Use realistic pictures with clearly worded captions. This design guideline was implemented in the eye tracking experiment. For example, the risks of eye damage, gum disease and heart attack/stroke were presented using realistic pictures of other patients. Clear text accompanies each picture that explains the risk. Although the results of the experiment showed that the pictures that accompany the risks did not appear to make the material more memorable, they proved to be related to the attention and comprehension of the information.
The stakeholders recommended reducing the amount of text that accompanies each picture in order to be shorter, clearer and more direct. Feedback from the patients’ focus groups indicated that the pictures are an important element of the reports because they help to personalise the cases. Based on the results of the patient and GP focus groups, fewer pictures and words were included: two images for positive messages and two for negative messages. Narrative information that accompanies each picture was further cut on recommendation of the patient and GP focus groups. While results from the trials indicated this was effective as patients agreed and understood the report, memory effects have not yet been tested.
Nevertheless, as found in the focus groups of patients, some specific pictures appeared to be unsuitable or scary such as the grape and syringe pictures respectively. These pictures were in turn replaced with less harmful and more suitable pictures in the following tests and trials, which proved to be acceptable by patients, as found in the GP trial.
Therefore, it is imperative to use non-confronting, suitable pictures with clear narrative information in the report.