How do we advance toward the national vision of a health literate society in
which everyone gets actionable health information along with the support
needed to use it in context for personal benefit?
The first requirement is actionable information that fits the learner. We
know that info that is meaningful and useful to me may not be suitable for you.
We are using the Suitability Assessment of Materials - SAM to check the
Beginnings Guides for promoting health literacy in mothers of children aged
0 (pregnancy) to three years. Part 6began our consideration of graphic elements.
This Part 7 addresses the type and relevance of illustrations and captions.
Illustrate key messages. The purpose of an image on the page is to present
the key content visually, to “say” the important point another way. Avoid
using images to fill space or carry the design; that is like introducing background
Every image needs a caption to tell the reader where to focus and what to think
about. An image without a caption is a missed teaching and learning opportunity.
An intended learner should be able to look at the images and read only the captions
and still get the key points.
Your baby has strong feelings.
Keep illustrations simple
SAM recommends simple line drawings that promote realism without distracting
details. The line drawings part may be out of date; learners have become much
more sophisticated viewers of images in the 20 years since Len and Cici Doak
wrote and tested the SAM. However, the part about keeping illustrations simple,
omitting distracting detail, has become more important as the competition for
attention and memory has increased. Non-essential details distract from the key
point. For example, in info for pregnant women and parents, wedding rings can
distract readers into all sorts of tangents and emotional issues unrelated to the
I prefer photos to clip art, as long as they look “real” and there is not too much
detail. Black and white photos are less expensive to print than color and can help
focus readers on the important content.
people who look like them in settings they have
experienced. We have learned from testing
Beginnings Guides that abstract symbols are
often not recognized. Anatomical drawings break the
rules about simplicity and familiarity - we just are
not accustomed to seeing the inside of the body.
Sometimes they are appropriate but must be carefully
labeled,and require direct assistance to make meaning
out of them. Illustrations of detached body parts made
our testers uncomfortable.
Pregnancy is not a time to lose weight.Do not go on a diet. Eat eat often.
Only the learners know for sure which images aid their understanding and lead
them into action. Test the images along with the text. If you need to change them,
you need to retest to be sure you solved the problem and did not create a new one.
Beginnings Guides get three Superior ratings in this section: for consistent use of
simple, familiar images; for presenting key messages so the learner can “get”
the main ideas from the images alone; for using a caption on nearly all illustrations.
Next: Lists, tables, charts, forms.
Breastfeed your baby for as long as possible.