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Theory and Method

in Health Audience
Segmentation
MICHAEL D. SLATER
Published online: 29 Oct 2010.
To cite this article: MICHAEL D. SLATER (1996) Theory and Method in Health
Audience Segmentation, Journal of Health Communication: International
Perspectives, 1:3, 267-284, DOI: 10.1080/108107396128059
To link to this article: http://dx.doi.org/10.1080/108107396128059
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Theory and Method in
Health Audience Segmentation
MICHAEL D. SLATER
Department of Technical Journalism
Colorado State University, Fort Collins, Colorado, USA
Audience segmentation is widely regarded as essential to effective health communica-

tion campaign efforts. Nonetheless, its practice is typically ad hoc. The conceptual his-
tory and theoretical bases for audience segmentation are reviewed, and typical
audience segmentation strategies for health communication efforts are described and
critiqued. An analogy is drawn between the methodological problems associated with
audience segmentation and those of multivariate classication and taxonomy in botany
and zoology. Cluster analytic techniques responsive to these issues are described, as
are applications of these techniques for analysis of health communication campaign
audiences. Approaches that would permit widespread use of such segmentation strate-
gies are discussed, and recommendations for such efforts are made.
Audience segmentation is widely acknowledged as essential to creating effective commun-

ication efforts (Atkin & Freimuth, 1989; Donahew, 1990; Grunig, 1989). Audience seg-
mentation, communication authorities continually point out, is the necessary prerequisite to
creating messages that are responsive to the concerns, needs, and perspectives of specic
populations. Similarly, segmentation provides the basis for selecting the media, commu-
nity, organizational, or interpersonal channels most appropriate to such populations (e.g.,
Cutlip, Center, & Broom, 1985; Wells, Burnett, & Moriarty, 1989). Unfortunately, as is
detailed in this article, typical strategies for segmenting audiences are often ad hoc, crude,
or based on typologies more appropriate for theory development than for campaign design.
Campaign and intervention planners usually recognize the necessity for formative
research on both audience attitudes and audience assessments of intended messages or
interventions. What may be less well recognized are the implicit assumptions made in con-
ducting such formative research. When, as is increasingly standard practice, focus groups
are the primary tool for audience research, the planner implicitly segments the audience a
priori. For example, in a smoking cessation intervention, the focus groups may be recruited
on the basis of age, gender, and ethnicity—whether or not these are in fact the most appro-
priate or useful segmentation variables. Even when a knowledge– attitude–behavior survey
is conducted, results are typically described in terms of mean levels for some various a pri-
ori groups— such as young African-American women or middle-aged White men. If these
a priori choices turn out to be inaccurate, or less than optimal, the resulting message or
intervention design and dissemination decisions will suffer.
In other words, if one is to communicate, one must begin with an implicit or explicit
de nition of who one’s audiences or interlocutors are. Segmentation is, at its core, a sys-
tematic and explicit process for arriving at such a de nition. This article includes a brief
review and critique of the concept and practice of audience segmentation. I also offer an
alternative conceptualization of audience segmentation as a research activity and suggest a
model for conducting audience segmentation in support of public health communication
and other similar behavior change efforts.
Address correspondence to Michael D. Slater, Department of Technical Journalism, Colorado

State University, Fort Collins, CO 80523, USA.
267
Journal of Health Communication, Volume 1, pp. 267–283, 1996
Copyright © 1996 Taylor & Francis
1081-0730/ 96 $12.00 + .00
268 M. D. Slater
Dening Audience Segmentation

Audience segmentation has its roots in the history of social sciences and social philosophy
over the last 75 years. In the early years of the century, theories of mass society and crowd
psychology were highly in uential as thinkers grappled with the phenomena of industrial
society and rising totalitarianism (see Bauer & Bauer, 1960; McQuail, 1983, for reviews).
Other theorists, including John Dewey (1927), more concerned with understanding the
social processes characterizing heterogeneous, pluralistic societies, took a very different
view. Dewey introduced the notion of publics into the study of public opinion. Publics
were subgroups or subpopulations that shared similar values or interests with respect to a
given issue; public opinions was larged shaped, in Dewey’s view, by the formation and the
activities of such publics. Focus also shifted in other social sciences to identifying and
describing typologies of people, as reected in the rise of personality research in psychol-
ogy (e.g., Allport & Odbert, 1936) and in the use of theoretical typologies in sociology,
which have their roots in Weber’s (1949) model of “ideal-typing.”
These concepts moved, in time, into the more applied social science disciplines. The
term segmentation was introduced in the marketing eld by Smith (1956). Smith pointed
out that marketers typically increased market share by product differentiation—attempting
to increase demand by creating a supply of a product unique in some respect. Smith advo-
cated, instead, market segmentation— identifying promising subgroups of consumers,
learning what their needs and desires were, and developing products tailored to those sub-
groups.
Segmentation became one of the central strategies taught and utilized in the marketing
eld (e.g., Bonoma & Shapiro, 1983; Kotler & Andreason, 1987; Weinstein, 1987). The
advantages of segmentation were clear: Marketing and promotion efforts could generate a
higher return by creating products and promotions tailored to the desired segment.
Audience segmentation has also been widely accepted as essential in conducting commu-
nication campaigns intended to in uence health and other socially relevant behaviors (e.g.,
Atkin & Freimuth, 1989). The purpose of audience segmentation is to make communica-
tion efforts more effective and ef cient. Effectiveness and ef ciency are de ned with
respect to intended communication outcomes: typically, to change levels of knowledge or
concern about some topic or to shift valence or increase accessibility of relevant attitudes
and ultimately to reshape behaviors, such as dietary patterns, sexual practices, or substance
use (Rogers & Storey, 1987). Nonetheless, there remains a certain ambiguity to the seg-
mentation concept. As Grunig (1989) pointed out,
the basic idea of segmentation is simple: divide a population, market, or audi-

