title: Patients' preferences for visuals: differences in the preferred level of detail, type of background and type of frame of icons depicting organs between literate and low-literate people.
abstract: OBJECTIVE
  To evaluate icons of organs with systematic variations in design to provide directions for the development of pictograms that support patient leaflets targeted at a low-literate audience.
  
  
  METHODS
  In interview questionnaires, 191 pharmacy visitors (IJsselstein, The Netherlands), indicated for four organs in which image the organ was represented most clearly. The icons vary in level of detail of the depicted organ, in the organs that are shown in the background, and in how much of the body is shown as frame. Participants' literacy was determined through the Dutch Rapid Estimate of Adult Literacy in Medicine (REALM-D).
  
  
  RESULTS
  For the three internal organs, the intestines, lungs and kidneys, low-literate participants were more likely than literate participants to opt for less context in the form of the frame of the body.
  
  
  CONCLUSIONS
  When the meaning of the visual is given, low-literate people prefer organ icons with less context of the body over a depiction of the whole body.
  
  
  CONCLUSIONS
  Since literate and low-literate people differ in perceptual preferences, continued involvement of people with limited literacy skills in the design process is essential to target the visuals to their needs.
authors.affiliation: Leiden University Medical Center, Leiden, The Netherlands; Science Communication & Society, Leiden University, Leiden, The Netherlands. Electronic address: m.m.van_beusekom@lumc.nl.
authors.forename: Mara
authors.initials: M
authors.lastname: van Beusekom
authors.affiliation: Science Communication & Society, Leiden University, Leiden, The Netherlands; The Hague University, The Hague, The Netherlands.
authors.forename: Mark
authors.initials: M
authors.lastname: Bos
authors.affiliation: Medical Statistics & Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Ron
authors.initials: R
authors.lastname: Wolterbeek
authors.affiliation: Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Henk-Jan
authors.initials: HJ
authors.lastname: Guchelaar
authors.affiliation: Science Communication & Society, Leiden University, Leiden, The Netherlands.
authors.forename: Jos
authors.initials: J
authors.lastname: van den Broek
mesh_terms: D000328:Adult; D001296:Audiovisual Aids; D003256:Community Participation / Q000523:psychology*; D032882:Comprehension; D005260:Female; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D057240:Patient Preference; D011795:Surveys and Questionnaires
keywords: Limited literacy; Patient leaflets; Visuals