Sometimes more is more: iterative participatory design of infographics for engagement of community members with varying levels of health literacy

Abstract

Objective: To collaborate with community members to develop tailored infographics that support comprehension of health information, engage the viewer, and may have the potential to motivate health-promoting behaviors.

Methods: The authors conducted participatory design sessions with community members, who were purposively sampled and grouped by preferred language (English, Spanish), age group (18-30, 31-60, >60 years), and level of health literacy (adequate, marginal, inadequate). Research staff elicited perceived meaning of each infographic, preferences between infographics, suggestions for improvement, and whether or not the infographics would motivate health-promoting behavior. Analysis and infographic refinement were iterative and concurrent with data collection.

Results: Successful designs were information-rich, supported comparison, provided context, and/or employed familiar color and symbolic analogies. Infographics that employed repeated icons to represent multiple instances of a more general class of things (e.g., apple icons to represent fruit servings) were interpreted in a rigidly literal fashion and thus were unsuitable for this community. Preliminary findings suggest that infographics may motivate health-promoting behaviors.

Discussion: Infographics should be information-rich, contextualize the information for the viewer, and yield an accurate meaning even if interpreted literally.

Conclusion: Carefully designed infographics can be useful tools to support comprehension and thus help patients engage with their own health data. Infographics may contribute to patients' ability to participate in the Learning Health System through participation in the development of a robust data utility, use of clinical communication tools for health self-management, and involvement in building knowledge through patient-reported outcomes.

Keywords: audiovisual aids; comprehension; health communication; health literacy; patient participation.

© The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Figures

Figure 1:

Infographic of Victor’s fruit serving consumption per week as compared to that of other men in his age group and to the minimum recommended servings.

Figure 2:

Infographic of Maria’s blood pressure in the context of criterion ranges alongside some of the risks of high blood pressure.

Figure 3:

Infographic depicting blood pressure values and criterion categories using a stoplight analogy.

Figure 4:

Infographic of Maria’s sleep and energy as compared to that of other women in her age group.

Figure 5:

Infographic of Maria’s level of chronic stress compared to that of other women in her age group.

Figure 6:

Infographic of (a) Maria’s days of exercise per week as compared to that of other women in her age group and (b) Victor’s self-rating of overall health as compared to that of other men in his age group. The icons in these infographics were employed in two qualitatively different ways that affected comprehension.