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Design and validation of pictograms in a pediatric anaphylaxis action plan
Author(s) -
Mok Garrick,
Vaillancourt Régis,
Irwin Danica,
Wong Alexandre,
Zemek Roger,
Alqurashi Waleed
Publication year - 2015
Publication title -
pediatric allergy and immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.269
H-Index - 89
eISSN - 1399-3038
pISSN - 0905-6157
DOI - 10.1111/pai.12349
Subject(s) - pictogram , medicine , comprehension , recall , anaphylaxis , allergy , pediatrics , physical therapy , psychology , immunology , philosophy , linguistics , archaeology , cognitive psychology , history
Background Current anaphylaxis action plans ( AAP s) are based on written instructions without inclusion of pictograms. Objectives To develop an AAP with pictorial aids and to prospectively validate the pictogram components of this plan. Methods Participants recruited from the emergency department and allergy clinic participated in a questionnaire to validate pictograms depicting key counseling points of an anaphylactic reaction. Children ≥10 years of age and caregivers of children <10 years with acute anaphylaxis or who carried epinephrine auto‐injector for confirmed allergy were eligible. Guessability, translucency, and recall were assessed for 11 pictogram designs. Pictograms identified as correct or partially correct by at least 85% of participants were considered valid. Three independent reviewers assessed these outcome measures. Results Of the 115 total participants, 73 (63%) were female, 76 (66%) were parents/guardians, and 39 (34%) were children aged 10–17. Overall, 10 pictograms (91%) reached ≥85% for correct guessability, translucency, and recall. Four pictograms were redesigned to reach the preset validation target. One pictogram depicting symptom management (5‐min wait time after first epinephrine treatment) reached 82% translucency after redesign. However, it reached 98% and 100% of correct guessability and recall, respectively. Conclusions We prospectively designed and validated a set of pictograms to be included in an AAP . The incorporation of validated pictograms into an AAP may potentially increase comprehension of the triggers, signs and symptoms, and management of an anaphylactic reaction.