Co-Creation and Cultural Relevance: Lessons for Material Testing

Theoretical Background and research questions/hypothesis:

We often use imagery in health communication materials to better engage the intended audience and convey messages. The Centers for Disease Control and Prevention emphasizes the importance of using culturally appropriate images — and including your audience in the decision-making process around imagery. But does imagery itself always help materials resonate with the intended audience? Or is it more complex?

In 2022, CommunicateHealth (CH) supported the National Eye Institute (NEI) in conducting material testing with Black/African American adults to inform the design and messaging strategy for an eye health campaign. We’ll share what we learned from this work — and how the lessons can be applied to other research to inform health communication campaigns.

CH gathered Black/African American people’s opinions on all aspects of a campaign fact sheet. Specifically, we asked them to assess whether the fact sheet was:

• Clear and easy to understand
• Motivating
• Credible
• Culturally and personally relevant

Methods:

CH conducted in-depth interviews with 9 Black/African American adults with different levels of risk for developing an eye condition. Using a co-creation approach, we applied a comprehensive and cutting-edge method to test each aspect of the fact sheet with participants separately:

• For the content, participants reviewed the written content only and shared their interpretation of the fact sheet’s purpose, audience, and relatability
• For the design and layout, participants shared feedback on the design elements — like colors — to help us understand what visual aspects resonated with them
• For the images, participants reviewed image options and provided feedback on their preferred images

Finally, we showed participants the fully designed fact sheet with their preferred images and revealed its main message and intended audience. After learning the fact sheet’s intended purpose and audience, participants then shared their reactions about its relevance.

Results:

Throughout the research session, participants had varying views on the fact sheet’s overall relevance to them. And their views changed between when they reviewed the written content only, when they saw the fully designed fact sheet, and after they learned more about the intended purpose and audience. Crucially, they shared that although the fact sheet included images of Black/African American people to enhance its cultural relevance, the images themselves didn’t always make the fact sheet as a whole seem personally relevant.

Conclusions:

Conducting material testing by isolating the different aspects of a material can better inform its design and content. This approach also provides more opportunities for partnership and co-creation with your intended audience. The result is that you’ll better understand what aspects of a material will resonate and help convey your message — and what might fall flat and hinder your efforts.

Implications for research and/or practice:

Following this approach can set up health communicators for successful material development by ensuring that all aspects of a material engage the intended audience— from the text, to the design, to the imagery.