Shared treatment decision making in a cancer setting requires a patient's understanding of the potential benefits and risks of each treatment option. Graphical display of risk information is one approach to improving understanding. Little is known about how patients engage with infographics in the context of health education materials and whether interactions vary with health literacy levels. We conducted an observational study, using an eye tracker device, of how men with newly diagnosed localized prostate cancer visually engaged with an on-screen infographic depicting risk information in the Personal Patient Profile-Prostate. Health literacy was measured with the Short Assessment of Health Literacy-English. Gaze patterns on an exemplar screens containing infographics about survival were analyzed and explored with respect to sociodemographic and health literacy data. Acceptability of Personal Patient Profile-Prostate was measured with the Acceptability E-scale. Twenty-six English-speaking men participated, and eye tracking data were collected for 12 men on the exemplar page of risk information that we analyzed. We found preliminary evidence of visual scanning and of participants with lower literacy focusing sooner on infographics versus text. Acceptability for Personal Patient Profile-Prostate was high. These findings suggest that infographics may be of higher relative value to participants with low health literacy. Eye trackers may provide valuable information on how people visually engage with infographics and may inform development of health education materials, although care must be taken to minimize data loss.
Computers, informatics, nursing : CIN. 2016 Apr 14 [Epub ahead of print]
Seth Wolpin, Barbara Halpenny, Erica Sorrentino, Mark Stewart, Justin McReynolds, Ivan Cvitkovic, Peter Chang, Donna Berry
Author Affiliations: Biobehavioral Nursing and Health Systems, University of Washington, Seattle (Dr Wolpin, Mr Stewart, Mr McReynolds, Mr Cvitkovic, and Dr Berry); The Phyllis F. Cantor Center, Dana-Farber Cancer Institute, Boston, Massachusetts (Mss Halpenny and Sorrentino and Dr Berry), and Division of Urology, Beth Israel Deaconess Medical Center, Boston, Massachusetts (Mr Chang).