1. Identify the most important principles of effective and persuasive educational materials.
2. Evaluate the feasibility and potential impact of existing educational materials.
3. Design simple but effective educational brochures or posters to target specific drug utilisation problems.
1. Read the Session Notes.
2. Briefly review the instructions for Activity One.
3. Activity one requires some sample print materials. Collect these in advance and review their strengths and weaknesses. Share them with participants after completion of the exercise and participant presentations. Try to include a range of different types of materials.
4. If additional materials, not included as overheads, are more illustrative of a principle or technique of visual communication (or are more relevant to the audience's national and cultural background), feel free to substitute or add overheads as appropriate.
1- Title Slide 2- Objectives3- Principles 4- Understanding reasons 5- Aspirin 6- Generic name7- Nurses at bed 8- Decisions and Actions9- Prescriptions 10- Read directions carefully11- Chloramphenicol contraindicated 12- Emphasise a Few Key Messages13- Clindamyacin 14- El Exito Depende15- Capture Attention with Headlines 16- If you want to save 17- No Medicine 18- Use visually appealing
illustrations19- Open wide 20- Tell story21- Humor-Gardez le sens de la medicine
22- Use brief and Simple Text
22- Organising medicines at home 24- Repetition25- Credibility 26- Savings 27- Wisdom 28- Relevance and Involvement29- Principles 1 30- Principles 231- Generics 32- Tonics 33- Injections 34- NEDP logistics 35-Sharing Drugs 36- Tetracycline37-Challenge 38- Murder39- Activity One 40- Activity Two
ORGANIZATION AND KEY POINTS OF SESSION
VA1 – 2 First Component
Introduction l0 minutes
Discuss the purpose and rationale for the session. Point out:
A wide variety of printed education materials are produced throughout the world. These include the clinical and pharmacy literature; drug bulletins and newsletters; pharmacy and therapeutic manuals; standard treatment guidelines; and illustrated brochures and posters.
These materials are often much cheaper than alternative prescribing and consumer education strategies, and can reach many prescribers through the mail, on bulletin boards, visual display or in person. They are also often very popular with funding agencies and government departments because they represent something tangible, that can be seen and are demonstrative of activity.
(Ask participants who has any experience of producing printed materials. Probe for constraints/successes encountered and how these were evaluated).
These materials are usually relied on exclusively to change prescribing and consumer practices although it has been shown that they barely work at all unless combined with other more interactive approaches, such as face-to-face education.
Many materials, even within these limits, are not designed in a way that increases their chances of increasing knowledge or changing practice. Few materials are pre-tested with the target audience, which is an essential step in effective communication.
The purpose of this unit is to introduce participants to some important principles for increasing the effectiveness of printed educational materials.
VA 3 Principles of persuasive print materials
Make the following points:
These are the main principles covered in the Participant Guide. Go over each principle very briefly – explain that you will give several
examples of each in the next few minutes. Most of these are applicable to consumer and prescriber education and to
many different types of educational materials as well. Effective printed materials don’t need to be extremely costly to be effective.
Good black and white line drawings can be substituted for multi colour photographs or designs. And where printing quality is low, for reasons of cost or equipment, it is better to use simple line drawings that will reproduce easily than complex illustrations, such as photographs, that will not reproduce well.
VA 4 Transition to the first principle (the need to understand motivations for behaviour)
Emphasise that it is extremely important to have an idea about prescribers’ or consumers’ motivations for "incorrect" drug use before designing educational materials.
Remind participants about the use of focus group interviews and surveys to uncover these motivations as described in a previous unit
VA 5 Present overhead ("plain aspirin" education brochure)
This is the front cover of a patient education pamphlet designed to be given to patients by their prescriber in a program to reduce propoxyphene use.
The pamphlet was designed because prescribers stated that patient demand was one of the most important reasons for using propoxyphene (as a placebo drug) in focus group interviews.
VA 6 Present overhead (what is a generic name)
This poster from the Philippines comes from research that consumers did not know the meaning of the term "generic name", and also that they were worried about high drug prices.
The text explains the meaning of term "generic" and links this knowledge with how consumers can save money on drugs.
VA 7 Present overhead (nurses at bed of patient)
Read the headline of this illustration.
The material makes the point that elderly patients in nursing homes wet their beds less when they are not exposed to anticholinergic drugs.
