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Applying the Stages of Change Model

Over the past several years, both marketers and customers have become much more savvy about the ways that marketers "tailor" catalogues, fundraising letters, and other appeals to individuals and segments of the population. Furthermore, computers and other new technology have made it possible to create and distribute highly customized materials.

When you get a Publisher's Clearinghouse Sweepstakes envelope in the mail, it tells you that you may already be a winner. Yes, you! There's your name on the envelope, confirming that this piece of mail is relevant because it's just for you. Tailored health messages are a practical application of this concept of personalization.

Tailored health messages build on information about individuals and their behavior change situations. By learning about an individual's particular stage of change and how that person views the pros and cons of changing a behavior, designers of tailored health messages can craft information that pushes the right buttons because it is relevant and useful to that individual at that particular stage in the change process.

Precontemplators with one set of characteristics might receive one behavior change message while people who are ready to change could receive another, different message. For example, a group of smokers (perhaps identified by their doctor) voluntarily answers a telephone survey about how long they have smoked, how many cigarettes they smoke every day, whether they have tried to quit before, and what their motivation for quitting is now. The survey results are used to classify each smoker into his or her stage of change. Then, each smoker receives an encouraging newsletter at regular intervals.

Those who are precontemplators might be given information to raise their awareness or shift their attention to the health of others (such as small children living in the same household). People in the preparation stage might receive helpful hints about how to make their first attempt at quitting more successful — such as letting friends and family members know about their effort, enlisting their support, and avoiding social situations that may trigger cravings for cigarettes.

Tailored health messages have been shown to be more successful than conventional health messages in changing behavior in a wide variety of settings and for many different behaviors, including smoking cessation, reducing dietary fat intake, increasing physical activity, and getting mammograms and childhood immunizations. Because they make the information more relevant, people pay more attention and are more likely to act on it. Learning the participants' stages of change allows the messages to be as relevant and useful as possible.

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