| Images are often perceived as a universal language, but when communicating health messages, lack of specificity can lead to misinterpretations with potentially dangerous consequences. This study evaluates the image-based Ending Pregnancy with Pills booklet in Lusaka, Zambia. Think-aloud interviews were conducted with 20 low-literate women to determine how they interpreted the health messages and clinical information contained in the booklet. Analysis focused on visual techniques and structures that helped or hindered accurate understanding of the intended message. Culturally-based visual conventions, such as thought balloons, that required symbolic interpretation strategies, contributed to misunderstanding. Iconic strategies, such as the sun and moon, to convey the passage of time increased comprehension. Recommendations for health practitioners developing image-based materials are discussed. |
