Original Article

New and improved: The role of text augmentation and the application of response interpretation standards (coding schemes) in a final iteration of birth defects warnings development†

  1. Christopher B. Mayhorn1,*,
  2. Richard C. Goldsworthy2

Article first published online: 23 JUN 2009

DOI: 10.1002/bdra.20601

Issue

Birth Defects Research Part A: Clinical and Molecular Teratology

Birth Defects Research Part A: Clinical and Molecular Teratology

Volume 85, Issue 10, pages 864–871, October 2009

Additional Information

How to Cite

Mayhorn, C. B. and Goldsworthy, R. C. (2009), New and improved: The role of text augmentation and the application of response interpretation standards (coding schemes) in a final iteration of birth defects warnings development. Birth Defects Research Part A: Clinical and Molecular Teratology, 85: 864–871. doi: 10.1002/bdra.20601

Author Information

  1. 1

    Department of Psychology, North Carolina State University, Raleigh, North Carolina, USA

  2. 2

    The Academic Edge, Inc, Bloomington, Indiana, USA

*Department of Psychology, North Carolina State University, 640 Poe Hall, Campus Box 7650, Raleigh, NC 27695-7650

  1. †

    The article's contents are solely the responsibility of the authors and do not necessarily represent the official views of NCBDDD/CDC.

Publication History

  1. Issue published online: 5 OCT 2009
  2. Article first published online: 23 JUN 2009
  3. Manuscript Accepted: 17 APR 2009
  4. Manuscript Revised: 9 APR 2009
  5. Manuscript Received: 24 FEB 2009

Funded by

  • National Center on Birth Defects and Developmental Disabilities (NCBDDD). Grant Numbers: 1R43DD00001-01, 1R44DD00001-01
  • Centers for Disease Control and Prevention (CDC)

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Keywords:

  • warnings;
  • symbols;
  • teratogen;
  • birth defects;
  • medications

Abstract

BACKGROUND:

Several birth defects warning symbols identified as most successful in an earlier study (Mayhorn and Goldsworthy, 2007) were further modified and then evaluated within a nationally distributed field trial (n = 2773). The purpose for the current research was to determine whether symbol warning components could be improved further, whether the addition of text enhanced comprehension uniformly across symbols, and whether results varied by the application of different interpretation standards (coding schemes).

METHOD:

A total of 11 warning labels were examined: four new symbols plus the existing baseline symbol, each in versions with and without text, plus a text-only condition. Participant interpretation accuracy and preferences were assessed during face-to-face interview sessions.

RESULTS:

For symbol-only conditions, several candidate symbols outperformed the existing symbol, one substantially so. The effect of adding text to symbols varied significantly by symbol. Symbol plus text and text-only conditions performed equivalently, generally exceeded symbol-only conditions, and often surpassed the American National Standards Institute benchmark of 85% accurate interpretation.

CONCLUSIONS:

The research effort has identified a teratogen symbol and warning that outperforms the one currently in use. The effort has also identified important pragmatic and conceptual issues that should inform future work to improve medication labeling and other hazard communication. Birth Defects Research (Part A), 2009. © 2009 Wiley-Liss, Inc.

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