Abstract
Background Productive patient–provider communication is a recognized component of high-quality
health care that leads to better health outcomes. Well-designed infographics can facilitate
effective communication, especially when culture, language, or literacy differences
are present.
Objectives This study aimed to rigorously develop infographics to improve human immunodeficiency
virus (HIV)-related patient–provider communication in a limited-resource setting.
A secondary purpose was to establish through participant feedback that infographics
convey intended meaning in this clinical and cultural context.
Methods We adapted a participatory design methodology, developed in a high-resource setting,
for use in the Dominican Republic. Initially, content to include was established using
a data-triangulation method. Then, infographics were iteratively generated and refined
during five phases of design sessions with three stakeholder groups: (1) 25 persons
living with HIV, (2) 8 health care providers, and (3) 5 domain experts. Suggestions
for improvement were incorporated between design sessions and questions to confirm
interpretability of infographics were included at the end of each session.
Results Each participant group focused on different aspects of infographic designs. Providers
drew on past experiences with patients and offered clinically and contextually relevant
recommendations of symbols and images to include. Domain experts focused on technical
design considerations and interpretations of infographics. While it was difficult
for patient participants to provide concrete suggestions, they provided feedback on
the meaning of infographics and responded clearly to direct questions regarding possible
changes. Fifteen final infographics were developed and all participant groups qualitatively
confirmed that they displayed the intended content in a culturally appropriate and
clinically meaningful way.
Conclusion Incorporating perspectives from various stakeholders led to the evolution of designs
over time and generated design recommendations that will be useful to others creating
infographics for use in similar populations. Next steps are to assess the feasibility
of using infographics to improve clinical communication and patient outcomes.
Keywords
patient–provider communication - participatory design - patient education - health
literacy - infographics - nursing informatics
