Message Frame–Tailoring in Digital Health Communication: Intervention Redesign and Usability Testing (Preprint)

Abstract

BACKGROUND Message frame-tailoring based on the need for autonomy is a promising strategy to improve the effectiveness of digital health communication interventions. An example of a digital health communication intervention is PAS, an online content-tailored smoking cessation program. PAS was effective in improving cessation success, but its effect sizes were small and disappeared after six months. OBJECTIVE We aim to improve the effectiveness of PAS further by incorporating message frame-tailoring, providing smokers with autonomy-supportive or controlling message frames – depending on their individual need for autonomy. METHODS Various methods were used to redesign the PAS program to include message frame-tailoring with optimal usability: usability testing, think-aloud methodology, heuristic evaluations, and an online experiment. RESULTS The most autonomy-supportive and controlling message frames were identified, the cut-off point for the need for autonomy to distinguish between people with a high and low need for autonomy was determined, and the usability was optimized. CONCLUSIONS This resulted in a redesigned digital health communication intervention that included message frame-tailoring and had optimal usability. A detailed description of the redesigning process of the PAS program is provided.