The effect of visual aids on the understanding of Human Immunodeficiency Virus (HIV) health information in persons with low literacy

Abstract

Low literacy levels have been argued to partially contribute to poor health literacy and poor health outcomes. Low health literacy refers to the inability to apply health information in pursuit of good health. While several strategies have been used to assist persons with low literacy to understand health information, these strategies have been focused primarily on improving medication taking in persons with low literacy. There is a paucity of research on the effects of these strategies on understanding chronic illness and self-management of these illnesses. This study aimed to determine the effects of a specific strategy, viz. visual aids, on the understanding of HIV health information in persons with low literacy. The study encompassed two tasks – the experimental and the iconicity tasks. The experimental task utilised a multi-group pre-test-post-test design comprising 90 participants who were divided into three groups. Group 1 received the HIV health education programme of the National Department of Health (NDoH) verbally and with visual aids (Intervention 1), Group 2 received the same programme verbally only (Intervention 2), and Group 3 served as the control group and did not receive the programme. Within-group analysis found statistically significant differences in pre-test and post-test scores of Groups 1 and 2 (p<0.05) and not for group 3. Between-group analysis found no statistically significant difference between Group 1 and Group 2 in terms of their understanding of HIV health information. There were, however, statistically significant differences between Groups 2 and 3 (p<0.001) and between Groups 1 and 3 (p<0.001). The iconicity task (N=39) adopted a survey related to the transparency and translucency of the visual aids used in the NDoH’s health education programme. It was apparent that none of the visual aids (0/19) used in this health education programme met the International Organization for Standardization score for transparency, while 13 of the 19 visual aids met the recommended score for translucency. It was concluded that the NDoH’s health education programme provided to both Groups 1 and 2 influenced the participants’ understanding of health information. However, the expected superior effect associated with the addition of visual aids was not evident in this study. This may be attributed to the inadequate transparency scores for the visual aids in the NDOH’s health education programme. Further studies to investigate the effects of visual aids with higher transparency values are recommended, as well as efficacy studies that will use visual aids developed with appropriate guidelines for persons with low literacy.