‘Tailoring’ means creating communications in which information about a given individual is used to determine what specific content he or she will receive, the contexts or frames surrounding the content, by whom it will be presented and even through which channels it will be delivered [1
]. Overall, tailoring aims to enhance the relevance of the information presented [3
] and thus to produce greater desired changes in response to the communications.
Since its introduction in the early 1990s, >100 studies of tailoring effects have been published in peer-reviewed scientific journals, and the National Cancer Institute (NCI) alone has invested ~$130 million in tailored communication research for cancer prevention and control since 1999. Much of this research focused mainly on whether individualized messages achieved greater impact than non-tailored (i.e. group-targeted or undifferentiated mass) messages, typically showing tailoring to be more effective than undifferentiated messages, though some studies have found no differences [4
]. A recent meta-analysis of tailoring studies utilizing print messages also concluded that tailored interventions are more effective than non-tailored ones and further explored a useful range of moderators of these effects [9
There is a widespread tendency to treat tailoring as a unitary construct, a specific thing one either does or does not do in health communication. But as one reads and thinks more about such tailoring, it becomes apparent that tailoring has encompassed a diverse set of both message construction methods and the psychological and social processes (generally assumed) by which enhanced communication effects are brought about. Therefore, this paper aims to provide a framework elaborating both the methods and their anticipated processes. With this conceptual explication, we hope to encourage researchers and practitioners to turn from whether tailoring works to more specific questions that open up the ‘black box’ of tailoring: ‘What aspects of tailoring work?’ and ‘How does tailoring work?’
Thus, after an initial section clarifying the meaning of tailoring, the next section identifies two overall goals implicitly present in tailored communications. First, tailoring often aims to either alter message processing or make message acceptance more likely by addressing cognitive preconditions of processing or acceptance. Alternatively, other tailoring focuses its efforts on the immediate behavioral determinants of the outcome goal. Given these goals, the next section proposes three basic tailoring strategies for achieving these goals: (i) overt demonstrations or claims of ‘personalization’, (ii) ‘feedback’ to recipients of what is known about them and (iii) ‘content matching’ based on recipients' personal data. The resulting 2 × 3 goals-by-strategies matrix clarifies a wide range of specific tailoring tactics and psychosocial mechanisms by which strategies might affect goals and thus suggests a richer and more precise understanding of tailored health communication to be applied in program development and evaluation. A final section identifies several research issues.
As we discuss mechanisms and strategies, however, we should be clear that a thorough review of tailoring research is not our purpose; that has already been done well by a number of articles cited above. In particular, although our discussion will cite examples of extant research or theory for clarity where available, we want to be clear that some parts of this framework either have thus far been taken for granted by researchers or represent suggestions and speculations by the authors about future research directions.