June 20

Using Formative Research to Tailor a Complex Health Literacy Program


Canyon Ranch Institute Life Enhancement Program is an evidence-based, integrative health and health literacy program that demonstrates significant and healthy outcomes across diverse cultures. This session will illustrate how formative research is used to tailor the program to local communities. Tailoring program materials to each community is a health literacy best practice. Canyon Ranch Institute Life Enhancement Program employs extensive formative research in the training of health care professionals and revision of program materials with our partner healthcare provider organizations. Participant guides are tailored through a series of narratives describing people reflective of the local population experiencing healthy changes.


Andrew Pleasant, Ph.D
Senior Director for Health Literacy and Research, Canyon Ranch Institute

Jennifer Cabe, M.A.
Executive Director and Board Member, Canyon Ranch Institute

Ana Lucero-Liu, Ph.D
Program and Evaluation Manager, Canyon Ranch Institute

Canyon Ranch Institute Life Enhancement Program

Canyon Ranch has an integrative approach to health to understand the personal and emotional connections.

They always have a local partner in every community where they work.

For any program: Engage people early and often. You will get to know them. Include their whole lives (integrative health). That will take you upstream from health care to prevention.

Finding Partners for the LEP program: You need an established health care organization to deliver the program to their people.


  1. Match program design and materials to realities of people’s lives
  2. Not a one-size-fits-all approach
  3. Tailered interventions are more likely to create change than non-tailored programs.
  4. Must be evidence-based. That’s why you need formative research.

Food desert example:

Sometimes they have to go into the community. E.g., they convinced a vendor to start selling fruits and vegetables, and said they would buy whatever wasn’t sold in the day. They had to buy back for about a week and a half. Now there are plenty of places to buy produce in that community.

In a community with a lot of unemployment: They partnered with Project HOPE to work on work skills with teens.

Canyon Ranch Institute Life Enhancement Program Process:

  1. They take the core team to Canyon Ranch for a week.
  2. They have individual interviews with audience.
  3. They determine the key concepts and messages: eg. Access to food, recreation, behavioural therapy etc.
  4. They focus on the causes of the problems for each individual.
  5. Then they recruit actual participants. And they engage with the core team weekly to check progress.

Evaluations: post, +3 months, +1 year

Find info, understand, evaluate, communicate, re-assess.

The LEP program takes a 2-sided approach by addressing challenges in both the health system AND the public.

Rather than always using the Plain Language standard of putting the most important message first, they recognize that sometimes people aren’t ready to hear the most important message. Sometimes they need to find a path to their true goal.

Rather than removing complexity, LEP works to make complexity understandable and actionable.

Use narratives: opening situation, a changing situation, a closing situation.

Stories are culture.

A good story:

  • Is understandable
  • Has context and cohesion (story holds together)
  • Has relevance to the listener’s life

So each LEP has a program guide (among other materials) that incorporates a number of unique narratives.

They test the stories with the community.

The core team comes from the participating health organization. Participants are recruited from the patient population.

Research Process

  1. Research to find issues
  2. Find a local person to represent the population
  3. Have one-on-one with members of the core team
  4. Team members report back to one another
  5. Evaluation of the “hand-off” happens onsite and through written feedback and video of the session.

A lot of information is given that is not directly related to the expertise or question of the specific person they’re meeting, but that is relevant to another person on the team.

The research process takes about 3 months.

Core team of 20. Each participant group is 100.





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