‘You must drink less’ – and why this message often doesn’t work

Eline Smit received a Veni grant for research into tailor-made health communication.

A large proportion of the population maintains an unhealthy lifestyle despite the huge volume of health advice provided by online and offline media. Eline Smit suspects that the key to this problem may well be the way people are spoken to. She has been awarded a Veni grant for research into tailor-made communication on healthy living.During Smit’s time as both a student and a PhD candidate, she examined the effects of online and offline health communication. “What fascinates me so much is that people know how important a healthy lifestyle is, for example, in order to prevent chronic illnesses, but they still persist in their unhealthy habits. I started to wonder why this is and how communication can help people to maintain a healthier diet.

Lack of autonomy
What strikes Smit the most about health communication is that it is often authoritarian: “Many sites use words like ‘must’ and ‘should’ all the time. There is also a lack of choice as readers are often given just one option. It may well be that people are irritated by a feeling that they have no autonomy, and they therefore disregard the information.  She bases this hypothesis on recent research conducted in the USA that shows that over half of the people need autonomy in this regard: to make decisions for themselves in relation to their health. “So don’t say ‘You should exercise more and you have to do it this way’, say ‘Exercising more is very positive for your health. For example, you could join a sports club, or if it suits you better, try walking to work’.”  However, not everyone feels this need for autonomy: around 40% need authority and a more directive style of communication. “I think that the percentages in the Netherlands will not differ greatly, so I’m going use this knowledge as a basis for further examination.”

Looking for an autonomy-supportive message
Smit’s research is divided into three subsections. In the first section, she will attempt to identify autonomy-supportive strategies. She will do so via two experiments in which the participants will be given texts offering either multiple options or just one option and that use either authoritative or non-authoritative language. “I expect that the feeling of autonomy will be greatest if we can use a combination of multiple options and non-authoritative language.” In the second section, the communication scientists will test the hypothesis that tailor-made communication is more effective in getting people to lead healthier lifestyles (in this case to drink less alcohol and exercise more).

Practical research
In the final subproject, Smit will investigate the effectiveness and cost-effectiveness of tailor-made health communication. This will involve practical research for which the participants will be ‘recruited’ via existing websites that offer information about drinking less and exercising more. “These sites already incorporate programmes that take all kinds of individual characteristics into account. All we will be doing is adding a tailor-made communication style. Using a questionnaire I have developed, we will determine how autonomous the person is, and he or she will then be given advice formulated in the manner that best matches his or her individual traits and personality.  During her project, she will collaborate intensively with various parties, such as the Trimbos Institute, the World Cancer Research Fund, Mentalshare Direct and Vision2Health.  “Of course, my ultimate goal is to help people live a healthier life, but for now, it is important that we learn  how to communicate with individuals in order to boost the effectiveness of online health communication.”

Link to document: Eline Smit VENI