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April 21, 2021

Picture This!

PeopleImages / E+ via Getty Images

By Marin P.  Allen, Ph.D., former NIH Deputy Associate Director of Communications and Public Liaison and Director of Public Information

Matching images to text is a process that aims to empower the intended audience using understandable, usable information and visuals.

If you are engaged in creating, approving, or sharing health materials with journalists and the public, your success can depend on your choice of the elements in your visualizations. An incorrect match of an image to text can fail to communicate what you intend. The product may be unclear, misleading, inaccurate, not culturally engaging, not understandable, or not appropriate to the environment or knowledge of the intended audience.

The following suggestions may be helpful to you as you work to inform, explain, or persuade an audience to take specific action (wear a mask or avoid gathering in groups). Your team may be small (you and one designer) or complex (many departments and programs within an agency or a university, laboratory, news organization, or company). Together, your goal is to orchestrate the marriage of images (drawings, illustrations, charts, maps, or animations) and text (or voice-over in video) to achieve a desired outcome.  

First, the Content

If you are the writer or content manager, you may want to borrow from the late James C. McCroskey. He suggested that selection, apportionment, and arrangement are key factors in communication. These principles apply to both text and visualization:

• Selection. The first job you have is to decide what is “in” or what is “out.” What is necessary for each audience? What is your credible source for the information? How does it compare with other sources? What are you providing that is different and for whom?
• Apportionment. Keep in mind that there is a link between how much space (print, text) or time (video, animation) is taken up and the perception of importance. How much space or time are you devoting to each concept or principle? 
• Arrangement. The order or pattern of your message can help your audience(s) understand interrelationships and significance. Make sure the order you use to present the content is correct and clear. Numbers often create mental hierarchies, where bullets tend to show similar importance or equivalence. When creating data charts and displays, think about the audience first to decide what they need to know and how to show it.  

Share the Language of Design 

If you are not the designer, know the fundamental tools your design team uses. You can help them see your vision by using common terminology and accurately using the and design principles.

Elements of design include point, line, shape form, space, , and texture. For example, color choices should not be made because of personal preferences; they should be informed by the goal of the project. If your images are going on the web, it’s important to check if they comply with the and accessibility standards for the general public and for people with disabilities.

Design principles include balance, contrast, direction, economy, emphasis (or dominance), proportion, rhythm, and unity. Gestalt is a measure of the full impact of an image or produced piece. 

It can help to ask your design team to summarize the needs of the content team or writers, to tell you what they heard. 

Engage the Audience

Clear communication has the tone of a shared process that makes information available in a useful, timely, memorable, and accurate way. Consider what your product communicates to your audience and what it communicates about your attitude toward them. Does it seem like you are sharing important information with another human or that you are giving the audience a command?

Cultural engagement is a fundamental part of clear communication. Clear textual and visual communication is not condescending or pedantic. To ensure this, include the intended audience in the content creation before your health communication product is released. (Note: Using cultural color schemes is not a short fix to cultural engagement.) When depictions include your intended audience, make sure they resonate with that audience. There is often a lack of accuracy when representing people of varying races or ethnicities.     

Be Aware of Problematic Images

Trigger images are those that may have the effect of stimulating negative behaviors related to substance abuse, addiction, or suicide. Avoid using images of drugs, alcohol, or implements of suicide in visuals related to these subjects. Decide what will help your audience understand the message without the visual triggers.

Images debunking a myth with the truth can also be problematic. For some audiences that believe the myth, seeing it restated in a parallel chart, even as “myth,” can reinforce the myth. Familiarity will help them retain the original belief rather than absorb the new information. How do you visually move the intended audience from a former belief to new data? Parallel columns do not really indicate change. When they are boxed together, it indicates a false equivalency. Challenge your team to work with size, direction, or color to demonstrate the change. Or develop something very different!

Visualizing Data

Maps. Work by Jeremy M. Crampton and others on maps as social constructions and the impact of maps on perception is important for public health workers and health journalists to understand. For example, accurately representing a disease’s spread is a notable problem when showing outbreaks. Maps may show an entire geographical entity colored in (usually in red) when there are only a handful of cases reported in a state, territory, or entire country. This can be misleading about where the outbreak is actually occurring. That may create more fear for those living in the area and inadvertently influence policy. 

Graphs and Charts. Many people have difficulty understanding graphs and charts. Health communicators should strive to design charts and graphs that only include what’s critical for understanding the data. Ask yourself: Does the format of the chart really respond to what the audience needs to know, or is it only a familiar template?

This is a key place to engage the Gestalt concept. When you and your intended audience look at the chart, does it communicate accurately and in context the underlying health data?

Some Final Suggestions

• Collect examples of both effective and weak visualizations. These references can help you in discussions with artists.  
• Include samples that effectively match the messages and images that you feel reflect audience engagement. Revisit your collection as you refine your judgment.
• Create a file of colors, textures, diagrams, data sets that become part of your own toolkit for discussions.
• Assemble a file of peer-reviewed publications on visualizations used in public health messages for your field. Be cautious about drawing generalizations from descriptions of materials that are not shown in the published articles.

Now, try out your skills! Consider topics important to your audiences and study the approaches on the sites below and others. Note any accompanying data about the materials, and identify strengths and weaknesses in the presentation of text and imagery. Start your files!

Public Health Messaging Examples

Selected NIH Education and Awareness Campaigns