Previous focus group interviews with nurses had already identified that nurses and aides would be very receptive to therapeutic recommendations which would decrease their workload (in this case the need for changing wet sheets).
VA 8 Transition to second principle of decisions and actions
Explain that if you wish to change behaviour an orientation to decisions and actions is critical. Yet many educational materials do not emphasise what prescribers or patients should do or not do for particular health problems, e.g. what should be stopped, what should be started, and why.
The following examples illustrate this action/decision oriented approach.
VA 9 Present overhead (talk about prescriptions)
This poster gives an overall message, that patients need to talk to their doctor or other health worker about the drug prescribed and explains why.
It then gives some key questions to ask.
VA10 Present overhead (if you are ill these few words will help you get better)
A striking consumer poster from Australia which encourages patients to read directions and labels carefully.
The principal strength is that it has a strong headline backed up by visual material (the graph).
The weakness is that because all the text is the same size you don’t get pulled into the "story".
VA 15 Present principle of headlines
Review the reasons for major headlines
They should capture the interest of the reader.
They should make the reader want to read the rest of the text. They can be provocative questions as well as recommended actions.
If two headlines are needed one is usually less important than the other and is considered a "minor" headline. This should be in smaller size and can be used to visually "pull" the reader’s eye down into the main part of material.
VA 16 (If you want to save on medicines)
Read the headline and point out that this is a strong enticement to the viewer to read further, one of the main purposes of a headline. After all, everyone want to save money.
Point out how the design of the poster pulls the reader’s eye down and onwards.
VA l7 (Sometimes the best medicine is no medicine)
Here is an example of a poster which is almost all headline.
It seemingly breaks some of the rules but it works because it is brightly coloured attract attention and the message is sufficiently provocative to
It was also, in real life, part of a campaign that included consumer education leaflets.
VA 18 Present principle of visually appealing illustrations
Many of the materials already shown have included visually appealing illustrations. These illustrations can be used to:
Tell a story;
Show a behavior which is being promoted or discouraged;
This is a very appealing illustration with a pun on what is said by the dentist "open wide".
See also how the bright picture of the clown which is intended to attract attention is reinforced further down by the bar chart which shows how to cut costs through oral administration of antibiotics
VA 20 (page from Bangladesh flipchart)
Point out how this page from a flipchart has attractive illustrations which tell a story (when to take a prescribed drug)
The time is shown not only by the sun and the moon through the window but also by the lamp illustrated in the third picture.
Patients were also given a simple black and white paper reproduction of the same illustration as a line drawing to take away with their medicine.
VA 21 (Gardez le sens de la mesure)
Read the translated text of the Swiss poster. "Keep a sense of proportion don't insist on a prescription at every consultation."
This is an example of the use of humour in printed materials point out that humour can be fun and can be very effective but it is also culturally specific (place and socio- economic level). In other words, what makes people laugh in one social group may be meaningless or even offend another group. So be quite sure that your material is culturally acceptable and understood before you print it.
VA 22 Present principle of brief, simple text
Emphasize the need to pilot test all educational materials to be sure that the text is easy to understand by the target audience. This also applies to illustrations which will be discussed in more depth later in the session.
Also, it goes without saying that the material must be culturally acceptable.
What ever you do, avoid "medicalese". For example, remind participants about the example in the Participant Guide recommending use of words like "stomach pain" instead of "gastrointestinal disturbances".
Explain that this is a text from a booklet for older citizens.
The advice is straightforward and in simple language.
The text is a good size – an important point for older people who may have poor eyesight.
The type of font used is informal – it helps to make the text look friendly and inviting.
VA 24 Repetition increases memory and learning
Repetition is the foundation of advertising and communication. Increases memory and learning. Key message should be included in headline, content and conclusion.
VA 25 Present principle of referencing respected research and sponsors
Point out how in the most effective prescribing education interventions in the United States the sponsorship of a respected medical institution (in one case a medical school, and in the other a local medical society) were obtained to increase credibility).
The respected sponsor of the educational materials should be very visible in order to be certain that the reader understands where the material comes from (otherwise they may think it is simply a drug company advertisement).
Another way of establishing credibility is to emphasise quotes from respected medical reference books which support your prescribing recommendations. For consumer information you may choose a well known public figure or a well known
Examples of these principles in action follow.
VA 26 (50% savings on essential drugs)
This is an example of where the then Minister of Health of the Philippines, Dr Bengzon, appeared in a poster which promoted l5 government outlets for essential drugs at half price.
