Social comparison target selections as health information preferences: exploring contextual influences among women in midlife with elevated risk for cardiovascular disease.

BACKGROUND: Insufficient physical activity heightens risk for cardiovascular disease (CVD), particularly among women ages 40-65 whose risk is already elevated by conditions like hypertension. Physical activity interventions exist for this group, but whether health information preferences (which may affect intervention outcomes) vary for the same individual across contexts is unclear. Little is known about contextual predictors of selections of health-relevant social comparisons (i.e. evaluating oneself relative to others), which represent sources of health information. METHODS: To explore social comparison selections as indicators of health information preferences, we conducted secondary analyses using data from tests of a web application designed to increase physical activity for women in midlife with elevated risk for CVD (N = 88). Participants completed an initial survey, used the web application each morning for 7 days (where they selected and viewed a comparison target), and completed daily surveys and exit interviews. We used multilevel models to assess stability versus fluctuation and associations between daily context and selections, and highlighted statements from interviews for additional context. RESULTS: Women showed considerable daily variability in physical activity satisfaction and social comparison target selections (ICCs < 0.63; Design Effects > 1.3); they attributed the latter in part to the desire to explore web app content. On days women reported greater-than-usual satisfaction with their steps, they were less likely to select a not very active peer (ORs < 0.78, ps < 0.03) and more likely to avoid making a specific target selection (ORs > 1.25, ps < 0.02). CONCLUSION: Women showed meaningful daily fluctuations in social comparison target selection, and contextual factors such as satisfaction with the previous day's physical activity predicted these variations. Findings indicate that health information preferences may be dynamic, underscoring the potential benefits of tailoring content to daily or momentary experiences to enhance the effectiveness of digital health interventions.