Table 2.

Patient Perspectives on Tailored Messages: Qualitative Themes, Sample Quotes, and Focus Groups in Which Themes Emerged

Preferences for tailored outreach messages		Concerns about tailored outreach messages
Privacy
“…if I did receive this as a real letter today, I would be happy. I would feel good about it because it feels like I’m not lost in the whole network of being a [health system] patient…I’m not really concerned about the privacy because this is all within [the health system].” Focus groups (3): Filipina; Mexican American; non-Hispanic white		“…it concerns me that it had so much information about my health. And I’m assuming it’s a template format that someone is kind of typing it in, sort of like, oh, it probably has like a database, and then all my health information is there. I will be wondering who typed up this letter. And it’s probably not my doctor who wrote this. It has to be somebody out there who somehow has my health record and is mailing this out to me…I did not like it at all.” Focus groups (2): Chinese American; Filipina
Authenticity
• “This way, someone is coming to me and saying, ‘Hey, you   know, we know that you had gestational diabetes, you know, we   want to help you with preventative care,’ which I love the idea   that we’re getting the support and someone is reaching out, that   it’s personal. It’s not like a generalized letter that’s going to a   bunch of people…I think the personal touch is actually   something that would draw me in, versus a general letter.” • “I liked it. It’s personal. It makes me feel like, ‘Oh, wow,   someone’s checking in on me.’ So, it feels really good that you   have our personal information on there.” Focus groups (5): African American; Asian Indian; Filipina; Mexican American; non-Hispanic white		• “[The message is] very generic, right? It’s very impersonal. It’s   like just mad libs, you know, and you fill in the blank.” • “…it’s endorsed by doctors. You have the clinical director of   the [program] and you have the chief of the OB/GYN   department…it’s vetted. It’s not like from some random person.   So, that’s good, but at the same time, I don’t have any illusions   that they know who I am and that they sent this to me. Like I   know this is—[the health system is] very big. So, I know it’s   created by—generically, really, by computers and whatnot….” Focus groups (4): Asian Indian; Chinese American; Filipina; non-Hispanic white
Sender
Personal Physician	• “I would read this if it comes from my personal   physician.” • “…I really took it from a good place because it’s   coming from my healthcare provider, from my   doctors, who have the utmost, you know, concern   and, you know, respect for my health. And they’re   addressing me personally with data and information   that is absolutely true. And I just felt like, ‘Wow,   they really care!’” Focus groups (6): All	(None)
Non- Personal Physician	• “…I don’t really see my doctor as [sic] often. Maybe   I should, but to know that they’re – the higher-ups   are involved in caring for my wellness, that – it’s   important to me.” • “Everyone’s working towards your benefit, the way I   look at it. That’s been my experience with [the health   system].” Focus groups (3): African American; Chinese American; Filipina	• “If it was from my specific doctor…it kind of would trigger me   more, instead of just…a different team that I’m not used to.” Focus groups (3): Asian-Indian; Chinese American; Filipina
Risk communication
“I see it definitely being, you know, ‘Hey, we’re all part of that— we’re all concerned, and you know, we see this. Let’s again talk about it, let’s get it—let’s work on it, get it fixed.’” Focus groups (5): African American; Asian Indian; Filipina; Mexican American; non-Hispanic white		“Not taunting. I mean, I know that’s not really the purpose or the intention. But it’s—say somebody has a blemish on their face and that person knows it, and then another person like points it out. It’s, like, ‘Gee, thanks.’” Focus groups (2): Chinese American; non-Hispanic white
Clinical risk factors
• “My gestational diabetes is something I do not think about. I   mean, I literally forgot about it, and I went about my life and   busy, and you know, eating kind of whatever I wanted. I just   never thought about it, you know, so it’s definitely a good   reminder.” • “It’s certainly not appealing [laughs] to be reminded you’re   overweight. But, you know, I actually thought about this but it is   not concerning because it’s just the truth…it kind of, you know,   kind of urges you to take action because of the truth.” Focus groups (5): African American; Asian-Indian; Filipina; Mexican American; non-Hispanic white		• “…I’m struggling with my weight. I know I need to exercise,   and here you are, like, poking me. So, I feel like sad, you know,   reaction kind of, like, annoyed. Like ‘Yeah, indeed, I do need –   I mentioned my blood sugar is high and I am at a risk for   diabetes…’ It’s kind of depressing.” • “…if we went through [gestational diabetes] before, we know   that we need to be careful…the first time I read it, I found   myself, like, I kind of stopped at that point and had to go back   and re-read it because it distracted me from the positive of, ‘We   have this great service that we want to offer you.’” Focus groups (3): Chinese American; Filipina; non-Hispanic white
Ethnicity as a risk factor
• “…it’s medical evidence. There are things that affect certain   races, certain genders, more than others. And let’s just put the   facts on the table…you can’t combat the truth. This is the truth.   Let’s work on it.” • “I actually thought that it was nice that they were focusing on   problems that we have as a culture, that I have as an individual;   and certainly being of Latina origin, that plays a role in my   health. So, I think it’s a relevant factor.”   Focus groups (4): African American; Asian Indian; Filipina;   Mexican American		• “I know I’m fat. I know I’m Chinese American and I know I   have a family history of diabetes, that it’s a risk. So, the letter’s   telling me things that I know, not necessarily like the most   flattering things, and that I need to do something about it. Like,   I know that! So, I’m not sure how effective stating this   information is.” Focus groups (3): Asian Indian; Chinese American; Mexican American