Abstract
ObjectivesGraphic display formats are often used to enhance health information. Yet limited attention has been paid to graph literacy in people of lower education and lower socioeconomic status (SES). This study aimed to: 1) examine the relationship between graph literacy, numeracy, health literacy and sociodemographic characteristics in a Medicaid-eligible population 2) determine the impact of graph literacy on comprehension and preference for different visual formats.MethodsWe conducted a cross-sectional online survey among people in the US on Medicaid, and of presumed lower education and SES.ResultsThe mean graph literacy score among 436 participants was 1.47 (SD 1.05, range: 0 to 4). Only graph literacy was significantly associated with overall comprehension (p < .001). Mean comprehension scores were highest for the table format (1.91), closely followed by bar graph (1.85) and icon array (1.80). Information comprehension was aligned with preference scores.ConclusionsGraph literacy in a Medicaid-eligible population was lower than previous estimates in the US. Tables were better understood, with icon arrays yielding the lowest score. Preferences aligned with comprehension.Practice implicationsIt may be necessary to reconsider the use of graphic display formats when designing information for people with lower educational levels. Further research is needed.
Highlights
Understanding health information and related numerical information is critical to making informed decisions, promoting adherence to treatment, and improving health outcomes [1,2,3,4,5,6,7,8]
Graph literacy in a Medicaid-eligible population was lower than previous estimates in the United States (US)
Results corresponding to the primary aim Health literacy and sociodemographic characteristics
Summary
Understanding health information and related numerical information is critical to making informed decisions, promoting adherence to treatment, and improving health outcomes [1,2,3,4,5,6,7,8]. There is a gap in numeracy skills between people of lower and higher educational attainment [11]. Numerical health information can be presented as numbers only or graphically, using graphic display formats [12] Graphic display formats, such as pie charts, bar charts, line plots, and icon arrays are frequently used to enhance communication [13,14,15]. They can minimize denominator neglect [16], framing effects [17, 18], and the effect of anecdotal reasoning [19]. Few studies have explored risk communication and the ability to understand graphic displays of risks in people of lower educational attainment and lower socioeconomic status (SES) [21]
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