Michigan Tailoring System

The Michigan Tailoring System (MTS)

CHCR has also developed free, open-source software to enable the creation of tailored messages.

What is Tailoring?

Tailored Interventions include:

  1. 1Assessment of individual characteristics relevant to a behavior
  2. 2Algorithms that use assessment data to generate intervention messages relevant to the specific needs of each user
  3. 3Individual feedback that delivers these messages to each user in a clear, vivid format
Assessment -> Algorithms -> Feedback


Why use tailoring? +

Unhealthy behaviors contribute to over 50% of the morbidity and mortality rates in the United States. Most people think their risk of getting cancer is largely genetic. In reality, 70% of all cancers are affected by behaviors, such as smoking, diet, physical inactivity, and obesity.

  • Mass media campaigns (e.g., public service announcements) reach a lot of people, but often have little affect on behavior.
  • One-on-One Counseling is extremely effective at changing behavior, but only reaches relatively small numbers.
  • By using technology to individualized programs to large numbers of people, tailoring can have both high efficacy and reach.
Impact = Efficacy x Reach

The impact of a public health program is the product of its efficacy (potency to affect behavior) times its reach (the number of people who participate in the intervention)

Tailored programs have the potential to:

  • Make a thorough assessment and combine critical information
  • Construct effective interventions, and deliver them confidentially
  • Make a personal connection with each individual
  • Work with each person over time to build a personal connection
  • Empower individuals to take control of their lives and their health


How do we tailor? +

  1. 1We identify psychosocial, behavioral, and physiological constructs, and their relationships to the health behavior we're trying to change.
  2. 2We gather standardized and psychometrically sound measures to assess individual characteristics relevant to the behavior.
  3. 3Content developers use the theoretical constructs to write selection algorithms and unique messages for people who answer the questionnaire in different ways.
  4. 4Graphic Designers create layouts, navigation, and media elements to support the message content.
  5. 5Programmers create systems that collect assessment data and use selection algorithms to automatically assemble appropriate messages, visual imagery, and media elements for each participant.

Tailored Intervention Components +

Computer tailored health programs present individually relevant content, based on what is known about the receiver. Several components are required to accomplish this.

  1. 1Individual user characteristics that may have an impact on behavior change, as indicated by behavioral theory and research.
  2. 2A comprehensive library (e.g., text, photos, graphics, animations, audio, video) of content that might be presented to any potential receiver.
  3. 3Selection logic that indicates which elements of the content library will be presented, based on particular characteristics of the receiver.
  4. 4A tailoring method that uses selection logic to extract relevant content from the comprehensive library based on individual user characteristics.
  5. 5Controlling processes (e.g., web application) to:
    1. manage individual users (e.g., access codes, account set-up, login, participant tracking)
    2. collect, store, and access user data (e.g., online survey, database queries)
    3. assemble the tailored content with page layouts and navigation into a coherent whole (e.g., interactive website, tailored publication)
  1. 6Optional project-specific elements, for example:
    1. research study elements (study description, eligibility screening, consent, randomization, experimental conditions)
    2. delivery timing (i.e., availability of sessions or "chapters" over time)
    3. additional content (e.g., About Us, FAQ, glossary, special features)
  2. 7Optional adjunct systems
    1. automated communication (e.g., email/text reminders to complete questionnaires or announcements of new sessions)
    2. participant communication management (e.g., triage, tracking, adverse events)
    3. study management (e.g., alerts to mail incentives, make follow-up calls)
    4. usage tracking dashboard (e.g., recruitment/enrollment, attrition, frequencies)
    5. CATI (Computer-Assisted Telephone Interviewing)
    6. data management and analysis

Comparison of tailored content +

Vignette 1 is for a mom who wants her 11-13 year-old daughter to eat less junk food.

Vignette 2 is for a dad who wants his 14-16 year-old son to eat more fruits and vegetables.

Tailoring Vignette