ence into groups whose members are more like each other than members of
other segments. (p. 202)
Certainly, breaking up a heterogeneous audience into relatively more homogeneous audi-

ences is the essence of segmentation. But what criteria, what discriminators are properly
used to segment an audience or market? Grunig (1989) summarized criteria described in
the marketing literature:
In general, segments must be de nable, mutually exclusive, measurable,

accessible, pertinent to an organization’s mission, reachable with communica-
tion in an affordable way, and large enough to be substantial and to service
economically. (p. 203)
Health Audience Segmentation 269
These criteria certainly would characterize segments useful to health communicators.

They provide little guidance, however, for how to actually identify such segments. In fact,
what has emerged is a smorgasbord of segmentation techniques and strategies, with little
but personal preference as a guide for selecting a preferred strategy. Before critically
reviewing those strategies, however, it is important to develop more explicit and prescrip-
tive criteria for distinguishing audience segments.
Behavior Determinants: The Criteria for a Segmentation Strategy

The most straightforward model for in uencing health or other behaviors through commu-
nication proposes that if people will attend to, understand, accept, and remember relevant
information, they will change attitudes and nally their behavior (Fishbein & Middlestat,
1989; McGuire, 1989). Other approaches include in uencing perceptions of relevant
social norms (Ajzen & Fishbein, 1980), providing appropriate behavioral models and skill
training (Bandura, 1986; Maibach & Flora, 1993), increasing salience of attitudes support-
ive of the desired behavior (Vincent & Fazio, 1992), increasing salience of and cognitive
involvement with the behavior (Chaffee & Roser, 1986), and mobilizing the support of
in uential individuals and groups (Finnegan, Bracht, & Viswanath, 1989).
Few campaigns have the resources to use every strategy with the entire intended audi-
ence. Nor would such an effort be very ef cient or sensible. It is very unlikely that relevant
behavior of everyone in the intended audience is equally in uenced by each of the possible
determinants of that behavior. What is needed, clearly, is to identify subgroups that have in
common similar determinants of the behavior in question. In other words, segments should
be homogeneous with respect to patterns of variables (and values on those variables)
determining the attitudes and behaviors targeted by a communication effort. If such sub-
groups or segments can be identi ed, common messages or intervention strategies can be
designed for them.
Any segmentation strategy for a communication effort designed to in uence knowl-
edge, attitudes, or behavior in a given domain, then, should proceed as follows. The rst
step is to identify from existing research, as completely as possible, the known determi-
nants of knowledge, attitudes, and behavior in that domain. The second step is to identify
audience segments on the basis of distinctive patterns of determinants, each of which can
be addressed through tailored communications and related activities.
The remaining problem, of course, is how to go about identifying patterns of determi-
nants. With most health behaviors, it would not be dif cult to identify a dozen theoretical
perspectives that would suggest behavioral determinants. Although some theories overlap
to a degree, one may still expect to be looking at two dozen or more variables. Given that
each segment may best be distinguished by almost any combination of two or more of
those variables, the practical problem of identifying patterns from such multivariate data
may seem daunting. Later, I discuss some of the conceptual and methodological problems
posed by such data, some appropriate solutions, and some examples of audience segmen-
tation efforts utilizing these solutions. First, however, it is useful to review existing seg-
mentation strategies in light of the position just outlined.
Segmentation Methods: A Brief Review

