Table 5.

▪ Summary of Targeted and Tailored Interventions, Categorized by Delivery Device

Author[s]	Methods	Health Behavior	N	Results	Score
Mobile Communications:
Facchinetti & Korman, 1996,62199863	Quasi-experimental controlled trial	Medication adherence: reduce drug holidays	24	Text pager improved adherence, reduced number of “drug holidays” and total number of days without therapy.	4
	Reminder system vs. control
	Targeted, asynchronous
	(PRN: Prescription Reminder Network)
Milch et al.,199664	Quasi-experimental	Medication adherence: increase compliance	6	Mean compliance rose from 56% to 96% during pager use.	1
	Medication use before (control period) and during pager use
	Targeted, asynchronous
	(Neuropage)
Dunbar et al., 200065	Quasi-experimental	Medication adherence: increase compliance	26	Patients on HIV medications reported high acceptance of paging system.	2
	Interactive reminder system
	Targeted, synchronous
	(CareWave)
Computer Systems:
Shultz et al.,199257	RCT: Transmission of glucometer results via modem once a week vs. standard diary results	Diabetes: reduce blood glucose levels	20	Significant improvement in reduced blood glucose levels in modem intervention group over traditional diary group.	6
	Targeted, synchronous
Turnin, 199258	RCT: Diabeto use (computer-aided instruction) vs. no Diabeto use	Diabetes: increase dietetic knowledge and improved diabetes self-care	105	Diabeto use associated with significant improvement in dietetic knowledge, some decrease in caloric excess in overeaters, decrease in fat intake in over-consumers, increase in carbohydrate intake in under- consumers; no impact on caloric deficit.	9
	Tailored, synchronous
	(Diabeto)
Buchanan et al., 1993,59 199560	Quasi-experimental	Migraine: improve understanding of migraines	16	Presentation of information based on individual patient's medical record, concerns, questions, and physician input.	1
	Interactive explanation system			System “accepted by patients.”
	Tailored, synchronous
	(Migraine)
Carenini et al., 199461	Quasi-experimental	Migraine: improve understanding of migraines	16	Presentation of information based on individual patient's medical record, concerns, questions, and physician input.	1
	Interactive explanation system			Patients “found system useful.”
	Tailored, synchronous
	(Migraneur)
Gustafson et al., 1994,55 199956	RCT: CHESS use vs. no CHESS use	Information and support: improve social support, mood, and quality of life	204	CHESS users reported improved cognitive functioning, sense of social support, and more active life; reported more participation in health care and decreased levels of negative emotions.	9
	Tailored, synchronous			No significant differences between groups for depression, physical functioning or reported level of energy.
	(CHESS: Comprehensive Health Enhancement Support System)
Binsted et al., 199580	Quasi-experimental	Diabetes: improve diabetes self-care	10	Generation of diabetes information collected through medical record; includes personalized reminders.	1
	Interactive explanation system			Patients and medical staff found system helpful and easy to use.
	Tailored, synchronous
	(PIGLET: Personalized Intelligent Generator of Little Explanatory Texts)
McRoy et al., 199883	Quasi-experimental	Medical history taking: increase understanding of medical conditions and treatment	35	User satisfaction measured via online questionnaire: 87% of users completed evaluations; 87% prefer online system to paper.	1
	Generation of customized educational materials and medical explanations			Other findings: users like having medical information tailored to their interests; 71% found definitions somewhat or very helpful; 58% found dialog sections helpful.
	User satisfaction questionnaires completed online
	Tailored, synchronous
	(LEAF: Layman Education and Activation Form)
Jones et al., 1996,81 199982	RCT: Personalized cancer information (P) vs. general cancer information output via “computer consultation” (G) vs. cancer booklet (B) information group	Information and support: increase understanding of cancer information	525	P reported higher satisfaction with information, thought information was relevant, and learned something new.	9
	Tailored, synchronous			B more likely to feel overwhelmed by information than P or G. P and G thought information was limited.
				Printed information use at home: 83% B; 57% G; 70% P.
				P and G groups also sent printouts of information viewed; P more likely to use this information than G.
Rolnick et al., 199954	RCT: CHESS use vs. no CHESS use (included receiving a book related to either HIV or breast cancer)	Information and support: improve social support, mood and quality of life	107	HIV group: discussion service used more often (time and number of uses).	9
	Targeted, synchronous			Breast cancer group: discussions were “disease-based.”
	(CHESS)
Automated Telephone Communications:
Ahring et al., 199251	RCT: Transmission of glucometer results via telephone once a week vs. standard diary results every 6 weeks	Diabetes: reduced blood glucose levels	42	Significant difference in blood glucose levels between 6-week and 12-week experimental groups.	6
	Targeted, asynchronous			Approximately two thirds of experimental group expressed increased understanding of blood-glucose control, motivation for self-management and general knowledge about diabetes.
