Authorship credits: Conception and design, or analysis and interpretation of data (Choi); drafting the article or revising it critically for important intellectual content (Choi); and final approval of the version to be published (Choi).
Development and pilot test of pictograph-enhanced breast health-care instructions for community-residing immigrant women
Version of Record online: 29 JUL 2012
© 2012 Blackwell Publishing Asia Pty Ltd
International Journal of Nursing Practice
Volume 18, Issue 4, pages 373–378, August 2012
How to Cite
- Issue online: 29 JUL 2012
- Version of Record online: 29 JUL 2012
- breast health-care instructions;
- immigrant women;
- low literacy;
- visual aids
Current written text-based health-care instructions are not suitable for presenting lengthy, complex breast health-care instructions and are difficult for immigrant women with limited literacy skills. The aims of this study were to develop breast health-care instructions enhanced by pictographs (simple line drawings representing health-care actions) and pilot test the instructions in a sample of six immigrant women with limited literacy skills. Based on the Mayer's Cognitive Theory of Multimedia Learning, pictographs were developed in addition to low-literacy text. The text and the pictographs were then pilot tested with six immigrant women in community health centres for clarity, comprehension and acceptability through face-to-face interviews. Participants perceived that the drawings were engaging and enhanced clarity of the intended health-care messages. The black and white simple line drawings were well received by participants of varying race and ethnicity. The pictograph-based approach might be an effective tool in developing health-care instructions for immigrant women with limited literacy skills. Future research is needed to compare the effect of pictograph-enhanced instructions with written text-based instructions on adherence to instructions and health outcomes.