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

OBJECTIVE To examine whether explanatory illustrations can improve older adults' comprehension of written health information. METHODS Six short health-related texts were selected from websites and pamphlets. Young and older adults were randomly assigned to read health-related texts alone or texts accompanied by explanatory illustrations. Eye movements were recorded while reading. Word recognition, text comprehension, and comprehension of the illustrations were assessed after reading. RESULTS Older adults performed as well as or better than young adults on the word recognition and text comprehension measures. However, older adults performed less well than young adults on the illustration comprehension measures. Analysis of readers' eye movements showed that older adults spent more time reading illustration-related phrases and fixating on the illustrations than did young adults, yet had poorer comprehension of the illustrations. CONCLUSION Older adults might not benefit from text illustrations because illustrations can be difficult to integrate with the text. PRACTICE IMPLICATIONS Health practitioners should not assume that illustrations will increase older adults' comprehension of health information.

[1]  A. Paivio Mental Representations: A Dual Coding Approach , 1986 .

[2]  M. Just,et al.  Constructing mental models of machines from text and diagrams. , 1993 .

[3]  W. C. Shipley A Self-Administering Scale for Measuring Intellectual Impairment and Deterioration , 1940 .

[4]  Fergus I. M. Craik,et al.  A functional account of age differences in memory , 2016 .

[5]  P. Carpenter,et al.  Individual differences in working memory and reading , 1980 .

[6]  Mark A. Kutner,et al.  The Health Literacy of America's Adults: Results from the 2003 National Assessment of Adult Literacy. NCES 2006-483. , 2006 .

[7]  Allan Paivio,et al.  Dual Coding Theory , 1990 .

[8]  L W Poon,et al.  Effects of labeling techniques on memory and comprehension of prescription information in young and old adults. , 1990, Journal of gerontology.

[9]  The Influence of Pictorials on the Comprehension and Recall of Pharmaceutical Safety and Warning Information , 2011 .

[10]  James Hartley,et al.  Designing instructional text , 1978 .

[11]  S. Kemper,et al.  Eye movements of young and older adults during reading. , 2007, Psychology and aging.

[12]  D W Baker,et al.  Health literacy among Medicare enrollees in a managed care organization. , 1999, JAMA.

[13]  D W Baker,et al.  The association between age and health literacy among elderly persons. , 2000, The journals of gerontology. Series B, Psychological sciences and social sciences.

[14]  J. Pickova The Measurement and Appraisal of Adult Intelligence , 1959 .

[15]  James A. Bovaird,et al.  Comprehension of Health-related Written Materials by Older Adults , 2009, Educational Gerontology.

[16]  W. Howard Levie,et al.  Effects of text illustrations: A review of research , 1982 .

[17]  V. Leirer,et al.  Icons improve older and younger adults' comprehension of medication information. , 1998, The journals of gerontology. Series B, Psychological sciences and social sciences.

[18]  Denise C Park,et al.  Theoretical models of cognitive aging and implications for translational research in medicine. , 2003, The Gerontologist.

[19]  Rudolf Franz Flesch Marks of readable style : a study in adult education , 1943 .

[20]  T. Ryan Guidelines for percutaneous transluminal coronary angioplasty. A report of the American College of Cardiology/American Heart Association Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (Subcommittee on Percutaneous Transluminal Coronary Angioplasty). , 1988, Journal of the American College of Cardiology.

[21]  M. Just,et al.  From the SelectedWorks of Marcel Adam Just 1992 A capacity theory of comprehension : Individual differences in working memory , 2017 .