A randomized study of multimedia informational aids for research on medical practices: Implications for informed consent

Abstract

Background/aims Participant understanding is a key element of informed consent for enrollment in research. However, participants often do not understand the nature, risks, benefits, or design of the studies in which they take part. Research on medical practices, which studies standard interventions rather than new treatments, has the potential to be especially confusing to participants because it is embedded within usual clinical care. Our objective in this randomized study was to compare the ability of a range of multimedia informational aids to improve participant understanding in the context of research on medical practices. Methods We administered a Web-based survey to members of a proprietary online panel sample selected to match national U.S. demographics. Respondents were randomized to one of five arms: four content-equivalent informational aids (animated videos, slideshows with voiceover, comics, and text), and one no-intervention control. We measured knowledge of research on medical practices using a summary knowledge score from 10 questions based on the content of the informational aids. We used ANOVA and paired t-tests to compare knowledge scores between arms. Results There were 1500 completed surveys (300 in each arm). Mean knowledge scores were highest for the slideshows with voiceover (65.7%), followed by the animated videos (62.7%), comics (60.7%), text (57.2%), and control (50.3%). Differences between arms were statistically significant except between the slideshows with voiceover and animated videos and between the animated videos and comics. Informational aids that included an audio component (animated videos and slideshows with voiceover) had higher knowledge scores than those without an audio component (64.2% versus 59.0%, p<.0001). There was no difference between informational aids with a character-driven story component (animated videos and comics) and those without. Conclusions Our results show that simple multimedia aids that use a dual-channel approach, such as voiceover with visual reinforcement, can improve participant knowledge more effectively than text alone. However, the relatively low knowledge scores suggest that targeted informational aids may be needed to teach some particularly challenging concepts. Nonetheless, our results demonstrate the potential to improve informed consent for research on medical practices by using multimedia aids that include simplified language and visual metaphors.

The potential of comics in science communication

“…Animations are a passive medium, in which the flow of information is not controlled by the receiver and this may be a disadvantage from an educational perspective [Tversky, Morrison and Betrancourt, 2002;Yang, 2008]. Only a recent study directly compared comics and animation as medical informational aids, finding that animated videos (or slideshows with voice-over narration) are more effective than comics in explaining medical practices, although both were more effective than text alone [Kraft et al, 2016]. More studies of this kind will be required in order to determine which visual strategies are more effective, on which topics and for which audiences.…”

“…When compared to traditional text-based material, comics appear to significantly improve understanding and recollection of medical conditions [Diamond et al, 2016;Tekle-Haimanot et al, 2016], compliance with medical instructions [Delp and Jones, 1996;Tjiam et al, 2013], promote informed consent [Furuno and Sasajima, 2015;Kraft et al, 2016], facilitate interactions between patients and doctors [Anderson, Wescom and Carlos, 2016] and between patients and their communities [McNicol, 2014;McNicol, 2017], and generally improve community engagement with medical issues [Leung et al, 2014;Wang, Acevedo and Sadler, 2017]. However, the health-related information presented in these comics clearly has a different emotional value than generic scientific knowledge.…”

Genetic Counseling and the Central Tenets of Practice

“…Many of the attributes of digital platforms, such as dual-channel messaging-coupling audio to video-and use of quizzes to check for understanding, can enhance learning for patients/clients who benefit from taking in new information through multiple means (Kraft et al 2017). Digital platforms can also extend access of services to patients/clients who may otherwise not be able to travel to a medical center.…”

Integrating Parents in Neonatal and Pediatric Research

“…In our experience, this process enriches the investigation as parents provide a complementary lens in the analysis. In many of our projects, we found that resource parents make invaluable contributions to the development of themes, results, and analysis of results [33]. …”