Methodology of an approach for modifying pictograms showing medication side effects or indication

ABSTRACT

Background:

Pictograms may improve user-friendliness and comprehension of written or verbal health information. This paper describes a method to modify pictograms to improve their visual clarity, appeal and overall interpretive complexity in order to reduce the cognitive load on the viewer during comprehension.

Methodology:

Nine pictograms previously tested for comprehension were selected for modification. In phase 1, two participatory design workshops were conducted with (a) three limited literacy, first-language isiXhosa-speaking participants and (b) four university students. Opinions and ideas for improving interpretation were discussed. In phase 2, revised visuals were generated by the graphic artist and subsequently modified in an intensive, multistage, iterative process.

Results:

As no guidelines for pictogram modification exist, a modification schema was developed based on the process described in this study. Adopting a participatory approach combined with a systematic, intensive modification process enabled the opinions and preferences of the end-users to be heard, ensuring cultural relevance and contextual familiarity of the final product. Careful scrutiny of all individual visual elements of each pictogram, considerations of space, and thickness of lines all contributed to improving the legibility of visuals.

Conclusions:

The methodology for designing and modifying existing pictograms using a participatory process resulted in nine final pictograms that were approved by all design team members and considered good candidates for subsequent comprehension testing. The methodological schema presented in this paper provides guidance to researchers intending to design or modify pictograms.

KEYWORDS:

• Medication pictograms
• visuals
• design elements
• iterative design
• participatory
• side effects
• indications
• visual legibility

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics approval statement

Ethics approval for the study was obtained from the Rhodes University Ethical Standards Committee (REC-241114-045).

Acknowledgements

The authors would like to thank our participants for their time and valuable contribution to the study, our graphic artist Mrs Susan Abraham, our interpreter Mr Efese Betela, and staff at the Assumption Community Centre, Joza, Grahamstown .

Additional information

Funding

This work was supported by Rhodes University [grant number RC_2019].

Notes on contributors

Ros Dowse

Ros Dowse is Emeritus Associate Professor, Faculty of Pharmacy, Rhodes University

Sam Okeyo

Sam Okeyo was an undergraduate pharmacy student at the time of the study in the Faculty of Pharmacy, Rhodes University where he is now currently completing his MPharm.

Simise Sikhondze

Simise Sikhondze was an undergraduate pharmacy student at the time of the study in the Faculty of Pharmacy, Rhodes University where she is now currently completing her MSc(Pharm).

Nosihle Khumalo

Nosihle Khumalo was an undergraduate pharmacy student at the time of the study in the Faculty of Pharmacy, Rhodes University and is now a community service pharmacist, Rietvlei Hospital, KwaZulu Natal, South Africa