Pictorial art for gaining informed consent in low-literacy settings

Gaining informed consent for research in low-literacy setting is challenging. This study explores the creation and use of pictorial art in information and consent form in Sierra Leone (SL).

A pictorial 'information and consent' (PIC) sheet was developed with an illustrator (co-author) and local colleagues for a national oral health survey involving school children in SL. Evaluation included 500 participants (children and parents) who received a feedback form to assess their satisfaction with pictures and also their effectiveness in aiding understanding of the research process, using a visual five-point Likert scale. Data were descriptively analysed using STATA v.18.

Feedback was received from 360 children (aged 12 and 15 years) and 14 parents of 6-year-olds. The average rating, out of five, for the question about liking pictures on the PIC sheet was 4.83 (S.D. = 0.62), while rating for how well pictures helped them understand the survey was 4.87 (S.D. = 0.54). Although most feedback was positive, a small minority expressed negative views.

Overall, participants appreciated that the pictorial aids had helped in understanding the research process.

Pictorial aids show potential to improve comprehension and informed consent in low-literacy settings, indicating a promising approach for future research in similar contexts.