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ANN ARBOR, Mich.— As much as 70 percent of a person’s chances of developing cancer can be attributed to their behavior, says Dr. Victor Strecher, who has spent the better part of two decades examining ways to help people change their behaviors to become healthier. “The problem we have” says Dr. Strecher, “is reaching as many people as mass media does, while being as effective as an interaction with an expert counselor can be.” Strecher, a professor at the University of Michigan’s School of Public Health and Associate Director of the UM Comprehensive Cancer Center, is concerned about helping populations change, not just a few individuals. With a $10 million grant from the National Cancer Institute, Strecher is forming the new University of Michigan Center for Health Communications Research, which will study how new information technology such as the Internet and digitally customized print materials can be used to tailor behavior change advice to the specific needs and interests of the user. Information on its own is not the answer to helping individuals quit smoking, lose weight, eat more fruits and vegetables, or obtain screenings to detect cancer while it’s early enough to treat. Most smokers, for example, know smoking is unhealthy, yet they keep doing it, he noted. But messages customized, or “tailored,” to each individual’s specific motives, perceived barriers, family and social environment, health history, and other relevant factors change unwanted behaviors far more than generic, one-size-fits-all information. In fact, Strecher has seen between a 50 and 300 percent improvement in participants’ ability to quit smoking, lose weight, eat more fruits and vegetables, and get essential cancer screenings after computer-tailored advice. While Strecher has seen computer-tailored messages work on health concerns from obesity to regular mammograms, what remains unclear is how and why they work. To better understand ways of optimizing the help they can provide, the Center for Health Communications Research teams health experts with UM statisticians and biostatisticians, who will build complex sequential experimental designs to figure out which elements of a tailored message change behavior. Dr. Roderick Little, UM professor of biostatistics, will head the data analysis team. Drs. Vijay Nair and Susan Murphy, professors of statistics, will create the experimental designs used to identify the “active ingredients” of tailored messages and how to optimize them to the needs and interests of the individual user. The type of tailored programs developed within Strecher’s Health Media Research Laboratory are now available to the general U.S. population and many other countries through HealthMedia, Inc., a UM technology spin-off created to disseminate tailored health products through managed care organizations, employers, universities, pharmaceutical companies, and many other channels. Strecher says that the Internet is one excellent way to deliver tailored information, replacing much of the generic information currently available through this medium. “That’s why a lot of the Internet models have failed,” he said. “Just dumping brochure content online does not accomplish what our tailored programs do.” UM researchers will look at tailored communications in three separate trials: one aimed at getting people to quit smoking, another encouraging people to eat more fruits and vegetables, and a third assisting women in deciding whether to take a specific drug to prevent breast cancer. Dr. Kenneth Resnicow, a professor of Health Behavior and Health Education in the UM School of Public Health, will direct the fruit and vegetable study. Dr. Peter Ubel, professor of Internal Medicine in the U-M School of Medicine, will direct the breast cancer prevention study. A key aspect of the new Center is the collaboration with the National Cancer Institute’s Cancer Research Network, a group of eleven pioneering Health Maintenance Organizations from around the country. The Center will collaborate initially with three of these HMO’s: Group Health Cooperative in Seattle, Washington, Henry Ford Health System in Detroit, Michigan, and Kaiser Permanente of Georgia. The Cancer Research Network is run by Dr. Ed Wagner of Group Health Cooperative; the collaboration will be directed by Sarah Greene of Group Health Cooperative. Strecher expects early results about two to three years into the five-year study. Determining how best to influence behavior has implications for HMOs and doctors, as well as health-focused agencies like the American Cancer Society and private businesses like Weight Watchers or Jenny Craig, Strecher said. Strecher is professor of health behavior and health education at the U-M School of Public Health, director of the Health Media Research Laboratory, and associate director for cancer prevention and control at the U-M Comprehensive Cancer Center. In addition to the University of Michigan, Saint Louis University, University of Wisconsin, and the University of Pennsylvania are receiving similar grants from the National Cancer Institute. Strecher’s faculty profile:
http://www.sph.umich.edu/iscr/faculty/profile.cfm?uniqname=strecher
For further information contact: Colleen Newvine cnewvine@umich.edu, (734) 647-4411
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