In the digital age, it is critical for both healthcare professionals and consumers to electronically express, receive, and process important health information. This is especially true for populations with language barriers and low literacy. Visual literacy and health literacy enable optimal health communication and wellbeing. A standardized interface terminology is a linguistic tool that can be used to convey health information at the human-computer interface. The Omaha System has been evaluated and found to be a promising standard for use as a simple, standardized terminology that may promote health literacy and communication between healthcare professionals and consumers. However, a method for visually representing health concepts described by the Omaha System has not been developed. The purpose of this study was to develop a complete set of 42 icons that convey the meaning of each of the 42 Omaha System problem concepts as defined by Martin (2005). Design thinking, universal design methods, and informal survey evaluations were used to determine appropriate imagery for the icons. Data-based revisions were incorporated after each of three informal survey evaluations. The resulting set of 42 icons for Omaha System problem concepts is available in the public domain. Future plans are to conduct extensive global evaluation of concept validity and usefulness of the icons across literacy levels.

Omaha System problem concepts describe a comprehensive, holistic view of health in simple terms that have been represented in a set of prototype icons intended for universal use by consumers and clinicians. The purpose of this study was to evaluate Omaha System prototype icons internationally across ten languages through an on-line survey and in-person focus groups. The icons were generally rated above 3 on a scale of 1 to 5 by 1568 survey respondents, with notable exceptions for some of the more abstract concepts. Overall, the icons were rated 3.49 on a scale of 1 = strongly disagree to 5 = strongly agree, with a range of 3.09 (Japanese language) to 3.88 (Norwegian language). A pattern of differential agreement was noted among respondents from Asiatic languages compared to all other languages. Feedback from survey respondents and focus group participants was used to refine the icons. General themes related to icon development were synthesized from focus group interviews. Further research should continue to refine and evaluate the icons in different languages for international use to support health literacy through visual literacy.

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