Literature review: using pictographs in discharge instructions for older adults with low‐literacy skills

Choi, Jeungok

doi:10.1111/j.1365-2702.2011.03814.x

Cited by 57 publications

(47 citation statements)

References 66 publications

(128 reference statements)

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“…Several studies showed the relevance of pictograms in health (Choi 2011;Dowse and Ehlers 2005;Houts et al 2006). The present study, however, focuses on the use of pictograms in the field of medicines and driving and, to the best of our knowledge, it is one of the few (Orriols et al 2010;Veldhuijzen et al 2006) in this field and the first one to evaluate the use of such pictograms.…”

Section: Discussionmentioning

confidence: 87%

How Effective Are Pictograms in Communicating Risk About Driving-Impairing Medicines?

Monteiro

Huiskes

Dijk

et al. 2013

Traffic Injury Prevention

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Despite not being fully self-explanatory in conveying warnings and safety-related information, the pictograms evaluated in this research provided good insight into the different levels of driving risks, especially the rating model pictogram, because respondents' intentions to change their driving behaviors increased with higher categories of risk. The added value of the side-text in the rating model pictogram was not confirmed in this research. Pictograms can be seen as a valuable means to reinforce both written and spoken information given to patients by health care providers at the time of consultation.

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Section: Discussionmentioning

confidence: 87%

How Effective Are Pictograms in Communicating Risk About Driving-Impairing Medicines?

Monteiro

Huiskes

Dijk

et al. 2013

Traffic Injury Prevention

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“…Further, while eight Web sites (n = 8) provided information in Spanish, Web sites that provide more information about aging and menopause in culturally meaningful ways would also be useful. In addition, not all of the Web sites capitalized on strategies that are known to help facilitate understanding of information, such as incorporating glossaries, using illustrations, and providing audio versions of information about menopause (Choi, 2011;Houts, Doak, Doak, & Loscalzo, 2006;Lewis, 1999;Oermann & Wilson, 2000).…”

Section: Relevance To Health Educators and Practitionersmentioning

confidence: 99%

Readability of Menopause Web Sites: A Cross-Sectional Study

Charbonneau

2012

Journal of Women & Aging

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More women are frequently referring to the Internet for health information, yet the readability of information about menopause on the Internet has not been widely studied. To address this gap, this study examined the readability of information about menopause on 25 Internet Web sites. Findings included that information on the Web sites had a reading level higher than the recommended sixth-grade level, and culturally appropriate health information was lacking. Health educators and practitioners are in a pivotal role to help women understand information useful for healthcare decisions. Several criteria are discussed to help practitioners evaluate Web sites.

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“…This challenge is particularly acute for patients with low literacy levels, since medical instructions are commonly written at a level exceeding the average American’s reading level, and the average reading level is even lower in certain regions, like inner cities and impoverished areas [2,3]. …”

Section: Introductionmentioning

confidence: 99%

Crowdsourcing Participatory Evaluation of Medical Pictograms Using Amazon Mechanical Turk

Willis

Sun

et al. 2013

J Med Internet Res

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BackgroundConsumer and patient participation proved to be an effective approach for medical pictogram design, but it can be costly and time-consuming. We proposed and evaluated an inexpensive approach that crowdsourced the pictogram evaluation task to Amazon Mechanical Turk (MTurk) workers, who are usually referred to as the “turkers”.ObjectiveTo answer two research questions: (1) Is the turkers’ collective effort effective for identifying design problems in medical pictograms? and (2) Do the turkers’ demographic characteristics affect their performance in medical pictogram comprehension?MethodsWe designed a Web-based survey (open-ended tests) to ask 100 US turkers to type in their guesses of the meaning of 20 US pharmacopeial pictograms. Two judges independently coded the turkers’ guesses into four categories: correct, partially correct, wrong, and completely wrong. The comprehensibility of a pictogram was measured by the percentage of correct guesses, with each partially correct guess counted as 0.5 correct. We then conducted a content analysis on the turkers’ interpretations to identify misunderstandings and assess whether the misunderstandings were common. We also conducted a statistical analysis to examine the relationship between turkers’ demographic characteristics and their pictogram comprehension performance.ResultsThe survey was completed within 3 days of our posting the task to the MTurk, and the collected data are publicly available in the multimedia appendix for download. The comprehensibility for the 20 tested pictograms ranged from 45% to 98%, with an average of 72.5%. The comprehensibility scores of 10 pictograms were strongly correlated to the scores of the same pictograms reported in another study that used oral response–based open-ended testing with local people. The turkers’ misinterpretations shared common errors that exposed design problems in the pictograms. Participant performance was positively correlated with their educational level.ConclusionsThe results confirmed that crowdsourcing can be used as an effective and inexpensive approach for participatory evaluation of medical pictograms. Through Web-based open-ended testing, the crowd can effectively identify problems in pictogram designs. The results also confirmed that education has a significant effect on the comprehension of medical pictograms. Since low-literate people are underrepresented in the turker population, further investigation is needed to examine to what extent turkers’ misunderstandings overlap with those elicited from low-literate people.

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Literature review: using pictographs in discharge instructions for older adults with low‐literacy skills

Cited by 57 publications

References 66 publications

How Effective Are Pictograms in Communicating Risk About Driving-Impairing Medicines?

How Effective Are Pictograms in Communicating Risk About Driving-Impairing Medicines?

Readability of Menopause Web Sites: A Cross-Sectional Study

Crowdsourcing Participatory Evaluation of Medical Pictograms Using Amazon Mechanical Turk

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