The broad array of strategies and methods used to segment audiences— including demo-
graphics, surveys in which demographics are crosstabbed with media use and some key
psychosocial variables such as involvement and behavior, focus group discussions with
270 M. D. Slater
key target groups, and commercially available segmentation schemes such as Values and
Lifestyles (VALS)—have led to characterizations of segmentation as being more art than
science. There are, however, clear conceptual distinctions and implicit hierarchies in seg-
mentation strategies.
Bonoma and Shapiro (1983) argued that segmentation strategies form a nested hierar-
chy (an argument further developed and interpreted by Grunig, 1989). The most general
segmentation schemes discriminate between audience or market groups on the basis of
easily accessed variables, such as demographics (education, race, income, gender) and
geographic location. More sophisticated schemes use inferred variables to discriminate
segments— variables that more precisely describe differences between groups of people
and that therefore yield more informative segments, but that require more resources to
identify and access.
In other words, it is easy to de ne low-income, urban African-American adolescent
boys as an audience segment. Such a segment is only truly useful to a campaign designer
insofar as it provides a basis for campaign design. If it turns out that there are some very
different patterns of beliefs, behavior, and value in this population, this demographically
based segment would prove inadequate. For example, consider the following hypothetical
situation: Some members of this demographically de ned group are anomic, poorly con-
nected to school, family, or any social institution except perhaps law enforcement; others
are characterized by much closer ties to family and community institutions such as the
church; and still others are torn between family and community values and the norms of
more anomic peer groups. Clearly, a single message or channel strategy directed to all of
these demographic members would probably be counterproductive. A more productive
strategy would include some inferred, psychosocial variables that serve to identify these
differences and that could be addressed in message design.
The problem with the demographic segmentation suggested here also describes a aw
besetting much focus group and other qualitative audience research methods. Focus
groups involve in-depth discussions with individuals recruited to represent some particular
target group. The representativeness problems in such recruitment are well recognized. A
more insidious problem involves the initial identi cation of the target group itself. Most
often, the target group is de ned demographically. If demographics are not a good basis for
segmentation for the topic or issue in question, the focus group will not describe a seg-
ment. Instead, it will simply alert the researcher that the segment seems unexpectedly het-
erogeneous in its concerns and motivations—if the recruitment was fortunate in reaching
the range of people who in fact compose that demographic group. Focus groups and other
forms of qualitative research are often most effective when a rigorous, quantitatively based
segmentation strategy has helped de ne the segmentation scheme. Then, individuals can
be recruited who in fact t the de nition of the segment, and rich qualitative data can be
obtained and be more meaningfully and usefully interpreted.
The problem is exacerbated when one is concerned with in uencing behaviors that
may be poorly described by demographics. Crack cocaine use, for example, may be
closely associated with demographics, but demographics alone are of more limited use in
describing cigarette smokers or alcohol abusers. A variety of psychosocial and behavioral
variables must be tapped to reasonably differentiate between types of audiences.
Problems such as these are most acute in industrialized countries or in urban areas in
developing countries, in which there is considerable heterogeneity with respect to cultural
norms and values even within demographically similar groups. In national or regional
environments that are marked by long-standing, relatively intact and homogeneous cul-
tures and traditions, the segmentation problem is less complex. However, such cases are
increasingly becoming the exception rather than the rule.
This returns us to the quandary discussed earlier: How does one develop segmentation
schemes when dealing with many variables simultaneously? A typical compromise strat-
egy— and one, given limited research resources, that has much to recommend it—is as fol-
lows. Demographic categories known or reasonably suspected to be at least somewhat
associated with the target health behavior become a starting point. One then reviews the
literature for what might plausibly be crucial psychosocial variables— self-ef cacy and
peer or family support for cigarette smoking cessation, for example. These are then used to
further segment demographic categories.
This approach has obvious and not-so-obvious drawbacks. First, it assumes that there
are in fact just a few crucial variables that dwarf others in explanatory power. This may be
true for some health behaviors; it certainly is not true for all or even most. Second, it
assumes that one has correctly identi ed those variables. Third, even if the rst two
assumptions hold, one may well miss additional, less dominant but useful distinctions
among segments. Such subtle distinctions are precisely what permit careful and creative
targeting of messages. 1
The segmentation process, nonetheless, usually stops there. The reason it does is, in
part, embedded in the standard training and socialization of academic social scientists
(though not, typically, of market researchers). Empirical, academic social science devel-
ops, tests, and applies theoretical models. Such models emphasize parsimony—explana-
tion of a given process or phenomenon using a minimum number of variables (e.g.,
Babbie, 1983; Boltzmann, 1960). The statistical models used to do hypothesis testing
quickly become cumbersome to analyze and interpret when overloaded with variables. The
value of parsimony in theory building and testing and their associated statistical method-
ologies is directly opposed to the need to deal with many, even dozens, of variables simul-
taneously to optimally segment audiences with respect to health behavior.
There are alternative statistical methodologies, detailed later in this article, intended
precisely to create typologies based on patterns across multivariate data. Before reviewing
these methods, it is important to establish and further clarify the theoretical justi cation for
their use, as an alternative to more conventional approaches to typology in the academic
social sciences.
Social Science and Typology Construction
Segmentation as normally conducted is, from a methodological point of view, a process of

