Monteiro, S.P., Van Weert, J.C.M., De Gier, J.J., & van Dijk, L. (2017). Age and education related preferences for pictograms concerning driving-impairing medicines. Health and Primary Care, 1(2), 1-6. doi: 10.15761/HPC.1000107

Abstract
Purpose:
Pictograms can increase public awareness about driving-impairing effects of medicines. However, pictograms that are not clear will negatively affect the comprehension of the message. Older and low educated adults are particularly vulnerable to misunderstandings. Comprehension is expected to be influenced by preference for the type of pictograph, but little is known about the preference of pictograms among drivers of different age groups and education levels. This study aims to investigate older and lower educated adults’ preference for a pictogram (triangle model pictogram versus rating model pictogram) related to the influence of
taking driving-impairing medicines on driving fitness.
Methods:
Interviews among 270 drivers visiting a pharmacy were conducted. Participants were asked about their preference for the best pictogram expressing a warning message and expressing levels of impairment. A comparison between a pictogram with a more complex design (rating model) and an already implemented one (triangle model) was made.
Results:
74.4% of the participants preferred the rating model to express warning messages and 82.6% preferred this model to express levels of impairment. However, older and low educated participants were more likely to prefer the triangle model over the more complex rating model. Age was the strongest predictor influencing participants’ preference for pictograms to express a warning message and levels of impairment. Young participants (18-39 years old) with high education level had the highest preference for the rating model, whereas older participants (> 60 years old) with low education level showed the lowest preference for this pictogram system.
Conclusion:
Age and education level are sensitive factors to be considered when designing a pictogram. In order to be equally well understood by older and low educated adults, pictograms should have a simple design and make use of familiar objects.