Content Salience Drives Communication Effectiveness

This is a follow-up to one of our earlier posts in our series on how to leverage the accumulated evidence from the scientific study of persuasive communication.  That post, entitled The Power of Tailoring to Customer Psychology, was a chance for us to demonstrate why paying attention to customer psychology is such a huge lever for marketers.  Specifically, we showed that tailoring communications based on customer psychology can produce impressive improvements in the power of your communications in terms of shaping attitudes, beliefs, intentions, and behaviors.  In the world of life science marketing, we need every advantage we can get because communication effects are innately so much smaller than they are in other domains (as we discussed in Why We Can’t Expect the Same Level of Impact from Healthcare Messaging). 

In this post, we’ll explore the underlying phenomenon that makes tailored communication work – a phenomenon that we call content salience.  Content salience refers to the extent to which the topic of your communication already has personal relevance to the audience you are trying to reach (see Fiske & Taylor, 2021).  As you will see, it is a robust moderator of how effective (or not) your communication campaigns will be at updating the beliefs and attitudes held by customers.  More importantly, if we understand the extent of content salience that exists in our target audience, we can make more effective decisions about our marketing content, tone, emphasis, and channel selection.  To us, understanding salience in advance of a campaign is essential because it is the baseline from which we will evaluate what we have accomplished with a campaign.  Our goal with this post is to underscore the importance of the concept and why paying attention to it is extremely useful for understanding marketing impact.  We will also discuss some examples and how we can measure it in specific contexts.

To illustrate the power of tapping into salience, let’s revisit an example that we used in the above-referenced post on psychological tailoring.  It may be trite to point out that it can be challenging to get humans to eat healthy foods on a consistent basis.  It’s probably also trite to point out that that using marketing to get humans to eat more healthily is a big lift.  Interestingly, there’s evidence that sometimes it can be quite effective.  But (shocker) other times the effects are weak.  A simple illustration of this can be seen in comparing the results of several recent meta-analyses.  Both examined eHealth communication interventions on diet – specifically targeting an increase in fruit/vegetable consumption.  The mix of interventions used in the included studies is similar for both analytic groupings. 

Table 1.  Comparing Two Meta-Analyses of Marketing Interventions to Improve Diet

What we see is that the behavior change effect size is virtually three times larger in the first meta-analysis.  What’s the difference?  Not surprisingly, the answer lies in the different populations of humans under study.  The first analysis by Duan et al (2021) focuses on populations of people diagnosed with what they characterize as non-communicable diseases (NCD), which, in the individual studies, mostly relate to cardiometabolic conditions, such as Type II diabetes, hypertension, hypercholesterolemia, etc.  The second analysis by Rodriguez-Rocha and Kim (2019) focuses on how persuasive communications influence diet in healthy populations.  This difference is explicitly noted by Duan et al, who attribute it to the underlying psychological urgency of being formally diagnosed with conditions that are known to be mediated by diet.  In other words, the topic of diet (and its relationship to disease) is highly salient content for one of these populations, but obviously much less so for the other.  And for marketers, there is an important learning:  The degree of underlying content salience that exists with your target audience is a major driver or barrier to what you can achieve with your communications.     

These effects generalize across healthcare endpoints.  In a 2008 meta-analysis of persuasive communication effects in 60 experiments focused on changing patients’ intentions to engage in diverse health-related behaviors, Keller and Lehmann found that ingoing salience with individual study participants was a strong predictor of how persuasive the communications were.  Specifically, the average difference in the correlation between ingoing salience and intended behavior change for low-salience vs. high-salience groups was .11 – a rather robust effect in the context of healthcare messaging, as we have seen from our prior posts.  Intentions among the high-salience participants were more positively responsive to communications, whereas participants with low content salience actually showed a negative reaction to persuasive communications (that is, their behavioral intentions moved in the opposite direction).  As we will see shortly, the direction of the content salience effect varies as a function of how customers are engaging with the topic.

