How should we communicate information regarding birth choices to women?:
An online randomised survey
Abstract
Objective: To identify which risk communication graphics are
easiest to understand when communicating risks surrounding birth; and
investigate the effect of numeracy and health literacy on understanding.
Design: Online survey with randomised content Setting:
UK Population: Women and their partners, healthcare
professionals and stakeholders in the UK. Methods: Seven
candidate graphics (’10-person’, ‘100-person’, ’10-circle’, ‘100-circle’
icon arrays, ‘bar charts’, ‘pie charts’ and ‘words’) were co-produced
with a patient and public involvement group. These were used to develop
seven online surveys. Participants were recruited using social media and
adverts in participating hospitals. Each participant was randomised to
see one of seven surveys, the survey questions remained the same, the
graphics varied. Data were collected on risk perception, perceived ease
of understanding and preference, alongside demographic factors, numeracy
skills and health literacy. Main outcome measures: Objective
comprehension and subjective preference for graphics. Results:
There were 858 participants, 771 women/partners/parents and 87
healthcare professionals and stakeholders. 70% of participants answered
all four numeracy questions correctly, and respondents reported high
health literacy (76.5% can understand health material, 72.8% were
comfortable completing medical forms). All graphics were understood;
however, the ‘100-person’ icon array elicited the best score when
comparing two risks (mean score 97.5% compared to next best performing
graphic 95.8%), 41% believed it was the easiest to understand and 36%
selected it as the preferred graphic. Conclusions: All graphics
are well understood. The ‘100-person’ icon array scored best in terms of
risk comparison and participant preference. Using this graphic may
support high-quality communication of risk in maternity care.