Evaluation of messages tailored to cancer prevention guidelines Public Deposited

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  • March 20, 2019
Creator
  • Quintiliani, Lisa M.
    • Affiliation: Gillings School of Global Public Health, Department of Nutrition
Abstract
  • Researchers using tailored messages in cancer prevention intervention studies have not sufficiently studied how best to tailor messages about multiple behaviors. One important question is whether behavioral change strategies and feedback should include only behaviors participants indicate they most want to work on (i.e. a behavioral priority) or behaviors selected on their behalf based on expert evidence of potential disease prevention benefit. Compared to expert-based tailoring, tailoring to participants' behavioral priorities may be of greater relevance, prompting information processing, and ultimately facilitating behavioral changes. This dissertation included three lines of research. First, from six focus groups, we elicited participants' perceptions about components of a healthy lifestyle and used this information to design a tailored feedback graphic. Second, we conducted secondary analyses of data from two large worksite intervention trials, in which subsets of female participants received tailored messages. Results indicated that those who chose the 'healthy eating' priority and received a tailored message increased servings of fruits and vegetables by 1.8-2.0 compared to women who had also chosen 'healthy eating' but did not receive a tailored message. Building from these results, we conducted a randomized web-based trial to directly evaluate tailoring to participant-selected behavioral priorities versus expert-based health behaviors and a non-tailored comparison group. Six cancer prevention guidelines for nutrition and physical activity were targeted. Immediately before and after reading the tailored or non-tailored feedback on-screen, we measured guideline-specific intention, self-efficacy, goal commitment, and goal difficulty. Female college students (n=408), 74% non-Hispanic white, participated. Overall, support for tailoring to behavioral priorities was found for increasing fruits and vegetables and physical activity with statistically significant improvements in self-efficacy, goal commitment, and goal difficulty. Even stronger effects on these variables were found among participants randomized to the expert-tailored group, but only among those who received a message that happened to match their selected behavioral priority. Overall, results from this dissertation support tailoring to behavioral priorities and provide a tool to increase message effectiveness. Tailored health communications effective in facilitating healthful nutrition and physical activity choices have the potential to impact cancer incidence population-wide.
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  • Campbell, Marci Kramish
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