Most health professionals try to inform, educate and engage their patients. However, for a long time, information leaflets were the only medium available for patient education. This changed with the rise of digital communication. Nowadays, many different formats can be used. Video, for example, is a strong medium and seems to be a promising alternative to more standard, written information. Nevertheless, the effectiveness of videos over written information has not consistently been shown in research and the production of a video is time consuming and expensive.
That is why we conducted an experiment focusing on one type of video: animation. We tried to answer: Are animations effective in patient education? What makes them effective and do people with limited health literacy benefit from them?
Text vs. Spoken Animation: The Study
Our study focused on features in which traditional, written leaflets and animations fundamentally differ, namely:
- How information is communicated (written versus narrated)
- Whether images are moving (illustration versus animation)
To conduct this study, we compared the impact of explaining colorectal cancer screening via animated content vs. static on-screen text. Through both mediums, content messages remained similar across conditions, but the text (written or narrated) and images (illustrated or animated) differed.
More than 200 people participated in the study, and each person was randomly exposed to one of the animated or printed materials. Their health literacy was measured with the Short Assessment of Health Literacy in Dutch (SAHL-D).
The results of our study, published in the Journal of Medical Internet Research, showed that people remember narrated information better than written information.
Also, narrated information resulted in better attitudes to the information, especially among people with limited health literacy.
Narrated text also had an indirect effect on intention to have colorectal cancer screening. We found that narrated text resulted in better attitudes towards the message, which positively influenced screening attitudes. These positive screening attitudes, in turn, resulted in more intentions to have screening.
Our study showed that, when combined with narrated text, animated messages were better recalled and evaluated by people with limited health literacy. When presented the narrated animation, no significant differences in information recall were found between people with limited or adequate health literacy. This was surprising as oftentimes significant differences in recall are found between health literacy groups. This finding made us conclude that narrated animations are especially effective for people with limited health literacy skills.
In our paper, we note the content of the material might have contributed to the findings. First, the animations in our study were created by a professional animator, which could have influenced our results. Second, the development of colorectal cancer and the procedure to test for it are relatively easy to visualize, where more abstract types of medical information is more challenging to visualize. Patients viewing abstract messages might benefit less from the animated format. Nevertheless, we conclude that the use of narration is always recommended as people with limited health literacy seem to benefit from this type of patient education.
Corine Meppelink is a PhD candidate in Health Communication at the Amsterdam School of Communication Research (ASCoR), University of Amsterdam.
The paper is published as: Meppelink, C. S., van Weert, J. C., M., Haven, C. J., & Smit, E. G. (2015). The effectiveness of health animations in audiences with different health literacy levels: An experimental study. Journal of Medical Internet Research, 17 (1), e11. doi: 10.2196/jmir.3979
A Dutch version of this blog was written for the foundation, SWOCC.
What kind of educational resources do you use with your patients? Have you tried using content which pairs voice-over with animation? And have you noticed a difference in whether this helps those who seem to have lower health literacy? We are interested to hear about your experiences.