Interpretation of pharmaceutical warnings among adolescents

Warnings are an important component of pharmaceutical risk mitigation efforts, yet very little research attention has been directed toward adolescent interpretation of such warnings. This study examined adolescents' interpretations of and preferences for warning symbols and statements related to pharmaceuticals with teratogenic properties.

A total of 200 adolescents interpreted one of four warning symbols and four warning statements. Responses were coded using an established three-tier coding system. Symbol preferences were elicited. Interpretation accuracy and symbol preferences were analyzed by symbol and statement.

The symbol in use on medication labels at the time of the study elicited nearly goal levels of interpretation accuracy; however it exceeded allowable levels of critical confusion. An alternative symbol elicited more fully correct responses than the existing symbol and was preferred to the existing symbol by a margin of 2 to 1. Yet another symbol was most preferred despite eliciting fewer correct interpretations. The impact of warning statements on overall warning interpretation varied by statement and statement-symbol combinations. At least one statement appeared to lessen the overall message of caution, and few adolescents expressed an awareness of risk if one "may become pregnant" until explicitly informed of this risk.

Comprehension of medical warning symbols and statements among adolescents is an important public health issue. Those involved in adolescent health education and research have considerable theoretical and practical tools for approaching the development and evaluation of such warning messages. Understanding how warnings are interpreted can lead to more effective communication efforts and reduce risk.