Abstract
BackgroundHealth risk assessments with tailored feedback plus health education have been shown to be effective for promoting health behavior change. However, there is limited evidence to guide the development and delivery of online automated tailored feedback.ObjectiveThe goal of this study was to optimize tailored feedback messages for an online health risk assessment to promote enhanced user engagement, self-efficacy, and behavioral intentions for engaging in healthy behaviors. We examined the effects of three theory-based message factors used in developing tailored feedback messages on levels of engagement, self-efficacy, and behavioral intentions.MethodsWe conducted a randomized factorial experiment to test three different components of tailored feedback messages: tailored expectancy priming, autonomy support, and use of an exemplar. Individuals (N=1945) were recruited via Amazon Mechanical Turk and randomly assigned to one of eight different experimental conditions within one of four behavioral assessment and feedback modules (tobacco use, physical activity [PA], eating habits, and weight). Participants reported self-efficacy and behavioral intentions pre- and postcompletion of an online health behavior assessment with tailored feedback. Engagement and message perceptions were assessed at follow-up.ResultsFor the tobacco module, there was a significant main effect of the exemplar factor (P=.04); participants who received exemplar messages (mean 3.31, SE 0.060) rated their self-efficacy to quit tobacco higher than those who did not receive exemplar messages (mean 3.14, SE 0.057). There was a three-way interaction between the effect of message conditions on self-efficacy to quit tobacco (P=.02), such that messages with tailored priming and an exemplar had the greatest impact on self-efficacy to quit tobacco. Across PA, eating habits, and weight modules, there was a three-way interaction among conditions on self-efficacy (P=.048). The highest self-efficacy scores were reported among those who were in the standard priming condition and received both autonomy supportive and exemplar messages. In the PA module, autonomy supportive messages had a stronger effect on self-efficacy for PA in the standard priming condition. For PA, eating habits, and weight-related behaviors, the main effect of exemplar messages on behavioral intentions was in the hypothesized direction but did not reach statistical significance (P=.08). When comparing the main effects of different message conditions, there were no differences in engagement and message perceptions.ConclusionsFindings suggest that tailored feedback messages that use exemplars helped improve self-efficacy related to tobacco cessation, PA, eating habits, and weight control. Combining standard priming and autonomy supportive message components shows potential for optimizing tailored feedback for tobacco cessation and PA behaviors.
Highlights
BackgroundHealth risk assessments plus feedback and additional educational approaches have been shown to be effective for supporting health behavior change [1]
There was a three-way interaction between the effect of message conditions on self-efficacy to quit tobacco (P=.02), such that messages with tailored priming and an exemplar had the greatest impact on self-efficacy to quit tobacco
Findings suggest that tailored feedback messages that use exemplars helped improve self-efficacy related to tobacco cessation, physical activity SCT (PA), eating habits, and weight control
Summary
Health risk assessments plus feedback and additional educational approaches have been shown to be effective for supporting health behavior change [1]. Online delivery of health risk assessments and tailored feedback present opportunities for greater reach and dissemination of effective health interventions that have the potential to lower costs, alleviate barriers to participation, and facilitate adherence to healthy behaviors. A large body of evidence supports the efficacy of tailored communications for promoting healthy behaviors (eg, [2,4,5,6,7]), there is limited evidence to guide the optimal presentation of automated tailored feedback on health behavior data to individuals [8]. Health risk assessments with tailored feedback plus health education have been shown to be effective for promoting health behavior change. There is limited evidence to guide the development and delivery of online automated tailored feedback
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