From Demographics to Behavior: Rethinking How NHLBI Reaches Its Audiences
The National Heart, Lung, and Blood Institute needed a digital strategy built for real people — not for org chart logic. I led the audience research and digital governance work that replaced 20 demographic personas with 7 behavior-based profiles, and built the content framework to support them.
A world-class research institution with an identity crisis online
The National Heart, Lung, and Blood Institute produces some of the most consequential health research in the world — from clinical guidelines on hypertension to landmark trials on sickle cell disease. But its digital presence wasn't built for the people who needed that research most.
NHLBI's web strategy had been organized around the institute's internal structure: divisions, programs, and offices — not around patients asking about chest pain at midnight, or clinicians looking for updated treatment protocols. The result was a site that served the organization better than it served its mission.
20 demographic audience personas — too many to actually design for, too shallow to drive strategy
Content organized by NHLBI org structure, not by user need or task
No formal governance model for how content moved from idea to publication
Inconsistent voice, IA, and metadata across disease areas and program pages
Growing digital footprint with no shared standards across divisions
UX & Content Strategist — audience research, IA, and governance design
Behavioral Audience Research
Redesigned NHLBI's audience model from the ground up — consolidating 20 demographic personas into 7 behavior-based profiles using a health savvy × digital engagement matrix. Each segment includes critical info needs, challenges, habits, and NHLBI name recognition levels.
Information Architecture & Content Strategy
Developed content strategy recommendations grounded in user task flows, not program structure. Defined how each audience segment navigates the site, what they need at each step, and how content should be organized and tagged to serve multiple audiences from a single asset.
Digital Governance Framework
Designed the 4-layer governance model covering Policy, Oversight, Execution, and Concept — with a formal content approval workflow from new idea through publication. Built to support NHLBI's scale while maintaining federal compliance and editorial quality.
From 20 demographic personas to 7 behavioral profiles
Demographic personas tell you who someone is. Behavioral profiles tell you what they do, what they need, and how they'll interact with your content. I rebuilt NHLBI's audience model on two axes — health savvy and digital engagement — that actually predict how people use a health information website.
Consumer — Searcher
Proactively seeking health information online. High digital engagement, varying health literacy. Responds to clear, actionable content and trusted sourcing.
Consumer — Non-Searcher
Reached through passive channels — social, media, community. Low motivation to seek health info independently. Needs accessible entry points and relatable framing.
Researcher
Academic and scientific professionals seeking data, publications, and funding opportunities. High both dimensions. Needs precision, depth, and credibility signals.
Medical Professional
Clinicians and healthcare providers seeking clinical guidelines, evidence, and patient education resources. High health savvy, moderate tech engagement with NHLBI specifically.
Advocate / Influencer
Patient advocates, nonprofit leaders, and community health voices. Amplify NHLBI content and translate research for affected communities. Varies widely by organization.
Policy Maker
Federal and state officials, congressional staff, and program administrators. Seek budget justification, program data, and policy impact evidence. Low day-to-day health engagement.
Consumer — Non-Searcher
Reached through passive channels — social, media, community. Low motivation to seek health info independently. Needs accessible entry points and relatable framing.
This segment has the highest potential health impact — and the lowest existing engagement. Reaching them requires meeting them where they are, not where we want them to be.
A 4-layer governance model built for NHLBI's scale
Content at a federal health agency can't just be correct — it has to be compliant, strategically aligned, and operationally sustainable. The governance framework I designed gives every layer of the organization clear ownership, while keeping the editorial chain moving.
Sets the rules. NIH, HHS, and federal policy define the compliance and security boundaries within which all digital content operates.
Governs program alignment. Division Directors, Office of Science Policy, and Communications (OSPEEC) ensure content supports NHLBI's strategic mission.
Day-to-day operations. The Digital Management Team handles IA review, content ticketing, staging, and production workflows.
Where content originates. Content Owners and Working Groups develop new ideas and route them through the approval chain.
Information-Centric
Content organized around what users need to know, not around NHLBI's internal structure.
Shared Platform
Common infrastructure, taxonomy, and governance across all NHLBI digital properties.
Customer-Centric
Audience behavior and needs drive content decisions — not institutional convenience.
Security & Privacy
Federal compliance integrated from the start, not retrofitted after the fact.
From concept to published — a 7-step approval workflow
One of the biggest sources of content debt in federal agencies is an unclear path from idea to publication. I designed a formal workflow that makes every handoff explicit — so nothing gets stuck in someone's inbox indefinitely.
New Concept
Content Owner or Working Group identifies a content need and drafts initial concept.
D/O/C Approval
Division, Office, or Center leadership reviews for programmatic alignment and priority.
OSPEEC Messaging Review
Communications reviews for on-brand messaging, tone, and cross-institute consistency.
Digital Management Team IA Review
IA and digital team assess placement, taxonomy, metadata, and user journey fit.
Ticket → Priority → Stage
Content enters the production queue, is prioritized, and staged for final review in the CMS.
Content Owner Final Approval
Originating owner reviews staged version and signs off before publication.
Publish Live
Content goes live. Post-publication analytics feed into the next content planning cycle.
The choices that shaped the strategy
20 personas were unusable in practice
7 behavioral profiles built on observable dimensions — health savvy and digital engagement — that any content creator could apply without a PhD in audience research.
Org structure was driving IA decisions
Shifted to task-based architecture: what does this user need to accomplish? Content is organized by user goal, with program attribution secondary.
Governance existed only at the top of the org
Distributed governance to the point of origin — Content Owners carry responsibility from concept through approval, not just at publication.
Digital and communications worked in silos
Integrated the OSPEEC messaging review into the digital workflow, so IA and brand voice decisions happen in parallel, not sequentially.
Strategy that put the audience first — and gave NHLBI the tools to keep it that way
Behavior-based audience profiles replacing 20 demographic personas
Governance layers with clear ownership at every stage
Formal content approval workflow from concept to publication
Governing values anchoring every digital decision to user and mission
The behavioral framework NHLBI adopted didn't just improve the website — it gave program teams a shared language for talking about their audiences across communications, digital, and policy work.
When strategy is grounded in how people actually behave online rather than how we categorize them demographically, the resulting content decisions are faster, more consistent, and measurably more effective at reaching the people who matter most to the mission.
What I learned
The most important thing I took from the NHLBI engagement is that audience models are only as good as the decisions they enable. NHLBI had 20 personas because they felt comprehensive — but no content team was actually using them to make choices. Seven profiles, built around behavior instead of demographics, gave people something they could actually act on.
The governance work reinforced something I'd learned on other federal projects: process failure is almost always a symptom of ownership failure. When it wasn't clear who was responsible for a piece of content at each stage, things stalled. The approval workflow I designed wasn't bureaucracy for its own sake — it was a clarity document.
Working at the intersection of health communication and digital strategy is where I find the most meaningful problems to solve. The stakes — patient health outcomes, public trust in federal science, equitable access to information — make getting the UX right genuinely matter.
Accessibility at American University
Building digital inclusion into the fabric of a university