Exploring the role of health literacy on attention to and recall of text-illustrated health information: an eye-tracking study

Although the use of illustrations is often recommended for audiences with limited health literacy, it is unclear how health literacy impacts the use of different online formats. The aim of this paper is therefore to investigate how health literacy influences attention to text and illustrations in online health information, and whether such attention is related to recall of information. Sixty-one participants were exposed to either text-only or text-illustrated information. Using eye tracking, we recorded attention patterns on a health webpage after which recall of information was assessed. Results showed that health literacy influenced the attention-recall relationship. For people with limited health literacy, attention to the illustrations was positively related to recall, whereas attention to the text improved recall of information in the adequate health literate group. As attention to different parts of online health information leads to different information processing routes for people with different levels of health literacy, effective health communication should consider both text and illustrations that attract attention and improve understanding of the health message.