creating typologies. Typologies have a familiar and respected role in the construction of
social theory. As McKinney (1966) argued, social scienti c inquiry seeks to identify uni-
form, predictable patterns or to impose conceptual order on the apparent disarray of the
social world, and typologies have an important role in such inquiry: “The constructed type
is a means of reducing diversities and complexities of phenomena to a generally coherent
1
In making this and following critiques, I outline what is an ideally preferable set of approaches
and strategies. I recognize that in reality compromises often have to be made. Given that the princi-
pal purpose of segmentation is to alert campaign planners and message designers to audience dis-
tinctions, even relatively ad hoc approaches are preferable to no segmentation efforts at all. Some
suggestions for segmentation choices under conditions of limited resources are outlined in Slater
(1995).
272 M. D. Slater
level … a manifest function of types is to identify and simplify” (pp. 5–6). This process of
identi cation and simplication is an important step in the theory building process: “The
constructed type as a conceptual device represents an attempt to advance concept forma-
tion in the social sciences from the stage of description and empirical generalization to the
construction of theoretical systems” (McKinney, 1966, p. 7). A construct type, as a build-
ing block of theory, exists primarily “for predictive rather than descriptive purposes”
(McKinney, 1966, p. 6).
Segmentation typologies, in contrast, are intended primarily to provide a basis for
obtaining descriptive information concerning the beliefs held, the behaviors enacted, and
the constraints faced by group members so that appropriate message design and communi-
cation strategies can be developed to in uence attitudes and behaviors. It is essential that
segments be predictive of the targeted behavior— if there is no association between seg-
ment membership and the behavior of interest, the segment will have little or no value to
the campaign designer or health educator. To better guide channel selection and interven-
tion design decisions, the segments should also be predictive of distinctive patterns of
media use or reliance on different organizational, community, or interpersonal channels.
The heuristic value of audience segments, however, is as much or more to describe, so as
to inform message and intervention strategy design, as it is to predict.
A typology in the theoretical context is a variable representing a single, nominal con-
struct (or, in more complex cases, two or even three nominal variables in a matrix, creating
four, six, or eight different types) intended to impose predictable order on empirical data.
For example, one of the best-known such theoretically based typologies used for segmen-
tation purposes is Grunig’s (1983) situational theory. Three variables— problem recogni-
tion, issue involvement, and constraint recognition— have been demonstrated to predict
information seeking behavior and attention to information with respect to a given issue
(e.g., Grunig, 1983). They are dichotomized and matrixed to create eight segmentation cat-
egories, which are then collapsed to identify four modal segments. The strength of this
strategy is that it provides a theoretically sound typology for understanding both informa-
tion-related behavior and for processes—such as public opinion formation— in which such
behavior is central (e.g., VanLeuven & Slater, 1991). However, such a typology is of lim-
ited use in identifying segments that can guide a communicator in developing the content
for a series of messages or in trying to select speci c channels for disseminating those
messages. The situational theory variables are very useful but alone are insuf cient to cre-
ate adequately informative segments, in particular for behavior change campaigns that
need to identify and address determinants of behavior. For example, knowing that some
group recognizes lifestyle-related heart disease risks, but is not especially involved with or
concerned about that risk, is useful. However, one needs to know a great deal more about
the nature of group members’ beliefs regarding risks and the proposed behavior change,
the possible reasons or context for their apparent lack of involvement as well as their over-
all orientation to their health, and the extent of their actual risk for this information to be
most effectively used in designing a health communication effort. In fact, this group may
prove to be several groups with very different patterns. One group might be distinguished
by beliefs that lifestyle changes have limited ef cacy and are relatively noxious, and
another might be characterized primarily by limited concern with their health and a result-
ing lack of interest in health-related behavioral changes. Obviously, message content or
interventions targeted at these two groups would have different content.
Segments, on the other hand, are constructed post hoc from empirical data, using a
variety of constructs and variables— the more the better, in terms of providing insight to
the campaign or education planner. A segment is not intended to operationalize an under-

lying concept—it can only be summarized by synthesizing and interpreting the variables
that uniquely identify it.
Nonetheless, social science researchers conducting audience segmentation research
are most likely to construct typologies in the manner most familiar to them—and most
respected by their colleagues and most publishable in journals. Typologies will most likely
be based, as described earlier, on one or more conceptually based variables, converted to a
nominal variable, and perhaps crossed with some demographic variables of interest.
Theory-based typological research has an important role to play in audience segmenta-
tion—by identifying additional variables that should be incorporated in segmentation
analyses. As a segmentation technique, such approaches, though useful, are not optimal.
Typing Audience Segmentatio n Strategies

Grunig (1989) adopted Bonoma and Shapiro’s (1983) concept of inferred segmentation
variables nested within objective variables and proposed a nested hierarchy of segmenta-
tion strategies. This hierarchy is based on a continuum of lesser to greater speci city and
utility. Visualized as nested boxes, the outermost box is the undifferentiated mass audi-
ence. The next box inside the mass audience represents demographic segmentation
schemes. Within that are geodemographic schemes (e.g., PRIZM, which identi es dozens
of demographic types located by census tract—Claritas, Inc., 1985; Winkelman, 1987),
followed by boilerplate lifestyle or psychographic schemes, such as VALS (Mitchell,
1983), which characterize segments in a richly multivariate way but seek to apply the seg-
mentation strategy to virtually all American consumers and a very wide range of different
behaviors. The other nested boxes, in order, are communities, publics (de ned as individ-
uals sharing similar communication behaviors with respect to a given issue), and nally
individuals themselves.
This nested hierarchy usefully highlights the advantages of focusing on the more spe-
cic, versus the more general segmentation strategies; with increasing speci city comes
increasing detail and increased ability to focus the communication to the audience.
Grunig’s (1989) approach, however, is in some respects debatable. His proposed hierarchy
is based on an interesting assumption concerning the intent of segmentation efforts. He
argued that theories or approaches guiding segmentation efforts should “help communica-
tion planners divide a population into segments of people who will communicate similarly
about the topic of a campaign” (Grunig, 1989, p. 208). This focus on communication
behavior led to his emphasizing, as criteria for identifying segments, those variables that
predict amount of media and channel use and that predict attention to information encoun-
tered on given topics.
Such variables are very important for one of the two functions that must be served by
a segmentation scheme: identifying appropriate communication channels. However, they
are less useful for providing the insight necessary to create the messages or the content of
intervention strategies designed to in uence a given behavior. These insights, as argued
earlier, must be based on knowledge about the factors that determine existing beliefs, atti-
tudes, and behaviors. Some critics (e.g., Cameron & Yang, 1991) have pointed out that
Grunig’s (1989) assumptions about segmentation exclude attitudinal variables as funda-
mental as the valence of people’s attitudes about a given topic.
Grunig’s (1989) nested approach makes useful points. He emphasized that the pre-
ferred inner boxes reect situational, issue- or behavior-speci c variables, though he
274 M. D. Slater
approached these in terms of theoretical typologies rather than multivariate analysis.