See the big Department of Health logo on the box illustrating that although the drugs were low cost they were backed by the government.
Ask participants if identification with a government agency would be advantageous from their perspectives. Point out the potential problem that
government may be viewed as "cost cutters" rather than interested in patient care.
1. Tell the participants that they have been exposed to important principles of persuasive print materials, they will have a chance to evaluate a number of different educational materials which have been used in different countries. Ask them to volunteer their opinions on the strengths and weaknesses of each of the following materials.
VA 31 (Prescribir en Generico)
This is a poster from Peru. It reads: Prescribe in Generics? And why not?Strengths Weaknesses
None that are apparent Visually dull Doesn’t demonstrate behaviour Gives no rationale for message,
e.g. the "why"
VA 32 (Tonics)
Strengths Weaknesses Lively, eye-catching drawing. Does the visual of a slightly
drunk individual (looking very happy) really look like a strong negative statement about tonics containing alcohol.
Includes an alternative behaviour (food) to inappropriate drugs.
VA 33 (Do not ask for injections)
Strengths WeaknessesGood strong illustration Underlying rationale (the "why") not
totally clearGood graphic use of headlines Use of the crossed out symbol not
always understoodGives alternative behaviour Somewhat prescriptive
Strengths WeaknessesProvocative/catchy headline Too much text, not sufficiently broken
into digestible chunks
Colorful Text too smallStrong graphic image Fear appeal may be
counterproductiveCites credible authority (WHO) at beginning of argument
Too many messages for a poster/Key message not clear
VA 39 & 40
Principles of public educational materials
Present VA and review the underlying reasons for each principle. These are summarised in the session notes. Don’t spend too long on this because there is some overlap with the earlier material.
If possible, involve participants in the review, particularly when discussing pre-testing. Ask participants if any of them have been involved in pre-testing materials; if so what they had to change as a result of the test. .
ACTIVITY ONE: EVALUATION OF EXISTING PRINT MATERIALS
Present rationale for the unit (5 minutes) - this activity will enable participants to critique two sample educational materials
Facilitate conducting the activity (30 minutes)
a) Ask participants to break up into small groupsb) Pass out the sample print materials. If there is a poster collection displayed
participants can choose a posters as one of their two materials. c) Read the instructions on both sides of the worksheet. Emphasise that they should
not try to read the entire text but rather "skim" the material to get a quick feel and impression of its target audience (e.g. prescribers, press, patients) and what are its objectives (behavioral change, general advocacy, knowledge change).
d) Ask participants to rate the materials one at a time on the first side of the worksheet. Also have them briefly jot down answers to the questions on the back of the worksheet.
e) Allow 5-10 minutes for three of the groups to report their evaluation on one of the samples and respond to questions from other participants. Ask the groups not report point by point because this takes too long. They should rather summarise what the material aims to do and whether it is effective (main strengths and weaknesses).
ACTIVITY TWO: SKETCHING OUT A PRINTED EDUCATIONAL BROCHURE OR POSTER FOR PRESCRIBERS OR CONSUMERS (ONE HOUR AND FIFTEEN MINUTES)
Present rationale for the unit (five minutes)
This activity will give participants a chance to begin to develop a printed education brochure or poster, using the principles discussed in the session, which demonstrates that the design of effective materials is a skill that can be developed with practice.
Tell participants that the materials will go on display and at the end of the afternoon ballot papers will be distributed so that each person can vote for their favourite brochure or poster. Count the votes overnight and award the groups who come first, second and third with a small prize, such as a bag of sweets.
Facilitate conducting the activity (45 minutes)
Ask participants to:a) Break up into small groupsb) Read the rationale and instructionsc) Make sure that the materials reflect the principles discussed in the session
Make sure participants understand that they don’t need to write the text of the brochure (if that is what they choose to do) in detail. They just need to put blocks or lines in to show where the text would go and what would be covered. Equally, if there are no "artists" in the group, they can simply use a minimalist line drawing or even write what the illustration would be. Tell them to spend a maximum of ten minutes deciding what topic to cover.
After completing the activity, each group will present its material to other participants for comments and recommendations.
Note: This activity almost always runs over time. Participants enjoy it and get very enthusiastic. It can be hard to stop the "creation" process within the time available. One possibility to cope with this is to let those who wish continue to work during the lunch break and have the presentations after lunch, if the facilitator of the