Tailored Health Messages

The National Cancer Institute has invested more than 130 million dollars in research exploring the efficacy of tailored health messages since 1999. The ultimate outcomes of this investment suggest that tailored messages are more effective than non-tailored messages: however, research is still needed to explicitly explore factors that most contribute to tailoring success. The exact number of variables needed and the level and intensity of tailoring (depth of tailoring) required to achieve the research goals is not known. Furthermore, physician-patient communication is a dynamic process. Yet to our knowledge no studies have explored the impact of involving patients and physicians in tailored health message interventions that target consultation communication.

Using Tailored Messages to enhance AA patient participation in clinical trial communication

In this study we focused on intervening at the physician and patient level. Patients, who are activated through the application of tailored messages of different depths that are conveyed to their oncologists, are more likely to have their individual issues addressed thus, lowering barriers to participation in trials. Our choice of tailoring variables is based on a model developed by Ford et al. and supported by the NIH and AHRQ. This model was derived from a systematic review of 65 articles (selected from over 5,000) that detail barriers to recruitment of underrepresented populations to cancer clinical trials. This review and conceptual model categorizes barriers to awareness of trials, opportunity to join trials and refusal/acceptance. While the model posits system factors as recruitment barriers, such as strict eligibility criteria, our intervention is focused only on the modifiable communication factors identified in the model. These include: a) lack of information and lack of education about trials as barriers to awareness, b) provider attitudes/beliefs and provider communication as barriers to opportunity and c) patient mistrust and the patient-provider relationship as barriers to acceptance of enrollment.

Related Publications

Brown, R.F.,Grant, S.,Davis, R.,Wilson-Genderson, M.,Cadet, D., Lessard, M.,Alpert, J., Ward, J & Ginder, G.(2016) African American cancer patients Talking About Clinical Trials (TACT) with oncologists during consultations: Evaluating the efficacy of tailored health messages in a randomized controlled trial – the TACT study protocol. British Medical Journal (Open) 2016 Dec 16 doi 10.1136/bmjopen-2016-012864