For those readers with an appetite for more data, please consider reviewing The Power of Tailoring to Customer Psychology, on our website.  But to save you time, a summary of our synthesis of that literature is below.  On balance, the reason that tailored communications work is because they capitalize on content salience.  The main take-away from our prior post was that the more your communication can either align to or prime salience for your customers, the more effective it will be.  And the results are not trivial.  You can reasonably expect to get a 2x to 3x lift in the persuasive power of your communications by using tailored communications that are deeply salient to customers.

Table 2.  Meta-Analytic Results of Using Tailored Communications to Increase Salience

The concept of salience goes by various names in the scientific literature (other terms that mean the same thing include involvement and personal relevance) and has been a topic of study for decades.  Content salience can exist for a few different reasons.1  However, for the purposes of life science marketing, we suggest that two types of salience are of special importance.

  1. Goal-Relevant Salience: The content is salient to the customer because it deals with information about the achievement of a specific goal or the fulfillment of a specific role that we play in our lives.  This idea is captured in the segmentation technique we now commonly refer to as “Jobs to Be Done,” popularized by Clay Christianson.  Whether your audience happens to comprise patients, treaters or access stakeholders, most of the time their engagement will be driven by goals that they are trying to fulfill in their personal or professional lives.
  2. Value/Identity-Relevant Salience:  The content is salient to the customer because it deals with an idea that is important to the person’s views on life, personal ethics or values, or because it links to membership in a group that is important to the customer’s sense of self (identity).  While this is less common in the domain of life science, it does emerge in interesting ways.  For example, we sometimes observe identity-relevant salience emerging with deep specialists and thought-leaders because content may be challenging their sense of how they should be seen as a member of that group.  This kind of salience can also exist as a simple function of genuine intellectual interest, as is sometimes true when humans develop keen interest in topics that have nothing to do with their day-to-day roles and goals. 

Another way in which we encourage clients to think about salience is that it can exist on either at different intensities before and after communication exposure.  We specifically draw the following distinction.

  • Ingoing Salience:  This is the degree of personal relevance that your content already has with the customer today.  If you have ever watched a qualitative concept or message test and said, “this participant just gets it!” your moderator is probably talking to a person with high Ingoing Salience.
  • Evoked Salience:  On the other hand, the whole point of marketing is to take an idea or an object and make it salient for customers for whom it was not previously relevant. Evoked salience is what we think of as the net change in salience that results from being exposed to external persuasion, such as a marketing or educational campaign. 

One important point to emphasize is that we should not always assume that content salience will result in more persuasive communications.  A better way to think about salience is that it reliably mediates the relationship between communication and downstream response, but the direction will be highly context-dependent.  For example, we should not always assume that susceptibility to a disease or the presence of a diagnosed disease are tantamount to high ingoing salience.  Though this will sometimes be true (as illustrated in the opening example), there can be cases where content salience can be lower for high-risk or already-diagnosed populations.  In such cases, we can actually see lower responsiveness to health communications. 

To understand why this is true, we can turn back to one of the classic papers in communication science.  The first major synthesis of experiments on the role of content salience was published in the late 1980s, in a now-famous article in Psychological Bulletin.  The authors, Johnson and Eagly, integrated the results of experiments dealing with persuasive communication, which they coded the included studies on several key characteristics related to this discussion:

  • In what way was the content salient to the recipient (based on personal identity or based on personal values)?
  • How strong was the case made in the persuasive communication (strong argument, weak argument)?2

Their findings are summarized in Table 3 below, and while they require a bit of unpacking, are really useful for marketers and researchers to understand.  In the table, the Effect Size is the average reported change in attitude/perception observed in each of four conditions.  For example, the first row shows the persuasive effectiveness of communications delivered in conditions where strong (well-formed and detailed) arguments were delivered to targets for whom the communication content was salient because it related to a key personal goal.  The second row shows the same kind of scenario, but this time the arguments were weak (less coherent and less substantive).   

