The use of illustration to improve older adults’ comprehension of health-related information: Is it helpful?

Liu, Chiung-ju; Kemper, Susan; McDowd, Joan M.

doi:10.1016/j.pec.2009.01.013

Cited by 47 publications

(52 citation statements)

References 13 publications

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“…Some research has focused on how younger and older adults attend to online information; however, findings have not been consistent. Several studies have indicated that older adults spend in general more time looking at information because their pace of processing information is slower than that of younger adults (John & Cole, 1986;Liu, Kemper, & McDowd, 2009). However, other studies have found evidence to the contrary (Bol, Romano Bergstrom, et al, 2014) or found no age differences in attention to information when, for instance, videos were added to online information (Bol et al, 2013).…”

Section: Attention To Online Health Informationmentioning

confidence: 99%

“…Some studies have shown that older adults recall more information when cognitive illustrations are added to text (e.g., Cherry, Dokey, Reese, & Brigman, 2003), whereas other research has failed to find evidence for the multimedia effect in older adults (e.g., Bol, . Moreover, an eye-tracking study indicated that although older adults spend more time looking at text and illustrations, they have more difficulties integrating illustrations with text (Liu et al, 2009). Exploring whether attention is predictive of recall of information is therefore of special interest for those of older age.…”

mentioning

confidence: 99%

“…Previous research has shown the importance of recognizing the diversity among older adults and providing them with choices of mode (Soroka et al, 2006). In addition, there may be differences in people's ability to integrate illustrations with text information (Liu et al, 2009), level of education, and level of health literacy. Older adults' inability to integrate illustrations with text appropriately might be one explanation for their paying less attention to the cognitive illustrations than the younger adults in this study.…”

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confidence: 99%

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How Are Online Health Messages Processed? Using Eye Tracking to Predict Recall of Information in Younger and Older Adults

Bol

Weert

Loos

et al. 2016

Journal of Health Communication

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Little research has focused on what precedes the processing of health messages to predict recall of information and whether age matters in this regard. To address this gap, this study investigates the relationship between attention and recall among younger (<65 years) and older (≥65 years) adults. Using eye tracking, we exposed participants to a webpage consisting of text-only information, text with cognitive illustrations, or text with affective illustrations. When attention to text increased, older adults recalled more information, whereas younger adults did not. However, younger adults paid more attention to cognitive illustrations than older adults and recalled more information. These results reveal conditions under which health messages are effectively recalled by younger and older adults.Attention to information is a critical first step in information processing and eventual recall of information (Wedel & Pieters, 2000). Recall of information is the ability to remember and reproduce information correctly, and it plays an important role in predicting many health-related behaviors, such as successful disease management (Kravitz et al., 1993) and adherence to medical regimes (Ley, 1988;Linn, Van Dijk, Smit, Jansen, & Van Weert, 2013). Unfortunately, approximately 40% to 80% of medical information is immediately forgotten after exposure (Kessels, 2003), especially by older adults (Jansen et al., 2008). Older adults have more problems seeking, finding, and understanding health information than younger ones, particularly when information is presented online (Xie, 2008). Even though increasingly more older adults are using the Internet (Hart, Chaparro, & Halcomb, 2008; U.S. Census Bureau, 2010), this does not necessarily mean that they are able to understand and recall online health information. To optimize recall of information among older adults, information should be provided in such a way that older adults' cognitive abilities are taken into account (Van Gerven, Paas, Van Merriënboer, & Schmidt, 2000). One way to accomplish this is by using illustrations that complement online health texts. Illustrations can serve as cues that enable one to make connections between words and pictures in building mental images, thereby reducing working memory demands (Paivio, 1990). Numerous studies have revealed positive effects on recall of information when illustrations are added to information (e.g., Houts, Doak, Doak, & Loscalzo, 2006;Levie & Lentz, 1982).Although much research has focused on the effects of using illustrations in health messages (e.g., on recall of information), none to date has considered the process that precedes these effects. Even though three major subprocesses (encoding, storage, and retrieval) have been acknowledged (Lang, 2000), little is known about the association between encoding information (i.e., attention to text and illustrations) and retrieval (i.e., recall of such text and illustrations), whether the encoding process can predict retrieval, and whether age matters in this regard. This stu...

