As patients become more empowered and seek out vast amounts of information related to their options, it’s imperative that healthcare marketers expose them to the most impactful, persuasive messaging to promote their procedures, products, facilities, and/or programs. Engagious sought out to determine the types of direct-to-patient (DTP) messages that communicate most effectively in hopes of developing industry best practices. To do so, we identified three online videos that used different approaches to educate people about knee replacement surgery. We tested those videos and analyzed results to identify what worked well, what didn’t work, and recommend best practices for patient communications.

1. Creating Effective Direct-to-Patient
Materials
Research Report by Gina Derickson, Research Director
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2. DETAILED FINDINGS
www.engagious.com | 212.760.4358 | Gina.Derickson@engagious.com
BACKGROUND
As patients become more empowered and seek out vast amounts of information related to their options, it’s
imperative that healthcare marketers expose them to the most impactful, persuasive messaging to promote their
procedures, products, facilities, and/or programs.
Engagious sought out to determine the types of direct-to-patient (DTP) messages that communicate most
effectively in hopes of developing industry best practices. To do so, we identified three online videos that used
different approaches to educate people about knee replacement surgery. We tested those videos and analyzed
results to identify what worked well, what didn’t work, and recommend best practices for patient communications.
Who are we?
Engagious is a research and message refinement consultancy. We remove the guesswork from your
communications by blending art and science to uncover what connects best with your audience. That is why some
of the world’s largest companies and government leaders turn to us for our expertise. Our technologies are
industry-leading and our methods deliver proven results. Our expertise lies in a few key areas: Healthcare,
Financial Services, and Public Policy.
How do we do it?
We use dial testing to identify what works and what doesn’t by measuring audience responses moment-by-
moment. It allows us to overcome the negative impact of flawed memory and recall bias by capturing what people
are thinking in-the-moment. We then dive deep in interviews to find out the ‘why’ which allows us to fine-tune your
narrative for the best ROI.
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3. DETAILED FINDINGS
METHODOLOGY
Engagious conducted an online survey with 205 respondents to get feedback on these three videos. The survey
featured demographic questions, moment-to-moment interest measurement via Dialsmith’s Perception Analyzer
technology, interest in each video, and a few open-ended questions for deeper understanding.
All respondents were screened to meet requirements as follows:
DEMOGRAPHICS:
ATTITUDES:
• Expect to be considering a knee replacement within the next five years
• Have not had a knee replacement previously
• Interested in learning about knee replacement surgery options (average of 6.9 on a 0 to 10 scale for interest in
learning about)
• Have personally researched knee replacement surgery options (average of 1.9 sources)
We use Dial technology to capture how respondents are feeling
in-the-moment. This gives us their raw reaction, in real-time,
and unfiltered.
Once we have this data, the dial results help
guide our questioning so we can uncover the WHY and get to
the heart of the matter: what makes them tick.
• Age 45+ • U.S. resident
• Mix of gender • Mix of employment/retired status
• Mix of ethnicity • Mix of marital status
• Mix of education
Sample output – Moment-to-moment dial
responses overlaid on video
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4. DETAILED FINDINGS
Videos tested include:
This 2:06 video features two orthopedic surgeons who talk about
quality of life and describe aspects of the knee replacement surgery,
including total vs. partial replacement, muscle-sparing techniques,
robotics, and minimally invasive procedures. Imagery includes
patients with walking aids and the operating room. Respondents
described it as professional, detailed, and encouraging.
https://www.youtube.com/watch?v=pWK8lkmHmfk
SURGEON FOCUS
The shortest of the three videos at 1:29 is a narration of the surgical
process with video of the operating room and diagrams of the knee.
