The formative research process in developing and designing tuberculosis prevention and treatment display cards aimed at a community with a low level of literacy

This paper reports on the formative research process in the development of a series of tuberculosis prevention and treatment display cards, aimed at a community with a low level of literacy. The aim of the project was to evaluate existing posters and to develop a new series of display cards that health workers could use to discuss tuberculosis symptoms and treatment with their patients. Fifty two patients from eight tuberculosis clinics participated in the evaluative process of existing posters and the formative design process of display cards during a structured interview with a qualitative approach. The results indicated that the subjects had difficulty in understanding some of the Western-oriented graphic conventions, and the symbolic and latent messages in the existing posters. Only one of the existing posters obtained an acceptable comprehension level. The comprehension rating of the twelve new display cards improved when they were developed during a formative process with tuberculosis patients. A realistic photographic approach proved to be more effective in communicating the prevention and treatment messages to an audience with a low level of literacy, than did a simplified-illustrative approach. This paper compares the results of this project with those of others and suggests guidelines that graphic designers can use when designing for developing communities. The paper is illustrated with examples of both the existing and the new display cards.