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Section: Attention To Online Health Informationmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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How Are Online Health Messages Processed? Using Eye Tracking to Predict Recall of Information in Younger and Older Adults

Bol

Weert

Loos

et al. 2016

Journal of Health Communication

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“…In contrast to the findings by Houts et al (2006), a recent study found that one cannot assume that illustrations will increase older adults' comprehension of health information (Liu, Kemper, & McDowd, 2009). The research used eyetracking techniques to compare how young and older adults read and comprehend texts with and without illustrations.…”

Section: Graphicsmentioning

confidence: 85%

Assembly and Insertion of a Self-Fitting Hearing Aid

Caposecco

Hickson

Meyer

2011

Trends in Amplification

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A self-fitting hearing aid has been proposed as a viable option to meet the need for rehabilitation in areas where audiology services are unreliable. A successful outcome with a self-fitting hearing aid pivots in part on the clarity of the instructions accompanying the device. The aims of this article are (a) to review the literature to determine features that should be incorporated into written health-care materials and factors to consider in the design process when developing written instructions for a target audience of older adults and (b) to apply this information to the development of a set of written instructions as the first step in self-fitting of a hearing aid, assembling four parts and inserting the aid into the ear. The method involved a literature review of published peer reviewed research. The literature revealed four steps in the development of written health-care materials: planning, design, assessment of suitability, and pilot testing. Best practice design principles for each step were applied in the development of instructions for how to assemble and insert a hearing aid. Separate booklets were developed for the left and right aids and the content of each consisted of simple line drawings accompanied by captions. The reading level was Grade 3.5 equivalent and the Flesch Reading Ease Score was 91.1 indicating that the materials were "very easy" to read. It is essential to follow best practice design principles when developing written health-care materials to motivate the reader, maximize comprehension, and increase the likelihood of successful application of the content.

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“…In contrast to the findings by , a recent study found that one cannot assume that illustrations will increase older adults' comprehension of health information (Liu, Kemper, & McDowd, 2009). The research used eye-tracking techniques to compare how young and older adults read and comprehend texts with and without illustrations.…”

Section: Graphicsmentioning

confidence: 62%

Health literacy, instruction materials, and hearing aid management in older adults

Caposecco¹

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Approximately 11 million hearing aids were dispensed worldwide in 2012, and of these over 60% were fitted to older adults. All were accompanied by a printed user guide containing information on hearing aid management and troubleshooting. The user guide should play an integral role in the transfer of information on hearing aids particularly as many older adults experience difficulty with aid management tasks, such as cleaning the device or changing the battery. However, it is only effective if it can be read and understood by the client. Many older adults have deficits in vision and/or cognition which may affect their ability to read and use healthcare materials, such as hearing aid user guides, and at least 30% have low health literacy. Health literacy refers to the ability to obtain, process, and comprehend health information and services. To-date there has been limited research on health literacy and/or the design and suitability of instruction materials in the field of rehabilitation audiology.Hence, the overarching aim of this thesis was to determine the appropriateness of currently available hearing aid user guides for older adults and to explore the potential benefits of designing hearing aid instruction materials based on best practice guidelines for health literacy.The thesis is comprised of four studies. The first study analysed the content and design of a sample of printed hearing aid user guides to determine their suitability for older adults.Thirty six user guides from nine different hearing aid manufacturers were examined using a standardised assessment, the Suitability Assessment of Materials, along with four readability formulae. The results showed that hearing aid user guides are not optimal for older adults.Problems included frequent use of uncommon vocabulary, small text size and graphics, and high reading level.The second study involved a review of the literature to determine features that should be incorporated into written healthcare materials and factors to consider in the design process when developing written instructions for a target audience of older adults. The findings were applied to the design and development of a set of written instructions for a self-fitting hearing aid and also informed development of the modified hearing aid user guide used in the final two studies of this thesis.The next two studies explored the benefits of using best practice design principles in the development of hearing aid instruction materials. The studies involved 89 participants, with ii a mean age of 72 years, living in the community, and with no experience of hearing aid use or management. The aim of the third study was to investigate if a hearing aid user guide modified using best practice guidelines for health literacy resulted in superior ability to perform aid management tasks, compared to the user guide in the original form. Half the participants were randomly assigned the original user guide and half were assigned the modified user guide. All participants were administered the Hearing Ai...

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The use of illustration to improve older adults’ comprehension of health-related information: Is it helpful?

Cited by 47 publications

References 13 publications

How Are Online Health Messages Processed? Using Eye Tracking to Predict Recall of Information in Younger and Older Adults

How Are Online Health Messages Processed? Using Eye Tracking to Predict Recall of Information in Younger and Older Adults

Assembly and Insertion of a Self-Fitting Hearing Aid

Health literacy, instruction materials, and hearing aid management in older adults

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