Demographics are demographics, regardless of whether the topic is weight loss or crack
cocaine use. More sophisticated segmentation approaches identify variables that are less
generic and more likely to distinguish individuals with respect to the issue at hand.
However, Grunig’s hierarchical continuum emphasizes the increasing speci city of the
segmentation strategy with respect to the size of the unit of analysis (e.g., gender or eth-
nicity groups, communities, publics, then individuals), rather than simultaneously
increasing speci city and comprehensiveness with respect to the variables known to deter-
mine a target attitude or behavior.
One can then usefully recon gure Grunig’s (1989) nested hierarchy along a slightly
different axis. In Figure 1, segmentation strategies are organized in terms of the degree of
correspondence between segmentation variables and the variables that in fact are known to
shape or determine the attitudes or behaviors of interest. The outer box remains the same:
the mass audience, which is a univariate concept that does not vary. The next two remain
demographics and geodemographics. The separate category for lifestyle and psycho-
graphic methods has been dropped. Such methods are in fact multivariate classication
strategies. The implementations of such strategies (e.g., VALS) discussed by Grunig
(1989) involve classi cation schemes that are based in overarching models and assump-
tions about American lifestyles and values and not on variables that predict a speci c
behavior (except, perhaps, the purchase of certain categories of durable goods). As such,
they do not t the de nition of multivariate classication strategies as proposed here.
Figure 1. Segmentation strategies nested according to correspondence with determinants of target

attitudes or behaviors.
The next box is labeled theoretical typologies. These include publics, in the sense used
by Grunig: segments that are homogeneous with respect to values on one or several vari-
ables theoretically linked to the targeted issue or behavior. The penultimate box is labeled
multivariate classication: segments discriminated by, as proposed earlier, distinctive pat-
terns of the known attitude or behavior determinants. The nal box is labeled taxonomies.
What remains to be explored are the conceptual issues and the methods involved in multi-
variate classication and taxonomic approaches to segmentation.
Multivariate Classication and Taxonomy

The central argument of this article thus far has been that audience segmentation is funda-
mentally a problem in nding systematic patterns for the variables (and the values on those
variables) that determine a target behavior. This problem is closely analogous to what was
for centuries the central task of biology, and which still remains an important concern—the
organization and classication of the tremendous variety of living organisms, the enor-
mous intellectual enterprise of taxonomy. Both audience segmentation and biological tax-
onomy are problems in multivariate classication. Recent approaches and developments in
biological taxonomy provides some useful insights and methodological models for audi-
ence segmentation. Certainly, consideration of biological taxonomy underscores the
importance of conceptualizing audience segmentation, from a methodological point of
view, as a process of multivariate classication. Abbott, Bisby, and Rogers’s (1985) com-
ments about biological taxonomy are equally applicable to audience segmentation:
It seems increasingly clear that modern biologists must give up the idea that
there will ever be a single, ideal classication for any group. Instead, the spe-
cial purposes of any classication should be clearly stated and the data input
and methods of analysis be made as explicit as possible …. classication tech-
niques need to be understood by anyone doing research with comparative bio-
logical data, especially where large numbers of variables must be considered
simultaneously. (p. 7)
Biological Taxonomy
It is rst useful to brie y review some current issues and nomenclature in the eld of bio-
logical taxonomy. Taxonomy may be traced back to Aristotle’s early efforts to classify ani-
mals; its present form first began to take shape with Linnaeus and his proposed
hierarchical ordering— taxa—of kingdom, class, order, genus, and species (see Pellegrin,
1986). Generations of taxonomists in the centuries since have sought to classify the seem-
ingly endless variety of plant, animals, insects, and microorganisms into sets of categories.
Assiduous data collection permitted grouping together those specimens that were rela-
tively invariant on some set of characteristics, and further distinguishing them from speci-
mens better identi ed using some still different characteristics (Abbott et al., 1985; Mayr,
1964; Panchen, 1992).
Two developments led to considerable growth and controversy in biological taxon-
omy. First, as Panchen (1992) pointed out, the theory of evolution (as against the theory of
276 M. D. Slater
natural selection) really was a theory about taxonomy. Darwin’s argument was that taxo-
nomic classications in fact reected patterns of common ancestry. This eventually gave
rise to taxonomic schools—the phyleticists or cladists—who attempt to organize tax-
onomies to reect what they deduce to be phylogenetic or evolutionary history (Hennig,
1979; Scott-Ram, 1990). A second and related development was the growing use of com-
puters and mathematical algorithms for the computational analysis of multivariate classi-
cations, or numerical taxonomy (Clifford & Stephenson, 1975; Sneath & Sokal, 1973).
These mathematical approaches were adopted both by the phyleticists and by
pheneticists—taxonomists who argued that it was not possible to reliably deduce evolu-
tionary families and that therefore taxonomy was better practiced in terms of similarities
and dissimilarities of currently available data (Abbott et al., 1985).
The phenetic approach provides the closest analogy to the problem of audience seg-
mentation. At present, at least, there is no theory of audiences comparable to evolutionary
theory, and there is neither a prospect nor an obvious pressing need for such a theory.
Moreover, the differences between the cladists, especially the more recent transformed or
pattern cladists (e.g., Scott-Ram, 1990) and the pheneticists are far fewer than the similar-
ities in their use of numerical taxonomy. 2 The following discussion, then, reects primarily
the somewhat simpler phenetic perspective.
Numerical Taxonomy and Cluster Analytic Approaches to Classication