Details including the anesthesiologist, surgical time, incision, shaping
and sizing, and recovery process are featured. Respondents described
it as detailed, professional, and technical.
https://www.youtube.com/watch?v=yClr8q2oxtl
EDUCATIONAL
PATIENT STORY
This 3:37 video features a patient (at home and in dance class) with an
orthopedic surgeon and an inpatient physical therapist describing the
limitations of people who need the surgery, the hospital experience,
and recovery. Interspersed factual screens and soothing music are
also included. Respondents described it as encouraging, caring, and
calming.
https://www.youtube.com/watch?v=vhRwskqmwJl
Fletcher Allen Health Care, Vermont
“Total Knee Replacement Surgery
(Arthroplasty)”
Kaiser Permanente Thrive, Portland, Oregon
“Knee replacement surgery:
A new lease on life”
NYU Langone Medical Center,
“Knee Replacement Surgery”
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5. DETAILED FINDINGS
28%
32%
40%
MOST MOTIVATING VIDEO
SURGEON FOCUS EDUCATIONAL PATIENT STORY
INSIGHT #1:
WHILE THE PATIENT
TESTIMONIAL WAS MOST
EFFECTIVE, A MESSAGE
THAT COMBINES
PATIENT, CLINICIAN,
AND TECHNICAL
PERSPECTIVES WOULD
BE EVEN MORE
COMPELLING.
While the PATIENT STORY was chosen most often as best video (particularly among women), none of the videos were a clear
winner. In fact, all three videos were fairly effective, rated between 7.3 and 7.9 on a 0 to 10 scale for likelihood to consider the
hospital based on the video.
“I liked aspects of all 3 (videos). I want to
know how the knee surgery is done
(EDUCATIONAL), but I also like the doctor
video (SURGEON FOCUS) that talked about
the ways they could do the surgery depending
on what the issue was. I also liked the
patient’s point of view and how the surgery
helped her be active again (PATIENT
STORY).”
“I notice each video talking about only one
part of the process of having knee
replacement surgery. All three videos
together would cover as much material as a
person would need in order to make an
informed decision about the process.”
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6. DETAILED FINDINGS
Potential patients like hearing details of the surgery from the doctor, especially when they talk about how they uniquely add ress
patient concerns. For example, minimally invasive techniques, innovative technology, and options that provide faster or easie r
recovery such as muscle-sparing or partial replacement approaches drove interest and confidence.
However, actual surgical pictures and videos are polarizing – some like seeing the detail, and others are grossed out or
frightened.
The SURGEON FOCUS video effectively communicated
confidence because the surgeons described the option of a
partial knee replacement, innovative technologies, and
emphasized consistent patient outcomes and improved quality
of life.
Interest in the video however declines when these images of
actual surgery are shown.
“The video backed up its claims for successful outcomes for those suffering from knee pain and the resulting loss of freedom and activity. They
also described new procedures and technologies they use to accomplish the goal of making each patient's dream come true.”
“The doctors seemed more believable, credible and competent.”
“I liked how the hospital explained how they had robotics and minimal invasive techniques in place to maximize the patients knee function but
yet minimize muscle cutting and minimize scarring. I also liked they had the latest in technology/equipment.”
“It was professional and technical, but not too much. This video reassured me that each patient is an individual, and that their surgeries were
customized for their needs.”
“I liked the explanation of the partial vs full knee replacement and the determination on who can have which surgery.”
“This presentation inspires so much confidence that I'd consider traveling to New York to have the surgery.”
INSIGHT #2:
POTENTIAL PATIENTS
LIKE HEARING DETAILS
OF THE SURGERY FROM
THE DOCTOR, BUT
ACTUAL SURGICAL
IMAGES ARE
POLARIZING.
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7. DETAILED FINDINGS
INSIGHT #3:
PATIENTS ARE
INTERESTED IN THE
DETAILS ABOUT THEIR
CONDITION AND WHAT TO
EXPECT BEFORE,
DURING, AND AFTER
THEIR PROCEDURE
AND/OR TREATMENT.
Patients are interested in the details about how the procedure works, from how to prepare for the surgery to what happens dur ing
the surgery, recovery and physical therapy. This level of detail is critical to reassuring them that they will be fine throughout the
process.
