Comprehending instructions for using pharmaceutical products in rural Kenya

This paper reports two studies on comprehension of pharmaceutical texta containing pictorial and written instructions by mothers in rural Kenya. The subjects were asked to read and recall instructions for preparing and administering a solution for the treatment of dehydration due to diarrheal disease in children. A set of pictures describing the preparation procedure, together with written text instructions under two conditions, (a) original, as in the commercial product, and (b) revised, to include familiar terminology and explanations of some procedures, were presented to two groups of Kenyan mothers. The verbal protocols generated were transcribed and analyzed using propositional representation of instructional procedures. The results showed that mothers recalled the procedures for the preparation as in the pictures but not those presented in the written instructions. The written instructions were generally found to be difficult, with the original text being more difficult than the revised text. Any conflicting information between the written and pictorial instructions was resolved by selecting the familiar procedure. The information recalled from the revised text that was recalled was that which supported the procedures in the pictures. The results have implications for writing adequate pharmaceutical texts for users such that little room is left for misinterpretation.