Calculating alcohol risk in a visualization tool for promoting healthy behavior

Does Animation Improve Comprehension of Risk Information in Patients with Low Health Literacy? A Randomized Trial

Introduction. Enhanced visual effects, like animation, have the potential to improve comprehension of probabilistic risk information, particularly for those with lower health literacy. We tested the effect of presentation format on comprehension of colorectal cancer (CRC) screening probabilities to identify optimal risk communication strategies. Methods. Participants from a community foodbank and a cancer prevention center were randomized to 1 of 3 CRC screening risk presentations. The presentations used identical content but varied in format: 1) video with animated pictographs, 2) video with static pictographs, and 3) audiobooklet with static pictographs. Participants completed pre- and postpresentation surveys. The primary outcome was knowledge of probability/risk information regarding CRC screening, calculated as total, verbatim, and gist scores. Results. In total, 187 participants completed the study and were included in this analysis. Median age was 58 years (interquartile range [IQR]: 14 years), most participants were women (63%), and almost half had a high school education or less (46%). Approximately one-quarter had inadequate health literacy (Short Test of Functional Health Literacy in Adults marginal/inadequate: 28%; Brief Health Literacy Screener low: 18%), and about half had low numeracy (Subjective Numeracy Scale low: 54%; Graphical Literacy Measure low: 50%). We found no significant differences in total, verbatim, or gist knowledge across presentation formats (all P > 0.05). Discussion. Use of an animated pictograph to communicate risk does not appear to augment or impede knowledge of risk information. Regardless of health literacy level, difficulty understanding pictographs presenting numerical information persists. There may be a benefit to teaching or priming individuals on how to interpret numerical information presented in pictographs before communicating risk using visual methods. Trial Registry: NCT02151032.

Foreground-background salience effect in traffic risk communication

Pie charts are often used to communicate risk, such as the risk of driving. In the foreground-background salience effect (FBSE), foreground (probability of bad event) has greater salience than background (no bad event) in such a chart. Experiment 1 confirmed that the displays format of pie charts showed a typical FBSE. Experiment 2 showed that the FBSE resulted from a difference in cognitive efforts in processing the messages and that a foreground-emphasizing display was easier to process. Experiment 3 manipulated subjects’ information processing mindset and explored the interaction between displays format and information processing mindset. In the default mindset, careless subjects displayed a typical FBSE, while those who were instructed to be careful reported similar risk-avoidant behavior preference reading both charts. Suggestions for improving risk communication are discussed.