Although understanding how the procedure is performed is important and interesting, it doesn’t provide the full story potenti al
patients need to hear. Details they all want to learn about include the recovery and physical therapy, so they know what to e xpect
and how to prepare for their surgery and recovery.
“It gave the most detailed important information out of all of the videos. It showed the steps from the beginning of the
procedure all the way to when a person is in recovery.”
“It gave me less fluff and more actual data about what to expect before and after my surgery in a more professional
manner.”
“It provides the most basic information. I understand the procedure best with this video.”
“I did not know this surgery was so complicated until I saw this video.”
“It's very factual but does not make me feel like
I (the patient) am the focus.”
“It was too graphic to view the operating room.”
The EDUCATIONAL video was well-liked because the details
and visuals provided a solid description of what the patient
should expect, instilling confidence in the hospital and
surgeons. However, some of the details were too graphic for
some people and they want to hear more about the hospital’s
care and recovery experience. They also felt this video was
the most believable of the three and was best at preparing
them for a future knee replacement.
The few images of the O.R. were too graphic for some,
and the darkness of the environment, although real,
seemed dirty.
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8. DETAILED FINDINGS
INSIGHT #4:
PATIENT TESTIMONIALS
ARE ENCOURAGING AND
INSPIRATIONAL,
PROVIDING PERSUASIVE
REASSURANCE.
IMPORTANTLY,
PATIENTS SHOULD BE
ABLE TO SEE
THEMSELVES AS A
PATIENT.
Potential patients want to be able to connect with other patients and see the success they achieved after their knee replacem ent.
When showing patient stories, it’s best to represent a diverse patient base so that people can “see themselves” and relate
strongly.
PATIENT STORY video’s patient testimonial was personal and relatable, which provided helpful information in a way that
was described as upbeat, encouraging, genuine, caring, and calming. Even though it lacked detail about the surgery and
recovery processes, 40% of respondents (and 44% of female respondents) selected it as the most motivating video of the
three.
“I felt encouraged that I would have a good surgery and recovery there.”
“The lady in this video was saying all the things that I'm going through right now. The fact that she had it done and is now able to return
to her normal activities is very encouraging to me.”
“It tells you how this hospital treats the patient from start to finish.”
“It was more friendly and showed the patient, nurse and doctor talking. It seemed as if the whole hospital was invested in the patient.”
This Perception Analyzer output
demonstrates how the interest by
females (red line) was much
higher than that for males (blue
line), because females related to
the female patient story better
than the men did.
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9. DETAILED FINDINGS
They see the knee replacement surgery as complex, needing to last for a long time, and requiring significant physical
therapy for the best outcome. Furthermore, many have heard about failures from people they know. They need significant
reassurance that the surgeons and hospitals have depth of experience and an impressive success rate.
INSIGHT #5:
POTENTIAL PATIENTS
ARE CONCERNED ABOUT
THE RISKS OF SURGERY,
PARTICULARLY WHEN
THEY CONSIDER IT TO
BE INVASIVE OR
COMPLEX.
PATIENT STORY inserts a few key factual statements that effectively build confidence in the hospital and procedure.
Interest values consistently rise sharply when each of the three statements appear on the screen:
Respondents also had fewer questions about the hospital’s success rate for this video compared to the other two videos.
Like Joanne, millions of seniors
and baby boomers face arthritic
knee pain.
Full recovery depends on
completing physical therapy.
More people have had their
knees replaced (here) than
anywhere else in (the local area).
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10. DETAILED FINDINGS
Even though over 2/3 of the respondents had a close friend or family member with a knee replacement, they have A LOT of
questions.INSIGHT #6:
POTENTIAL PATIENTS
HAVE A LOT OF
QUESTIONS – ALL OF
WHICH NEED TO BE
ADDRESSED, EITHER
VIA PATIENT
MATERIALS OR
CONVERSATIONS WITH
HEALTHCARE
PROFESSIONALS
Interestingly, the EDUCATIONAL video which contained a lot of surgical details also generated additional specific
questions, and just as many overall surgical questions as the SURGEON FOCUS video.
