller and Lehmann, 2008). The authors used two approaches to identify matches between message tactics and audience characteristics: a full and a reduced regression model. The results from the full regression model suggest that the meta-analysis supports the majority of the effects observed in the literature. The results indicate that various audience segments may respond differently to certain message tactics: * Low-involvement audiences are more persuaded by moderately fearful gain frames, other-referencing, vivid messages, and strong source credibility. * High-involvement audiences prefer base information and strong messages that are also moderately fearful, but they do not distinguish between levels of vividness, source credibility, and referencing. * Younger audiences prefer social consequences over multiple exposures. * Older audiences are more influenced by physical consequences regardless of the number of message exposures. * All ages respond to messages advocating detection behaviors. * Nonwhites seem to care more about vivid messages that emphasize the effect of health consequences on loved ones. * Women respond to emotional messages with social consequences for themselves or health consequences to near and dear ones. * Men are more influenced by unemotional messages that emphasize personal physical health consequences. Keller and Lehmann's research suggests an empirical model to tailor health communications for different target audiences to increase intentions. Results were further validated through application to the CDC Verb campaign (2004-2006), a process which involved 1.) coding CDC Verb campaign advertisements; 2.) using the model to calculate intention and behavior estimates; and 3.) comparing the model estimates to extensive evaluation data collected on outcomes of the Verb campaign. 

Conclusions: Keller and Lehmann's empirical model provides 10 variables that are significant predictors for stated intentions and behavior when socio-economic, social influence, beliefs and attitudes, number of ads, and exposure frequency are accounted for. Intention and behavior predictions are approximately equally sensitive to family and social influence, parent education, and recall of message exposures, and in general have less impact than the child variables or model predictions.

Implications for research and/or practice:  Results show there is a significant opportunity to tailor health communications and even market public health more efficiently to different market segments. Keller and Lehmann's (2008) model formed the basis for CDC DCPC's Message Development Tool (MDT).