Table 3.  How Salience Moderates the Effectiveness of Persuasive Communications

At first blush, this doesn’t look great for those of us who work on persuasion for a living.  By and large, persuasive communications designed to move people away from their initial position on a salient topic actually tended to strengthen their ingoing views.  However, the top row of the table highlights the effect that is most relevant for the overwhelming majority of persuasive situations in life science marketing:  Situations where humans are trying to achieve specific outcomes.  In this setting, the persuasive effects of well-structured, strong communications are enhanced by ingoing salience, and to a considerable degree.  That’s good news because it underscores a basic reality.  When humans are trying to achieve or get something, then a communication that coherently presents them with a way to move toward that goal will tend to be very persuasive.  On the other hand, this seminal paper also underscores that some types of salience can actually make customers more immune to persuasion.  Knowing the difference is key.

1 Readers with an interest in a more detailed look at this topic are invited to read chapter 10 of Fiske & Taylor’s wonderful book, Social Cognition. 

2 Note that Johnson & Eagly also examined a third category of salience (involvement), which focused on social scrutiny.  Because this type of salience is not terribly relevant to most healthcare contexts, we decided not to focus on it for this post. 

So, if we accept the fact that content salience is a major driver of communication effectiveness, one immediate practical implication is that it makes sense for us to know where our customers are today.  In other words, we should want to understand how salient our planned content already is among customers prior to initiating a marketing campaign.  To do this, we ordinarily create a conceptual scorecard with two basic features.

  1. What is the specific marketing objective that we have?  That is, what specific changes in customer belief, feeling, intention or behavior are we trying to achieve?
  2. What specific measures and observations would indicate the extent of customers’ current alignment to that marketing objective? 

The table below illustrates some simple examples that most life science readers will probably be able to relate to.  In the first case, imagine a disease or condition that has a complex symptom profile.  In such cases, it is common for the most prominent symptoms to get the greatest attention.  For example, treaters will be most concerned about symptoms that are organ threatening.  Whereas symptoms that deal with impediments to lifestyle might be secondary.  Our hypothetical marketer wants to encourage treaters to be more attentive to some of the softer, less urgent, and more subtle ways in which the condition influences the lives of patients.  This kind of marketing objective is common in more mature markets where decent therapies are already widely used.  As a second example, imagine that we are working in a market where treaters are not fully aligned with how disease severity should be defined.  Interestingly, we have worked in a variety of disease settings where different segments of treaters focused on completely different sets of markers to classify patient severity (and thus patient appropriateness for drugs).  Here, our marketer might be looking to reduce idiosyncrasies of severity definition by orienting customers to some specific severity cues.   With our marketing goals in hand, we would then ask ourselves how customers might differ in their current orientation to the two topics that we care about.    

Table 4. Linking Hypothetical Marketing Objectives to Measures of Salience

Obviously, we could devise lots of additional nuanced examples for each marketing topic, but the point of these hypothetical examples is just to illustrate that it is straight-forward to come up with indices of ingoing content salience among your customers.  This kind of scorecard can allow you to get a solid handle on the type and intensity of salience that your customers may already have for your planned communications, and you can evaluate these indices in a variety of ways.

Earlier, we introduced the idea of Evoked Salience.  This can be thought of as the net change in personal relevance that you activate in your customers by exposing them to your communication content.  In several of our science posts, we have referenced the truly massive 2022 meta-analysis of the persuasive communication literature by Joyal-Desmarais et al.  Among the trove of insights provided by this analysis is a nugget that directly addresses the power of evoked salience.  The basic focus of their study was on the effects of matching communication style and content to various aspects of the underlying psychology of the participants.  In some cases, the matching process was focused on the ingoing, innate psychological characteristics of the participants, but in other cases, those characteristics were directly manipulated through the communication exercises themselves – that is, the psychological state was evoked.  The effect sizes here represent downstream changes in attitudes, intentions and observed behaviors that stem from the communication.  One of my favorite things about this comparison is that it gives us a proxy for estimating (at least very approximately) the kinds of changes in salience that a customer might experience based on exposure to a well-crafted concept or message suite.  The delta reflects a roughly 25% advantage for the studies where the psychological engagement of the participants was deliberately influenced by the communication content itself.  To be clear, we would not suggest that this is some kind of lawful effect – instead, we are simply using it to underscore the point that the salience of a topic or product can be heightened directly by the communication.