Stehr-Green 199349	RCT: Computer-generated telephoned immunization reminders vs. control	Preventive health: increase immunization rate	222	11.6% improvement in immunization rates in intervention group. On-time immunizations: 52.9% intervention, 41.3% control.	9
	Targeted, asynchronous.
Friedman et al., 1996,44 199745	RCT: TLC use vs. no TLC use (control)	Hypertension: increase medication compliance and lower blood pressure	267	Medication adherence: improved 17.7%–18% in TLC, 11.7%–12% in control. If nonadherent at baseline: 36% improvement TLC, 26% control.	10
	Tailored, synchronous			Blood pressure: mean systolic and diastolic blood pressure decreased in both groups.
	(TLC: Telephone-linked Care)
	Model: social cognitive theory
Hyman et al., 199650	RCT: Computer-interactive phone call re: total cholesterol and weight vs. no call (control)	Preventive health: decrease cholesterol level and body weight	115	Subjects recruited from those who completed a 4-week cholesterol behavioral and diet program.	9
	Targeted, synchronous			No significant difference between experimentals and controls.
Baer and Geist, 199784	Quasi-experimental	Mental health: increase adherence to behavior therapy program	65	Patients who completed two or more phone sessions were “greatly improved.”	2
	Computer-administered behavior therapy program (BT STEPS) using interactive voice response (IVR)
	Tailored, synchronous
	Model: “behavioral theory”
Jarvis et al., 199747	RCT: TLC vs. control	Physical exercise: increase activity	52	Increase in stage of change: TLC 88%, control 62%.	7
	Tailored, synchronous
	Model: stages of change
Piette and Mah, 199753	Feasibility study	Diabetes: improve diabetic self-care	65	98% reported no difficulty under-standing and responding to AVM queries. AVM system could identify potentially serious health problems. 71% were willing to listen to preventive care messages.	2
	Automated voice message (AVM) calls vs. no calls
	Targeted, synchronous
Friedman, 199846	RCT: Report of three TLC studies: hypertension medication adherence (MA); dietary modification (DietAid); exercise (ACT)	Hypertension: increase medication adherence and lower blood pressure	267	MA: 18% mean adherence improvement in TLC users vs. 12% control. TLC diastolic blood pressure reduction 5.2 mm Hg vs. 0.8 mm Hg in control.	10
	TLC use vs. no TLC use (control)	Physical exercise: increase activity		DietAid: TLC reduced mean total cholesterol vs. no change in control.
	Tailored, synchronous			ACT: TLC increased walking to 121 min/week vs. 40 min/week in control.
	Models: social cognitive theory, stages of change
Lieu et al., 199848	Randomized trial: Automated telephone call (TC) vs. letter only (L) vs. TC followed by L (TC+L) vs. L followed by TC (L+TC)	Preventive heath: increase immunization rate	648	TC+L and L+TC led to significantly higher immunization rates than L or TC.	8
	Targeted, asynchronous
	Model: health belief
Meneghini et al., 199852	Controlled trial	Diabetes: lower diabetes or hypoglycemic crises and emergency room visits	107	58% of clinic patients used ECM.	5
	Daily report of self-measured glucose levels or hypoglycemic symptoms via voice-interactive phone system vs. no ECM use			Three-fold decrease of diabetes-related crises or hypoglycemia in ECM group. Two-fold decrease in clinic visits of complex diabetes management issues.
	Targeted, synchronous
	(ECM: Electronic Case Manager)
Print Communications:
Prochaska et al., 199341	Randomized assignment via stage of change	Smoking cessation: abstinence from smoking tobacco	756	ITT outperformed other conditions at each f/u point and demonstrated higher prolonged abstinence rates than other groups.	8
	Standardized self-help manual (ALA+) vs. manual matched to stage (TTT) vs. interactive computer report plus individualized manual (ITT) vs. four counselor calls plus stage manual plus report (PITT)
	Tailored, asynchronous
	Model: stages of change
Campbell et al., 199426	RCT: Well-child appointment letter vs. postcard vs. control	Preventive health: increase immunization rate	558	Letter and postcard rates significantly higher than control rates (75.0%, 73.7%, and 67.5%, respectively).	10
	Targeted, asynchronous			No difference between letter and postcard groups.
	Model: health belief model
Campbell et al., 199431	RCT: Multicenter study.	Nutrition: lower fat intake	558	Tailored group was more than twice aslikely as non-tailored group to remember receiving information.	10
	Tailored nutrition information packet vs. non-tailored packet vs. control			Tailored group significantly reduced total fat and saturated fat intakes compared with control.
