When Targeted Health Messages Are Too Close for Comfort

Public health advocates try to convince people to adopt all kinds of behaviors, from exercising to getting screened for diseases to receiving life-saving vaccines. But what sorts of messages encourage people to take action and protect their health? One common strategy is making the message relevant for recipients. For example, communicators might distribute a message specifically to groups who they think are at higher risk of developing a particular health problem or incorporate personal information about the recipient into the message. This strategy has merit; researchers have shown that relevant messages usually increase recipients' engagement with the messages.

One way to ensure that a message is relevant is through information targeting, in which messages are delivered specifically to audiences believed to be at higher risk for a health condition or disease. For example, a doctor might talk about or distribute brochures about breast cancer more with women than men because women are more likely to develop breast cancer. In this way, doctors are targeting breast cancer information to women.

In light of recent pushes to develop and distribute health messages based on recipients' personal characteristics, my colleague and I wanted to know how Black adults would respond to health messages that they received because of their race. While the use of race could make the message more relevant, being Black is highly stigmatized in the U.S. We expected that when Black adults received race-based targeted messages, they would become more concerned about how their race is perceived by others, which could ultimately make such messages backfire.

Reacting to Racially Targeted Messages

First, we wanted to know if receiving health messages that are ostensibly racially targeted raises alarm for all recipients or only for people with a stigmatized racial identity. So, in an online study, 200 Black and 201 White adults received a message about HIV or flu. For some of these participants, we aroused suspicions that the message they received was racially targeted. These participants first reported some of their demographic information (including their race) and were then told that they were receiving a health message about HIV or flu due to the demographic information they provided. Other participants were told that the HIV or flu message they received was decided at random by a computer algorithm. In reality, whether they got one message or the other was random for everyone, and neither message contained any references to race.

We found that when Black adults thought they were given a message because of their race rather than random selection—whether it was the HIV or flu message—they believed that they were being negatively judged based on their race. The more they felt judged, the less they paid attention to the message and the less they trusted the message provider. White adults, however, didn't respond any differently when they thought they received a racially targeted or randomly chosen message.

In a follow-up study, we wanted to know if Black adults would still show negative responses to targeted health messages when the message directly referred to race. Therefore, we invited 381 Black adults to participate in the study, half of whom we again led to believe were getting a message based on their demographics. This time, that message was always about HIV and specifically discussed the elevated HIV rates for Black Americans. The other half simply saw a message that discussed HIV rates in America without mentioning race.

As in the previous study, when these participants thought they were given information about HIV specifically because they were Black, they became more concerned about being judged based on their race, which led them to pay less attention to the message and report lower trust in the message provider. This also had further implications, like lower motivation to perform recommended HIV prevention behaviors.

When Targeted Messages Go Awry

Should messages try to engage recipients by incorporating information about their race? We found that when Black Americans believe that they are receiving health messages about HIV or flu because of their race, they experience worse outcomes because they feel they're being negatively judged based on their race. It's worth emphasizing, though, that targeting only seemed to backfire when the recipient's race is stigmatized in society (Black Americans) and did not backfire if their race is not stigmatized (White Americans).

Overall, efforts to make messages more engaging and relevant may have the opposite effect for Black Americans when they believe that they are being negatively judged due to their race. Health messages may be better received if they focus on incorporating important cultural values instead of superficial characteristics like membership in a certain social group, or if they include statements that express support of Black individuals.

For Further Reading

Derricks, V., & Earl, A. (2023). Too close for comfort: Leveraging identity-based relevance through targeted health information backfires for Black Americans. Journal of Communication. https://doi.org/10.1093/joc/jqad022

Derricks, V., & Earl, A. (2019). Information targeting increases the weight of stigma: Leveraging relevance backfires when people feel judged. Journal of Experimental Social Psychology, 82, 277-293. https://doi.org/10.1016/j.jesp.2018.12.003

Huang, Y., & Shen, F. (2016). Effects of cultural tailoring on persuasion in cancer communication: a meta-analysis. Journal of Communication, 66(4), 694-715. https://doi.org/10.1111/jcom.12243

Veronica Derricks is an Assistant Professor in the Department of Psychology at Indiana University-Purdue University Indianapolis. Her research focuses on understanding how social identity shapes responses to persuasive appeals, particularly in health contexts.