Understanding the effects of printed health education materials: Which features lead to which outcomes?

Printed health education materials (HEMs) are widely used to increase aware ness and knowledge, change attitudes and beliefs, and help individuals adop t and maintain healthy lifestyle behaviors. While much of the contemporary research and development of persuasive communication is based on McGuire's input/output model, to date few studies have compared the impact of a large set of inputs across a comprehensive set of the 12 outputs. We examined th e effects of printed HEMs on weight loss on the cognitive, affective, and b ehavioral responses of 198 overweight adults. Participants were recruited v ia a newspaper advertisement and were randomly assigned to review one of th ree HEMs. Participants were interviewed and asked to complete a series of q uestionnaires both before and after viewing the HEMs. Regression analyses w ere conducted to identify the input characteristics associated with success at each of the output steps. The results revealed attractiveness, encourag ement, level of information, and application to one's life were significant ly associated with early steps (attention, liking, and understanding) as we ll as some of the mediating steps (recalling, keeping, and rereading HEMs). Later steps, such as intention to change behavior and show others, were as sociated with readiness to change, self-efficacy, and perceived application to one's life. Behavior change was more likely for those who received tail ored materials and those who had higher self-efficacy. These results provid e useful direction for the use of computers in tailoring the content of HEM s and the development of effective communication of health information on w eight loss.