Results Summary

PCORI funded the Pilot Projects to explore how to conduct and use patient-centered outcomes research in ways that can better serve patients and the healthcare community. Learn more.


Research has shown that customized email messages can help motivate people to take steps to improve their health. Computer programs can create customized, or tailored, email messages based on information about a person. This can be done in two ways:

  • Standard tailoring. The computer program uses a set of rules to select messages for a person based on that person’s characteristics. For example, if someone is a smoker, the computer program might send a message like “Quitting smoking will make your teeth look much nicer.”
  • Content tailoring. The computer program looks at what a person does online, what similar types of people do, and uses machine learning to select the messages for the person. For example, if a person visits parenting websites and buys diapers, the program may recommend messages about baby food.

Content tailoring has not been well tested for communicating health messages.


The research team developed a content tailoring program that used data to learn about users and decide which messages to send them. The research team compared the new program with a standard tailoring program that was already shown to help people stop smoking.

A total of 120 current smokers took part in the study. All participants were age 18 or older, spoke English, and had access to the Internet. When participants joined the study, researchers asked about their age, sex, race and ethnicity, how much they smoke, whether they have tried to quit smoking before, and whether they felt ready to quit smoking.

The research team then randomly split participants into two groups: one group got emails from the standard tailoring program, and the other group got emails from the content tailoring program. Participants in both groups got emails for 30 days. Each email asked participants to rate whether they thought the message would help them quit smoking.

After 30 days, researchers contacted participants and asked whether the messages helped them take steps to quit and whether they had stopped smoking for at least one day during the study. The research team looked at how each group rated the daily messages. To see which computer program worked better, the research team looked at

  • How many people quit smoking during the study
  • How many people said the messages were motivational


Compared with participants in the standard tailoring group, participants in the group using the content tailoring program were more likely to say that the messages motivated them to quit smoking.

About the same number of participants in each group said they stopped smoking for at least one day by the end of the study.


Researchers asked people only at the end of the study if they had quit smoking for at least one day. The results might be different if the research team had asked again six months after the study started or asked if they had quit for longer than one day.


Smokers who got messages from the content tailoring program were more likely to say that the messages were motivational than smokers who got messages from the standard tailoring program. Both programs helped about the same number of participants quit smoking for at least one day.

Sharing the Results

The research team has published the results of this project in medical journals (see below) and given talks at scientific meetings.

Project Information

Thomas K. Houston, MD, MPH
University of Massachusetts Medical School
Patient Experience Recommender System for Persuasive Communication Tailoring

Key Dates

June 2012
June 2015

Study Registration Information


Has Results
Award Type
Funding Type
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: March 4, 2022