Table 5.  Meta-Analytic Proxy for Ingoing versus Evoked Salience

Salience is something that customers “bring to the table” – and each customer is going to be pre-engaged with the ideas and topics we care about to different degrees.  But salience is also something we can trigger and effect.  So, salience is both a baseline for understanding your market and an outcome variable that tells us how effective our communications are.  The question of how to measure these changes is a big topic that is worthy of its own separate discussion.  We will come back to this in a future post.

Typically, whatever the topic or focus of your campaign, some customers will naturally find it more or less personally salient to them as patients or professionals.  How salient the topic already is to your customers will reliably have a mediating effect on how influential your communications can be. 

  • Most of the time, salience in life science is driven by whether the communication content is related to a specific objective or goal in the life of the recipient.  But salience can also be driven by one’s values and personal identity. 
  • Generally, well-crafted, evidence-based communications will be quite effective in shaping beliefs, attitudes and behaviors related to goal-relevant topics. 
  • However, be cautious when your topic is salient because of personal values, intellectual interest, or group identity.  In many cases, persuasive communications that run contrary to these dynamics can actually push customers in the opposite direction relative to what you are trying to accomplish with your campaign.    
  • Mapping the type and the intensity of your content salience among your target audience is an important step if we want to rigorously evaluate the potential impact of a campaign.

In a future post, we’ll dive into the more nuance question of how to measure whether your communications are directly invoking or amplifying salience with your audience. 

If You Enjoyed This, You Might Also Like:  Have you ever had the feeling that life as a marketer is just a little bit harder in healthcare compared to other business sectors?  It turns out that your hunch is actually a fact.  Overall, persuasive communications are far less effective at changing the hearts and minds of customers in the life sciences.  In our science post entitled, Why We Can’t Expect the Same Impact from Healthcare Messaging, we present the evidence and some basic science that explains why communication in healthcare is harder.  But as you’ll see, all is not lost!  We have plenty of tools we can leverage to make our campaigns work for us. 

To learn more, contact us at info@euplexus.com.

We are a team of life science insights veterans dedicated to amplifying life science marketing through evidence-based tools.  One of our core values is to bring integrated, up-to-date perspectives on marketing-relevant science to our clients and the broader industry. 

Bishop, G. F. (1990). Issue involvement and response effects in public opinion surveys. Public Opinion Quarterly54(2), 209-218.

Duan, Y., Shang, B., Liang, W., Du, G., Yang, M., & Rhodes, R. E. (2021). Effects of eHealth-based multiple health behavior change interventions on physical activity, healthy diet, and weight in people with noncommunicable diseases: systematic review and meta-analysis. Journal of medical Internet research23(2), e23786.

Fiske, S. T., & Taylor, S. E. (2021). Social cognition, 4th Ed.. Sage.

Johnson, B. T., & Eagly, A. H. (1989). Effects of involvement on persuasion: A meta-analysis. Psychological bulletin106(2), 290.

Joyal-Desmarais, K., Scharmer, A. K., Madzelan, M. K., See, J. V., Rothman, A. J., & Snyder, M. (2022). Appealing to motivation to change attitudes, intentions, and behavior: A systematic review and meta-analysis of 702 experimental tests of the effects of motivational message matching on persuasion. Psychological Bulletin148(7-8), 465.

Keller, P. A., & Lehmann, D. R. (2008). Designing effective health communications: a meta-analysis. Journal of Public Policy & Marketing27(2), 117-130.

Noar, S. M., Benac, C. N., & Harris, M. S. (2007). Does tailoring matter? Meta-analytic review of tailored print health behavior change interventions. Psychological bulletin, 133(4), 673.

Rodriguez Rocha, N. P., & Kim, H. (2019). eHealth interventions for fruit and vegetable intake: a meta-analysis of effectiveness. Health education & behavior, 46(6), 947-959. 

Carter Smith, PhD

Carter Smith, PhD is a veteran of the world of healthcare insights with over 20 years of consulting experience. His work in evolving research methodologies to solve client business issues has been showcased in an extensive series of invited symposia at industry events, as well as a variety of custom training programs for insights professionals in manufacturing organizations. He received his doctorate in psychology, with an emphasis on decision-making and applied statistics. Carter is the President and Head of Applied Science at euPlexus.