	Tailored, asynchronous
	Models: health belief model; stages of change
Osman et al., 199489	RCT: Computer-generated tailored asthma education booklet (BI) vs. standard oral education (control)	Asthma: decrease hospital admissions	801	BI associated with reduction in hospital admissions for patients judged most vulnerable on study entry.	9
	Tailored, asynchronous
Rimer and Orleans, 199486	Controlled trial	Smoking cessation: abstinence from smoking tobacco	901	GC used Clear Horizons Guide tailored to older adult population.	8
	Tailored guide and counselor calls (GC) vs. standard guide (G) vs. control (CO)			20% of GC reported not smoking 12 months after intervention vs. 12% of G.
	Tailored, asynchronous			Higher proportion of both GC and G used quitting techniques, were more likely to set a quit date and use nicotine reductiontechniques than controls.
Skinner et al., 199429	RCT: Individualized mammogram recommendation letters vs. standard letter	Preventive health: increase mammogram rate	435	Individualized letter recipients were more highly associated with mammogram follow-up if income<$26,000 or if African-American.	10
	Tailored, asynchronous			Overall, individualized letters were better remembered and more thoroughly read than standard letters
	Model: stages of change			Higher-educated women less likely to report interest in content.
Strecher et al., 199443	RCT: Tailored letter vs. generic letter vs. control	Smoking cessation: abstinence from smoking tobacco	51 &197	Younger smokers more likely to quit	10
	Tailored, asynchronous			Significant effects of tailored letters only for moderate to light smokers.
	Models: health belief, stages of change
Brug et al, 1996,32 1998,33 1999a,34 1999b35	RCT: Tailored vs. non-tailored1996 and 1999b: Tailored vs. general nutrition information	Nutrition: lower fat intake, increase fruit and vegetable intake	1996, 1999b: 347	1996: Significant short-term effect of tailored messages on fat intake and opinions about vegetable and fruit intake. No significant effect on fruit and vegetable intake.	10
	1998: Tailored letter and iterative feedback (TI) vs. tailored letter (TL) vs. general letter (CO)		1998: 762	1998: TI and TL lower mean fat scores than CO. TI and TL higher mean vege- table scores than CO. No significant differences between TI and TL groups.
	1999a: Tailored feedback vs. tailored feedback and psychosocial information letter		1999a: 315	1999a: Significant reduction in mean fat score. Mean fruit intake increase. No vegetable change.
	Tailored, asynchronous			1999b: Personalized dietary and psycho- social feedback more likely to be read, seen as personally relevant and motivating to reduce fat intake.
	Models: social cognitive theory, theory of planned behavior
Kreuter and Strecher, 199688	RCT: Enhanced health risk assessment (HRA) vs. standard HRA vs. control	Preventive health: decrease fat intake and cholesterol and increase activity	1,317	Each behavior analyzed separately.	10
	Tailored, asynchronous			Enhanced HRA led to statistically or nearly statistically significant effects for cholesterol test, fat reduction, and exercise.
	Models: health belief, stages of change
Campbell et al., 199767	RCT: Risk result feedback vs. control	Preventive health: increase Pap test rate	411	No statistical difference between groups.	9
	Targeted, asynchronous			Women 50 to 70 years old who received results were “more likely” to have a Pap test in the next 6 months.
Baker et al., 199825	RCT: Personalized targeted reminder letter from physician vs. personalized postcard from physician vs. generic postcard vs. control	Preventive health: increase influenza immunization rate	24,743	64% of targeted letter group remembered reminders vs. 39% combined postcard groups.	9
	Targeted, asynchronous			Targeted letter more effective than either postcard intervention.
Dijkstra et al., 199839,42	RCT: Information on outcomes of quitting (O); self-efficacy-enhancing information (SE); O + SE; or no information (CO)	Smoking cessation: abstinence from smoking tobacco	752	Subjects considering change benefited most from O + SE intervention; those planning to quit benefited most from SE intervention.	10
	Tailored, asynchronous			Significantly more smokers in O, SE, and O + SE interventions attempted 24-hour quits.
	Model: stages of change
Dijkstra et al., 199838	RCT: 3 tailored letters and self-help guide (3TS) vs. 3 tailored letters only (3T) vs. 1 tailored letter and self-help guide (TS) vs. 1 tailored letter only (T) vs. non-tailored intervention (CO)	Smoking cessation: abstinence from smoking tobacco	752	3TS and 3T: more stage transition; higher intention to quit than CO; higher impact than TS or T.	10
	Tailored, asynchronous			TS led to more quitting behavior than CO.