Examples of these more specific questions include “How long does the drain stay in?”, “Are there toxins in the joint
materials?”, and “Does shaping of the bones cause additional pain?”
Most of the questions fell within the
following themes:
PHYSICAL THERAPY
How long will I need physical therapy?
Does my insurance cover physical therapy?
Where do I go for it?
COST/INSURANCE
How much does the procedure cost?
Does my insurance cover it?
SURGERY DETAILS
How long does the surgery take?
What kind of anesthesia will I be under?
How large is the scar/stitches?
What is the joint made of?
PAIN
How much pain will I have?
What pain medication will I be taking?
How long will the pain last?
SUCCESS RATE
How many procedures have been performed?
What is the likelihood of a complication?
What happens if something goes wrong?
ELIGIBILITY
How do I know if I'm ready or qualified for surgery?
Are there any age, weight, or health restrictions?
DEGREE OF RESTORATION
How much range of motion can I expect?
Will I be able to run or jog on my new knee?
Will I have any limitations?
PREPARATION
How do I prepare for surgery?
HOSPITAL EXPERIENCE
How long will I be in the hospital?
Will I be walking in the hospital?
Will I have physical therapy in the hospital?
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11. Patients want to see themselves and how a treatment or procedure can
help them.
O.R. pictures and videos can be scary and off-putting, particularly if
lighting is dark, the environment looks cluttered, or blood and organs are
shown.
A recovery process perceived as long and daunting can be a barrier to
procedure consideration.
Patients want to know how “serious” of a procedure they’re considering –
they ask questions about procedure time, risks, anesthesia type, and
success rates.
Real healthcare professionals are better than actors, but those who lack
charisma don’t effectively engage potential patients.
Patients need reassurance that safety and comfort needs will be met
during their experience.
Background music can be distracting.
INSIGHT
Include multiple patient testimonials representing diverse demographics and
disease states.
Consider showing realistic, staged hospital scenes versus actual procedures as
demonstrations. Use care to ensure lighting is bright and surroundings are clean.
Include information about the recovery process (time, intensity, and cost) in a way
that is encouraging.
Include reassurance messaging such as number of procedures performed by
hospital, surgeon credentials, success rates, or risk prevention.
Provide coaching for healthcare workers to improve their confidence and
presentation skills. Include their titles/credentials to prove they are real.
Include testimonials and/or visuals to demonstrate a positive experience focused on
the patient’s care, but don’t overdo it by talking about food or a “resort-like”
experience.
Ensure music is consistent with tone of video and not too loud.
RECOMMENDATION
KEY CONSIDERATIONS:
From our analysis of dial responses and verbatims, we’ve developed this list of watch-outs to consider when evaluating the
effectiveness of DTP materials you’re developing.
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12. About Us
ABOUT ENGAGIOUS
Engagious is a research and message
refinement consultancy. We remove the
guesswork from your communications by
blending art and science to uncover what
connects best with your audience. That is why
some of the world’s largest companies and
government leaders turn to us for our
expertise. Our technologies are industry-
leading and our methods deliver proven results.
www.engagious.com | 212.760.4358 | Gina.Derickson@engagious.com
ABOUT GINA DERICKSON
In her over 20 years in market research, Gina has
partnered with countless marketing and product
development experts to drive new product
development, messaging, brand positioning, and
customer experience strategies through a full
spectrum of qualitative and quantitative market
research methodologies. During her 12 years at
Johnson and Johnson & Johnson and as a research
supplier, Gina has developed a deep understanding
of patients, caregivers, doctors, nurses, materials
managers, C-level executives, and other influencers
for products and procedures in medical devices,
pharmaceuticals, and insurance.
Gina Derickson, Research Director
Gina.Derickson@engagious.com
https://www.linkedin.com/in/ginaderickson/
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