Multivariate data, of course, is typically represented in a matrix. Arrayed on one axis of the
matrix are the units of observation— people, in the case of audience segmentation, biolog-
ical specimens in the case of taxonomy. Arrayed on the other axis are the relevant charac-
teristics of the units of observation— determinants of a target attitude or behavior in the
case of audience segmentation, morphological or biochemical features in biological taxon-
omy. Such a matrix can also be represented spatially. The relationship between the units of
observation and a single variable can, of course, by represented in a two-dimensional
Cartesian coordinate graph. The relationships between units of observation and many vari-
ables can be conceived of as an n-dimensional plotting of points, with as many dimensions
as one has variables measured. 3
Earlier, the question was posed as to how one might discern complex patterns of rela-
tionships between many variables representing determinants of an attitude or behavior
simultaneously. If there is no pattern, if the population is uniformly homogeneous, all
points would tend to be equidistant from one another. To the extent that patterns exist—
that is, to the extent that a sizable subgroup is characterized by similar values on some
variables, points will tend to cluster in n-dimensional space accordingly. 4
2
Some cladist techniques for classi cation, including weighting of speci c characteristics for
classi cation purposes (Scott-Ram, 1990), might be adapted to audience segmentation strategies.
The use of numerical taxonomic techniques in audience segmentation has a long way to go before
such issues become salient.
3
An excellent discussion of these multivariate methods, including a review of various relevant
variants, is given in Aldenderfer and Blash eld (1984) and Abbott et al. (1985); the discussion here
brie y summarizes points elaborated in those two sources.
4
Another approach gaining increasing acceptance in the market research community is com-
monly known as Chi-Squared Automatic Interaction Detection (CHAID) (Kass, 1980; Magidson,
1993), which uses categorical variables (or collapses ordinal scales into categorical variables) to gen-
erate segments; CHAID is based, like regression or discriminant analysis, on prediction of a speci c
criterion variable and does provide signi cance tests of that predictive relationship.
Such cluster analytic techniques have been commonly used by marketers as well as by
numerical taxonomists in biology to conduct what are commonly called lifestyle or psy-
chographic studies (Weinstein, 1987; Wells, 1974). It is dif cult to ascertain the extent to
which such studies conform to the proposed model of building segmentation speci cally
on variables demonstrated to determine the target behavior, given that most are proprietary
and not accessible to critical review. They certainly do not easily generalize to other
domains, such as health behaviors. Several studies in the health education eld are avail-
able as models, such as Slater and Flora’s (1991) segmentation based on determinants of
cardiovascular risk behaviors, and Morris, Tabak, and Olins’ (1992) segmentation based
on determinants of prescription-drug information seeking by elderly persons.
A few examples from these studies may make the concept of multivariate classica-
tion intuitively clearer. In fact, one of the advantages of such classication is that the
resulting segments tend to be intuitively intelligible and of obvious heuristic value, despite
the mathematical and conceptual complexity underlying them. Slater and Flora’s (1991)
study identi ed seven principal segments with respect to cardiovascular disease risk in a
population sampled from several central California cities. Two of the segments are espe-
cially instructive, given their demographic similarities. Both segments were mostly White,
middle class, middle income. One was the lowest risk segment of all: Diets were consider-
ably better than the overall mean, and segment members engaged in moderate though not
vigorous exercise, tended not to smoke, believed cardiovascular disease was preventable,
were willing and believed themselves able to change their health behaviors, and were
attentive to health information. In contrast, the other group included persons with poor
diet, smoking, and alcohol consumption habits, low self-ef cacy with respect to diet
change, and peers with poor diet and smoking habits. They perceived themselves as being
at risk for disease but had little intention to reduce such risks, and they avoided exposure to
health information (Slater & Flora, 1991).
Morris et al. (1992) identi ed four segments describing older persons’ motives for
seeking information about drugs. These segments distinguished between, to take two
examples, elderly persons who were risk avoiders (relatively assiduous in accessing infor-
mation from reliable sources, heavily reliant on health professionals for care, and high in
both actual and perceived knowledge) and elderly persons who were more inclined to
practice self-care, were low in knowledge and perceived knowledge, and relied more on
advertisements and less on more credible information. Morris et al.’s study is particularly
useful as a procedural model—unlike in Slater and Flora’s (1991) study, instrumentation
and measurement were tailored for the research question rather than being based on sec-
ondary data analysis.
Slater and Flora’s (1991) research highlights another issue: that of validation.
Multivariate classification— be it biologic al taxonomies or audience segmentation
schemes—is a tool for collapsing complex data and rendering it interpretable and mean-
ingful, not unlike traditional factor analysis. Like factor analysis, multivariate classica-
tion is much less often used to test hypotheses— rather, it is used to provide effective
research tools. And, as is true of factor analysis, one can use techniques to assess reliabil-
ity, such as hold-out analyses (comparable to split-half reliability tests) and can use predic-
tive tests to examine construct validity (Aldenderfer & Blash eld, 1984).
Taxonomy and Hierarchical Segmentation Strategies

