How Are Tailored Messages Created?
The Center for Health Communication Research employs six production processes and psychometric rules for developing high quality interventions.

* First, health and behavior change experts delve into the subject area of the intervention being developed. The goal is to identify psychosocial, behavioral, and physiological constructs, and their relationships to the subject matter. For example, "severity of symptoms" is a construct that likely would have relevance in an asthma management program. Both theoretical and empirical findings are gathered together to begin creating a program conceptual framework for the program.

* Once there is a thorough understanding of what best influences behavior change for the program being developed, standardized and psychometrically sound measures are gathered to create a questionnaire. These measures serve as input data and provide the foundation, which content developers use to write unique messages, as well as create specific visual imagery to best meet the needs of the individual who desires to make a change.

* Following the conceptual framework and questionnaire development, program developers create a system of high-level algorithms that define decision rules that the system will run from. In simplest terms, these rules determine "who gets what" messages. A tailoring engine, designed and developed by Center software engineers, uses the taxonomy to re-code raw data gathered from an individual's baseline assessment into higher-level, aggregated "characteristics." For example, several questions about smoking habits are combined to yield a specific "nicotine dependence" characteristic. Based on characteristics, the taxonomy informs the tailoring engine whether and when to include particular tailored output for the expert-tailored intervention, the relative priority among several messages, and the depth of coverage of the feedback.

* Next, program designers and developers use past experience, focus group findings, and creative insight to develop innovative layouts and storyboards to demonstrate how imagery and major topics will be addressed throughout the intervention.

* Then, a large tailored multimedia message library (text, graphics, animation, audio, and video) with appropriate messages is compiled. The library also contains the specific logic rules that determine when a message should appear in a program. Theories from the fields of communication, health education, and psychology are all used to build the library and tailored messages.

* Finally, the entire program is integrated and the system is tested to ensure the accuracy of the algorithms, logic, messages, text layout, space and time constraints, and flow of the overall program. By the end of development, the Center will provide the individual with a program created to meet his or her unique needs. These programs can be delivered in many formats, from print booklets to personal web sites.

What Do You Tailor On?