	Model: stages of change			No difference between T and CO.
				In heavy smokers, tailored messages did not lead to more quitting than TS, T, or CO.
Greene and Rossi, 199836	RCT: 1 dietary feedback report and educational materials vs. control. Fat intake and stage-of-change assessments at 0, 6, 12, and 18 months	Nutrition: lower fat intake	296	Rate of progression to action stage by 18 months was found in 9%–12% of subjects in precontemplation or contemplation stage; 24% preparation stage subjects; 40% unclassified subjects.	10
	Targeted, asynchronous
	Model: stages of change
Marcus et al., 199885	RCT: Individual motivationally-tailored reports (IT) VS. standard self-help booklets (ST)	Physical exercise: increase activity	194	IT: significant increase in physical activity each week and self-reported time exercising; more likely to reach action stage of motivational readiness for physical activity adoption.	10
	Targeted, asynchronous
	Models: stages of change, health belief
Bastani et al., 199927	Randomized 2-group design	Preventive health: increase mammogram screening	901	8% increase in mammography after intervention.	10
	Educational booklet and personalized health risk letter			No intervention effect in women under 50 years of age.
	Tailored, asynchronous
Bull et al., 199968	Clinical controlled trial	Physical exercise: increase activity	763	No significant differences between groups.	10
	Tailored pamphlet vs. standard pamphlet vs. control
	Tailored, asynchronous
	Model: stages of change
Campbell et al., 199987	RCT: Multi-level, multi-component intervention	Nutrition: lower fat intake, increase fruit and vegetable intake	459	Recall receiving bulletin: 72.9% SPIR, 64.6% EXP, 38.2% control.	10
	Bulletin-orientations: expert (EXP) vs. spiritual and pastor-oriented (SPIR) vs. standard			High trustworthiness: 63.5% SPIR, 53.6% EXP, 48.6% control.
	Tailored, asynchronous			High credibility: 45% SPIR, 31% EXP, 33% control.
	Model: stages of change			Fruit/vegetable intake: SPIR did not differ significantly from EXP. SPIR and EXP mean consumption significantly higher than control.
				High impact of pamphlets: 58% SPIR, 45% EXP.
Dijkstra et al., 199940	RCT: Multiple tailored (MT) vs. single tailored (ST) letters vs. standard self- help guide (SHG) vs. control (CO)	Smoking cessation: abstinence from smoking tobacco	843	MT had more effect than SHG or ST.	10
	Tailored, asynchronous			ST had more effect than CO.
	Model: stages of change
Lutz et al., 199937	RCT: Tailored newsletter with tailored goal-setting component (TG) vs. tailored newsletter without goal-setting component (T) vs. non-tailored newsletter (NT) vs. control (CO)	Nutrition: increase fruit and vegetable intake compared with control	710	Daily fruit and vegetable intake was higher for all 3 newsletter groups	10
	Tailored, asynchronous			Differences from baseline to post-intervention were greatest in TG; next was T, then NT.
	Models: social cognitive theory, stages of change			No statistically significant differences among tailored newsletter groups.
Myers et al., 199930	RCT: Minimal intervention (MI) vs. enhanced intervention (EI)	Preventive health: increase prostate cancer screening rate	413	Age of 50 years or older positively associated with adherence. Married men more likely to adhere. Belief in having an early detection exam in the absence of symptoms predicted adherence.	10
	Tailored, asynchronous
	Model: preventive health, a combination of health belief model, theory of reasoned action, and social cognitive theory
Raats et al., 199966	Clinical trial.	Nutrition: lower fat intake	171	No real difference between groups.	8
	Tailored feedback vs. no feedback
	Tailored, asynchronous
	Model: theory of planned behavior
Rimer et al., 199928	Randomized trial	Preventive health: increase Pap and mammogram screening rates	1,318	TPC+TTC did not perform better than PI.	8
	Provider prompting alone (PI) vs. provider prompting and tailored print materials (TPC) vs. provider prompting and tailored print materials and tailored phone counseling (TPC+TTC)			TPC+TTC: 35%–40% increase for Pap tests and overall cancer screening.
	Tailored, asynchronous			Subgroup findings: TPC+TTC most effective on Pap among women who worked for pay and those who viewed interventions as “meant for them.” TPC+TTC most effective for mammo- graphy among married women.
	Model: stages of change
Velicer and Prochaska, 199990	Report of 4 studies	Smoking cessation: abstinence from smoking tobacco	756 to 4,144	Cessation rates: 22%–26%	8
	Computer-generated (Pathways to Change expert system intervention) tailored report
	Tailored, asynchronous
	Model: stages of change

Notes: RCT indicates randomized controlled clinical trial.