Biological taxonomies, however, go further than do existing multivariate audience classi-
cation efforts. Biological taxonomies are hierarchical. The problem of creating an ef -
278 M. D. Slater
cient information-storage-and-retrieval framework for a vast array of categories is man-

aged by the use of the familiar levels of subspecies, species, genus, phyla, and so on. At
every level, the taxa are constructed so that every specimen is included in one and only one
category, the categories being distinguished in increasingly gross ways (Abbott et al.,
1985; Panchen, 1992).
The question arises as to whether or not it is both desirable and possible to construct
such hierarchic taxonomies for purposes of audience segmentation. The answer, I believe,
is clearly yes on both counts.
Hierarchical audience segmentation taxonomies would be desirable for two prag-
matic reasons. First, communication campaigns use a variety of channels ranging from
national media efforts to sponsoring interpersonal interactions between, for example,
health care providers and patients. Obviously, the messages disseminated through
national media cannot be nearly so closely tailored to speci c audiences as can messages
disseminated on a community basis. The useful level of differentiation of segments is

therefore quite different: The planner of a national public service announcement (PSA)
effort will be interested in a segmentation scheme at a different level of precision and
detail than would the planner of a community intervention in a given city. Second, cam-
paigns vary in the types and variety of people they are trying to reach. Campaigns
intended to change cardiovascular risk factors may try to reach a very wide variety of per-
sons, and the breadth of a segmentation scheme is crucial. A campaign aimed at reducing
crack cocaine use, or the sharing of possibly AIDS-contaminated syringes among drug
users, is obviously far more targeted. Audience segmentation efforts in such a case would
be very concerned with identifying useful if even seemingly minor differences between
members of the target audience. After all, given the dif culty of in uencing such audi-
ences, no variation that might provide insight and permit development of a more effec-
tive, better targeted communication or intervention should be overlooked.
The problem of how to do such hierarchical segmentation schemes is more dif cult.
Numerical taxonomists in biology use a range of techniques based not only on different
algorithms but also on different conceptual models. Although cluster analyses of the type
described above may be the most common approach, other approaches are based on set
theory and information theory models that have yet to be applied to segmentation studies
(Abbott et al., 1985; Clifford & Stephenson, 1975). Moreover, cluster analyses in numeri-
cal taxonomy are typically translated into hierarchical representations such as dendro-
grams, tree-branching diagrams that show hierarchical relationships. The problems and
potential in using such approaches remain, so far as I am aware, to be explored in audience
segmentation.
It would not be dif cult, however, to develop hierarchical segmentation models using
the more commonplace cluster analytic techniques, given a large and well-constructed
sample population. One would simply need to develop an initial, more general set of seg-
ments or clusters and then proceed to analyze each into smaller components or clusters.
This could be iterated as far as sample sizes allowed and as the task demanded.
Whatever the benefits of multivariate classification approaches are for audience
segmentation, it is clear that they are complex and sophisticated approac hes.
Considerable resources are needed— the time and funds to collect necessary data, and
the expertise to analyze and interpret such data. How practical, how useful, are such
approaches, given the time and money limitations faced in most communication cam-
paign contexts?
Implem enting Multivariate Classication Segmentation

for Health Communication
Conducting multiple classication research to segment audiences clearly is not inexpen-

sive. Any population survey involving random sampling and requiring reasonably high
response rates involves substantial costs. (Response rates need to be good because some
segments may also be characterized by lower levels of accessibility to or cooperation with
researchers and thus could easily be minimized or missed. As is discussed further below,
oversampling of those demographic groups likely to have low response rates can help.)
Instruments tend to be lengthy, given the large number of psychosocial, knowledge, and
behavior items that must be measured (see Slater & Flora, 1994). Quali ed researchers
must be available to conduct classication analyses and interpret the resulting data. Given
these costs, it seems that only the largest, best-funded communication efforts can indulge
in multiple classication segmentation efforts. In fact, this is only the case if the audience
segmentation task is approached inef ciently.
Currently, very considerable resources are being devoted to audience segmentation
efforts when summed across hundreds of extant health campaigns that may take place in
the United States or other industrialized countries or the dozens that may take place in less
developed countries. Typically, these efforts are to a greater or lesser extent ad hoc . It is not
unusual, as discussed earlier, to rely on crude demographic distinctions to identify seg-
ments for the apparently more useful and pertinent focus group discussions and message
evaluation sessions. At best, surveys may be conducted that crosstabulate one or two rele-
vant theoretical variables with the demographic data.
An alternative, and far more ef cient, approach is to create on a regional or national
basis audience segmentation categories for each major health behavior of interest to sup-
plement (not to replace) local audience research efforts. The procedures for doing so are
relatively straightforward. An instrument could be constructed on the basis of thorough lit-
erature review to identify variables that have been shown to help determine health behav-
iors of interest. One of the major research decisions, in fact, will be determining which
behaviors are suf ciently similar to permit construction of a single instrument and allow
data collection in a single pass. For example, several health behaviors, such as diet, exer-
cise, and smoking, are sufciently similar that it may be possible to get all necessary items
onto a single, albeit lengthy, instrument, at considerable savings.
The next issue concerns sample selection and design. The basic model for a large-
scale segmentation effort is the national probability sample. For some behaviors, such as
dietary practices, all members of a national population may be of nearly equal interest.
However, in most cases there are subpopulations of particular interest. For example,
researchers, educators, and public health of cials concerned with smoking, alcohol abuse,
or drug use obviously need to learn more about the substance users and abusers and about
populations, such as young people, who are particularly at risk for becoming substance
abusers. In addition, it may be important to focus additional attention on racial and ethnic
minorities traditionally underserved or at risk.
The sampling strategy, then, would ideally involve systematic efforts to oversample
on the basis of relevant behavioral or demographic criteria. This does not contradict the
principles of multivariate classication: The segments may still not be dominated by
behavioral or ethnic differences if the sample is properly weighted. The additional data on
such populations, though, will permit more ne-grained analysis of the segments, includ-
280 M. D. Slater
ing potentially the development of hierarchical segmentation strategies or creation of seg-

mentation schemes focused on particular populations. After all, a campaign targeted
speci cally at inner-city African-Americans could not make use of the regional or national
segmentation tools unless enough of an oversample existed to provide speci c segmenta-
tion insights that would distinguish usefully among the intended audience.
The issue of the utility of regional or national segmentation efforts for community-
based campaigns and interventions is especially important. National education campaigns
may be more visible, but community-based efforts are arguably more important and cer-
tainly in total represent the bulk of health communication and intervention activity. To be
useful at the local level, segmentation information must be ne-grained enough to provide
useful insight for message or program design in the community. Communication or inter-
vention planners in a community must also have tools that allow them to easily and inex-
pensively identify the size, makeup, and communication channel use of the relevant
segments in their own community.

