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Rachael Zimlich is a freelance writer in Cleveland, Ohio. She writes regularly for Contemporary Pediatrics, Managed Healthcare Executive, and Medical Economics.
For diseases such as atopic dermatitis (AD) that require complex care, colorful infographics take the guesswork out of patient education.
Readiness, willingness to learn, and health literacy are cornerstones of patient education, and a recent presentation reveals that infographics might be the way to go-especially when it comes to complex conditions.
Kathleen A. Kent, DNP, APRN, CPNP-PC, coordinator of the pediatric nurse practitioner program and clinical assistant professor at the Indiana University (IU) School of Nursing, Indianapolis, and Carol Clark, DNP, APRN, FNP-BC, clinical assistant professor and coordinator of the family nurse practitioner program at IU, delivered a presentation at the National Association of Pediatric Nurse Practitioners’ 40th National Conference on Pediatric Health Care in March discussing the benefit of using infographics for educating patients and parents.
Whereas infographics are beneficial for almost any type of education, Kent and Clark note that they are particularly helpful when it comes to educating parents on managing complex conditions, including atopic dermatitis (AD).
AD is all too common
Twenty percent of children suffer from AD, and half of children with the condition report that it has a severely negative impact on their quality of life. Children with AD often suffer from depression anxiety, have activity restrictions attributed to the disease, and their families become financially burdened by the cost of care. Parents also become frustrated with managing the condition, which mostly affects very young children, because treatments are time consuming and the condition is fraught with frequent relapses. For providers, the condition is also frustrating because it’s complex to manage, guidelines for treatment are outdated, and it’s difficult for parents to comply with plans of care.
“A family with a child affected by AD spends considerable time, energy, and money to care for this disorder. The treatment success is directly linked to compliance,” Kent says. “To enhance compliance, parents need simplistic instructions with as few steps as possible.”
Wake Forest researchers studied several methods of teaching parents about the care of AD in children, Kent notes.
“Eczema action plans were found to be the most successful method over group education and extra office visits to teach parents the treatment plan,” she says. “However, the existing eczema action plans are all text based, which is a challenge for most people but especially for those with low literacy.”
If it’s known that infographics improve comprehension, Kent says, it’s worth investigating whether applied infographic education-based tools can aid in the complex care of AD in children.
Part of the challenge in managing AD is that it often affects very young children, and this is also a demanding time in parenthood, Kent says. “These kids with significant skin disease are crabby and unhappy because of their skin. When kids don’t sleep, parents don’t either. There are many quality-of-life studies out there that demonstrate this connection,” she says. “Frustrated parents try many treatment plans that until recently were vastly different between providers.”
New national guidelines that utilize evidence-based practices were released in 2014 and should help providers get on the same page with treatment plans, she adds, but the nature of AD means that more complications are likely when it comes to care plans and management.
“Because the nature of AD, where it comes and goes, varies depending on the season and health of the child, which also varies, there are many relapses after a period of good skin. It can take up to 3 hours a day to provide skin care to these children, and parents are busy,” Kent says. “Without consistent use of medications and skin maintenance, the disease will flare.”
Infographics vs text-only handouts
The problem is that these complex care plans and the health literacy of the average parent don’t pair well.
One in 3 adults reads below an eighth-grade level, according to Kent’s research, and 14% of adults have below-basic health literacy.1 People are visual learners, Kent adds.
“It has been established in physiology textbooks and research that humans are visually wired and can more quickly process information when in a picture format over text,” Kent says. “When using pictorial tools in the office, information may be taught more efficiently, and the goal is that the patient’s understanding of the information is improved.”
It can help patients and providers to embrace this and use it to improve compliance and outcomes.
“We wanted to shine a light on health literacy in the United States and how this impacts care and outcomes,” Kent says of her research. “By using infographics for patient education, our goal is to reduce the health literacy barrier. Creating infographics is not difficult and the simpler the better.”
Infographics are most helpful for individuals with a reading level at or below the fourth-grade level, Kent and Clark noted in the presentation. The most effective infographics keep messages to 1- or 2-syllable words; use large and basic fonts such as 14-point Times New Roman; offer a simple message; avoid jargon; and use simple color combinations with plenty of white space. One important consideration, Kent adds, is to be sure that whatever graphic feature, icon, or symbol is used is widely known enough to represent a common concept or definition in one’s culture or society.
Another problem is, when it comes to developing infographics that can help, providers may not know where to start.
“There are so many infographic-maker websites available and it is important for a provider to find one that works with his or her needs and budget,” Kent suggests, adding that there are many uses beyond AD for visual aids. “There are many health-related infographics. I have seen them in public spaces like the subway and in public restrooms. I have seen topics like flu prevention, handwashing, and many other topics. Some of these are free to use and some will have copyrights, so it is important to know the difference.”
Kent says she hopes to help spread the message of the benefit that infographics can provider to clinicians.
“When we only have 15 minutes with a patient and family, time is squeezed to cover every aspect of well care,” she says. “It is a challenge to address other conditions, so using an infographic handout to reiterate the points made verbally in the office helps save time and improves education.”
1. Kent KA, Clark CA. Utilizing an infographic patient education tool in the management of atopic dermatitis. Presented at: 40th National Conference on Pediatric Health Care; March 7-10, 2019; New Orleans, LA. Available at:
. Accessed August 9. 2019.