Exploring the role of health literacy on attention to and recall of text-illustrated health information: An eye-tracking study

Abstract

Although the use of illustrations is often recommended for audiences with limited health literacy, it is unclear how health literacy impacts the use of different online formats. The aim of this paper is therefore to investigate how health literacy influences attention to text and illustrations in online health information, and whether such attention is related to recall of information. Sixty-one participants were exposed to either text-only or text-illustrated information. Using eye tracking, we recorded attention patterns on a health webpage after which recall of information was assessed. Results showed that health literacy influenced the attention-recall relationship. For people with limited health literacy, attention to the illustrations was positively related to recall, whereas attention to the text improved recall of information in the adequate health literate group. As attention to different parts of online health information leads to different information processing routes for people with different levels of health literacy, effective health communication should consider both text and illustrations that attract attention and improve understanding of the health message.

An Examination of the Clarity of Government Health Websites Using the Centers for Disease Control and Prevention's Clear Communication Index

“…The consumer would be better served if health information websites target the users' literacy levels by using language that is easy to understand and apply using visual examples (Kreps and Neuhauser, 2010). Illustrations are also useful when consumers possess limited health literacy levels for increasing understanding and recall of health information (Meppelink and Bol, 2015).…”

Online Information and Communication Systems to Enhance Health Outcomes Through Communication Convergence

“…Digital systems need to incorporate message systems that are targeted to users' literacy levels and information needs, incorporating language that is easy for them to understand and apply, and providing vivid examples (visual, auditory, and language-based) with which users can identify (Kreps & Neuhauser, 2010a). Research shows that using illustrations with consumers who possess limited levels of health literacy can increase understanding and recall of health information (Meppelink & Bol, 2015). This suggests the need for careful audience analysis and user-centered design in developing multimodal and user-responsive digital messaging systems (Kreps, 2014b;Neuhauser & Kreps, 2014).…”

Eye Tracking-based Evaluation of User Engagement with Standard and Personalised Digital Education for Diabetic Patients

“…A contrasting approach to evaluating an individual's attention towards health information is through analysis of eye gaze activity. Eye tracking is a technique for documenting and quantifying eye movements [22], and has been employed to appraise users' focus of attention and cognitive load when searching for and using health information [10,23,24]. Eye movement data can indicate where the user's interest is directed on a visual display and how the level of interest fluctuates in response to different visual stimuli.…”

“…In order for a patient to process and subsequently recall health information they must be attentive to the information provided [10,11]. Nevertheless, a challenge exists in identifying methods of providing health information that will encourage patients to engage with the material.…”