Analyses of regional or national survey data, then, should include several steps
beyond creation of an initial set of segments and associated validation procedures. Where
appropriate (e.g., in segments that identify relatively high-risk populations), further efforts
should be made to develop subsegments, using one or more of the approaches to hierarchi-
cal segmentation discussed earlier. Such subsegments would be especially useful to com-
munication and intervention design at the community level.
Even more important, discriminant analyses (e.g., Abbott et al., 1985; Klecka, 1980)
and other statistical analyses should be carried out to identify a small subset of survey
items (e.g., 25–30 items) that can be used with reasonable accuracy to determine segment
membership. These items, with instructions for their use, could be provided to local health
planners and communication designers. Relatively brief, inexpensive surveys could then
be conducted locally to obtain the necessary segmentation information. Even if small-scale
random surveys are not possible, these short instruments could be used selectively to help
qualify and sort participants recruited for focus group research.
Finally, the national task should also incorporate a qualitative research component.
Once segments and important subsegments have been identi ed, it becomes a relatively
straightforward task to recruit a small number of members of each segment for focus
group, in-depth interview, or ethnographic research. This would considerably enrich the
insights made available through the segmentation study.
This broad-based approach to segmentation analysis is, of course, super cially not
dissimilar from some of the marketing segmentation schemes discussed earlier, such as
VALS and PRIZM. Large-scale health segmentation studies would share the virtues of
ef ciency in use of research resources, as well as helping provide a common vocabulary
for campaign and intervention planners and designers. Unlike such commercial schemes,
they would be explicitly rooted in analysis of the variables demonstrated to determine rel-
evant health behaviors and in the sampling of those populations of greatest concern with
respect to a given health behavior. Though not inexpensive, they would represent a more
cost-effective use of funds that are expended presently on attempting to solve, inade-
quately, the same segmentation problems over and over again.
Two substantive efforts to develop national health audience segmentation schemes
have been conducted to date in the United States (Maibach, Max eld, Radin, & Slater, in
press; Patterson, Haines, & Popkin, 1994). Both have identi ed somewhat comparable
segments and were well validated, with the clusters predicting various criterion health
behaviors in most cases substantially better than do regressions using demographic vari-
ables; Maibach et al’s (in press) study also provides a much more detailed psychosocial
pro le of cluster members. To date, however, neither segmentation effort has published
targeted subsample segmentation descriptions or associated qualitative studies or has made
available reduced item sets for cluster identi cation, though in at least one case such
efforts are currently nearing completion (A. Max eld, personal communication, March 19,
1996). A search of the literature also suggests that similar efforts have not been made else-
where than in the United States.
The health behavior problems confronted in the United States and in an increasing
number of other countries around the world—AIDS and safer sex; tobacco, alcohol, and
other substance abuse; cardiovascular and cancer disease risk—are urgent and costly.
Given the dif culty of in uencing such behavior through communication, health promo-
tion, and interventions, it is important not to compromise such efforts through impromptu
and inadequate audience segmentation strategies. The development and renement of
sophisticated health audience segmentation tools is long overdue.
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Audience segmentation is widely regarded as essential to effective health communica-

Audience segmentation is widely acknowledged as essential to creating effective commun-

Address correspondence to Michael D. Slater, Department of Technical Journalism, Colorado

Dening Audience Segmentation

the basic idea of segmentation is simple: divide a population, market, or audi-

Certainly, breaking up a heterogeneous audience into relatively more homogeneous audi-

In general, segments must be de nable, mutually exclusive, measurable,

These criteria certainly would characterize segments useful to health communicators.

Behavior Determinants: The Criteria for a Segmentation Strategy

Segmentation Methods: A Brief Review

Social Science and Typology Construction

Segmentation as normally conducted is, from a methodological point of view, a process of

the campaign or education planner. A segment is not intended to operationalize an under-

Typing Audience Segmentatio n Strategies

approached these in terms of theoretical typologies rather than multivariate analysis.

Figure 1. Segmentation strategies nested according to correspondence with determinants of target

Multivariate Classication and Taxonomy

Numerical Taxonomy and Cluster Analytic Approaches to Classication

Taxonomy and Hierarchical Segmentation Strategies

cient information-storage-and-retrieval framework for a vast array of categories is man-

disseminated on a community basis. The useful level of differentiation of segments is

Implem enting Multivariate Classication Segmentation

Conducting multiple classication research to segment audiences clearly is not inexpen-

ing potentially the development of hierarchical segmentation strategies or creation of seg-

segments in their own community.

sophisticated health audience segmentation tools is long overdue.

Englewood Cliffs, NJ: Prentice-Hall.

Smith, W. R. (1956). Product differentiation and market segmentation as alternative marketing

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Dening Audience Segmentation

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Multivariate Classication and Taxonomy

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Implem enting Multivariate Classication Segmentation

Conducting multiple classication research to segment audiences clearly is not inexpen-