Comprehensibility of South African pictograms by sub-Saharan African prospective-users

This work aimed to explore the validity of South African pictograms to be comprehended by sub-Saharan migrant populations in Spain.

A quantitative cross-sectional study was carried out. A voluntary survey was conducted among a population ≥ 18 years of age in a Temporary Stay Centre for Immigrants located in Spain, in June 2022. The form included a culturally and linguistically validated version of the Health Literacy questionnaire (HLS-EU-Q16), a brief questionnaire of sociodemographic variables and 10 South African pictograms selected to assess the comprehension. According to the International Organization for Standardization, a pictogram must receive 66.70% correct answers to be acceptable. Mann-Whitney U or Kruskal-Wallis tests were used to assess differences between group variables. Statistical significance was set at P < 0.05.

55 sub-Saharan migrants who newly arrived in Europe voluntarily agreed to participate. None of the pictograms evaluated met the validity criterion. For the selected pictograms, the range of correct answers was between 52.50% and 20.00%. Neither sociodemographic variables nor Health Literacy level were significantly associated with pictogram comprehensibility.

New culturally sensitive pictograms that are easily comprehended by sub-Saharan African population are needed.

These results may serve as a starting point for future studies that aim to create and evaluate new pictograms or create new culturally adapted versions of existing pictograms involving the target population.