ArticleResearch in social & administrative pharmacy : RSAP2021
Evaluation of pharmaceutical pictograms by older "turkers": A cross-sectional crowdsourced study.
Article in Research in social & administrative pharmacy : RSAP, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- A qualitative study to explore the perspectives of key stakeholders regarding pharmaceutical pictograms in Pakistan.Journal of pharmaceutical policy and practice · 2026Article
- Pictogram comprehension and medication-use literacy among undergraduate students: a cross-sectional survey study.Journal of pharmaceutical policy and practice · 2025Article
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Authors and funding
5 authors.
Funding
Abstract
backgroundWell-designed pharmaceutical pictograms may improve patients' understanding of medication instructions. However, the iterative participatory design process required to produce effective pictograms can be costly in terms of money, time, and effort. Crowdsourcing has been applied to bring down the costs of the participatory design process, but the feasibility of using this approach with older adults remains largely unknown.
objectivesTo evaluate the feasibility of using Amazon Mechanical Turk (MTurk), a leading crowdsourcing platform, for participatory pictogram evaluation with older adults (55+) and to evaluate the comprehensibility of USP pictogram, identify common misinterpretations, and explore the relationship between selected participant characteristics and their pictogram comprehension performance.
methods108 older adults (56.5% female; 57-80 years of age) were recruited via MTurk to complete a cross-sectional online survey that asked them to interpret 15 USP pictograms and answer questions about their health and health literacy.
resultsIt was feasible to perform pictogram evaluation with older adults on MTurk, as shown by ease of recruitment and high data quality. Of the 15 pictograms tested, seven (46.7%) resulted in a comprehensibility score below the threshold established by the American National Standards Institute (ANSI), eight (53.3%) elicited common misinterpretations, and two (13.3%) resulted in ANSI-defined "critical confusion." Age (P = 0.04) was associated with pictogram comprehension performance. Certain issues with the pictogram subtitles emerged during the evaluation.
conclusionsMTurk is a feasible platform for participatory pictogram evaluation, even for a sole target of older adults. The USP should develop a pictogram user manual, redesign pictograms confusing to older adults, and establish policies and procedures to ensure that pictogram subtitles conform to evidence-based best practices and standards for patient-centered written drug information.
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