Add well-designed pictures when patient materials must work for low-literacy readers
For patient education and shared decision-making communication, use pictorial encoding on materials that present quantitative health information to improve accessibility and mitigate comprehension problems for readers with low health, numeric, and graph literacy.
- purpose:refine
- basis:empirical
- data:quantitative
- quality:accessibility
- lever:encoding
- knowledge:low
- literacy:novice
advice
Add supportive pictures
Add well-designed pictures to patient education materials that present quantitative health information. For example, pair a numeric or graph-based explanation with a picture in the same material when the audience includes readers with lower health literacy, numeracy, or graph literacy.
reason
Why supportive pictures help here
Pictures reduce how much the reader must rely on reading skill, numerical skill, and graph-reading skill at the same time. That makes patient materials less dependent on abilities that were unevenly distributed in this sample.
Mechanism: Pictures give readers another route to the message when text, numbers, or graphs alone would demand more health literacy, numeracy, or graph literacy than the audience has.
Evidence: This study found substantial limitations in health literacy, numeracy, and graph literacy among veterans, with especially low scores among African American veterans in several measures, and its practice implications recommend well-designed pictures as a way to overcome some of these literacy limitations in educational materials (Rodríguez et al., 2013).
Notes: The paper discusses this move for patient education materials, not as a universal replacement for all quantitative displays.
context
Use when literacy demands are a real barrier
- User Goal: Understand health information well enough to support care decisions.
- Data: Quantitative health information that readers would otherwise need to interpret through numbers or graphs.
- Chart Setting: Patient-facing educational material or decision-support material.
- Audience: Readers with lower health literacy, numeracy, or graph literacy, including audiences where these limits are more prevalent.
- Success Criterion: Readers can follow the message without depending only on text, numbers, or graph-reading skill.
exceptions
Do not use as a universal rule
Break it when: the material is not patient education aimed at overcoming literacy limitations. Why: the paper discusses pictures specifically as an accommodation for low health, numeric, and graph literacy in patient-facing materials.
costs
Costs of adding pictures
Sacrifice: You take on extra design work because the material must be tailored to known literacy limitations. Risk: A picture that is not well designed may fail to reduce the literacy burden. Mitigation: Review the picture with the intended audience during design.
mistakes
Common failure with picture use
Mistake: Adding any picture without tailoring it to the audience’s literacy limitations. Why it fails: The paper recommends well-designed pictures as a targeted response to low literacy, not decorative visuals.
check
Check whether the material still over-relies on literacy
Failure Sign: The material asks readers to rely only on text, numbers, or graphs to understand the main point. Quick Check: Scan the material and verify whether each key quantitative message has a supporting picture. Stronger Test: Review the material with intended audience members during design and check whether they can explain the message back.
fix
Fix the literacy burden
- Add a well-designed picture next to the key quantitative explanation.
- Place the picture in the same patient-facing material as the numbers or graph it supports.
- Review the revised material with intended audience members before release.