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Center for Health Literacy Promotion Blog

Promoting Health Literacy with Beginnings Guides Part 7: Illustration

How do we advance toward the national vision of a health literate society in which everyone gets actionable health information along with the support needed to use it in context for personal benefit? 
The first requirement is actionable information that fits the learner. We know that info that is meaningful and useful to me may not be suitable for you.  We are using the Suitability Assessment of Materials - SAM  to check the fit of Beginnings Guides for promoting health literacy in mothers of children aged 0 (pregnancy) to three years. Part 6began our consideration of graphic elements. This Part 7 addresses  the type and relevance of illustrations and captions.

Illustrate key messages. The purpose of an image on the page is to present the key content visually, to “say” the important point another way.   Avoid using images to fill space or carry the design; that is like introducing background noise.
Every image needs a caption to tell the reader where to focus and what to think about. An image without a caption is a missed teaching and learning opportunity.  An intended learner should be able to look at the images and read only the captions and still get the key points.
Your baby has strong feelings.

Keep illustrations simple
SAM recommends simple line drawings that promote realism without distracting details.  The line drawings part may be out of date; learners have become much more sophisticated viewers of images in the 20 years since Len and Cici Doak wrote and tested the SAM.  However, the part about keeping illustrations simple, omitting distracting detail, has become more important as the competition for attention and memory has increased.  Non-essential details distract from the key point.  For example, in info for pregnant women and parents, wedding rings can distract readers into all sorts of tangents and emotional issues unrelated to the topic.
I prefer photos to clip art,  as long as they look “real” and there is not too much detail. Black and white photos are less expensive to print than color and can help focus readers on the important content.

Pregnancy is not a time to lose weight.
Do not go on a diet. Eat well and eat often.

Choose images that are familiar to the learners; people who look like them in settings they have experienced. We have learned from testing Beginnings Guides that abstract symbols are often not recognized. Anatomical drawings break the rules about simplicity and familiarity - we just are not accustomed to seeing the inside of the body.  Sometimes they are appropriate but must be carefully labeled, and require direct assistance to make meaning out of them. Illustrations of detached body parts made our testers uncomfortable. 

Only the learners know for sure which images aid their understanding and lead them into action. Test the images along with the text. If you need to change them, you need to retest to be sure you solved the problem and did not create a new one.

Breastfeed your baby for as long as possible.

BeginningsGuides get three Superior ratings in this section: for consistent use of simple, familiar images; for presenting key messages so the learner can “get” the main ideas from the images alone; for using a caption on nearly all illustrations.
Next: Lists, tables, charts, forms.
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