How the presentation of information about the prognosis of a health condition in different visual ways might affect people's comprehension?

Participants will be recruited either for Trial A or Trial B (conducted separately). Once enrolled in one of the trials, they will be randomised to one of the three interventions or to the control group. Trial A Trial A (acute condition: acute middle ear infection) will convey information about the number of children with and without pain at three time points if they received antibiotics or not (i.e., wait for it to spontaneously resolve). We chose acute middle ear infection (acute otitis media) because it is one of the most common childhood infections (Rovers and Zielhuis 2004), with about 50% to 85% of all children have experienced at least one AOM episode. Most people will have experience with it themselves or had someone they know who experienced it. The prognosis data comes from a high-quality systematic review (Venekamp, Sanders et al. 2015). 4 arms: 3 interventions and 1 control The interventions are different visual presentations to communicate prognosis information of acute middle ear infection. The three interventions communicate the same prognostic information. 1. Bar graph: the prognostic information will be presented at 3 timepoints, 2 bars for each time point (1 without antibiotics, 1 with antibiotics) 2. Pictograph: the prognostic information will be presented at 3 time points. Each time point has 2 (10x10 matrix) one without antibiotics and one with antibiotics. 3. Line graph: the prognostic information will be presented in a line graph as 2 lines (1 without antibiotics, 1 with antibiotics) Trial B Trial B (tennis elbow: lateral epicondylitis) will convey information about the number of people with tennis elbow who had complete recovery at two time points when they decided either to watch and wait, have physiotherapy, or have a corticosteroid injection. We chose tennis elbow as it is a chronic condition with a variable course, that has multiple treatment options including the option of waiting for the condition to spontaneously improve. The data comes from on a high-quality randomised controlled trial (Bisset, Beller et al. 2006). 4 arms: 3 interventions and 1 control The interventions are different visual presentations to communicate prognosis information of tennis elbow. The three interventions communicate the same prognostic information. 1. Bar graph: the prognostic information will be presented at 2 timepoints, 3 bars for each time point (1 wait and watch, 1 physiotherapy, 1 corticosteroid injection) 2. Pictograph: the prognostic information will be presented at 2 time points. Each time point has 3 (10x10 matrix) (1 wait and watch, 1 physiotherapy, 1 corticosteroid injection) 3. Line graph: the prognostic information will be presented in a line graph as three lines (1 wait and watch, 1 physiotherapy, 1 corticosteroid injection) For Trial A and Trial B Why Comprehension of the medical information might be affected by how this information visually presented to patients. This might have a further effect on their decisions regarding their health management plans. What They will not receive any educational material. However, the intervention itself is a type of medical information about the prognosis of a medical condition. Who provided The interventional surveys will be emailed by an online provider (Dynata) electronically. How The survey links will be emailed to the potential participants individually or they can access the survey link from their Dynata dashboard, who (in case they decide to click the link and proceed to fill the survey) will fill the survey from anywhere they would like to (e.g., home, work, café). They will have no direct contact to the person who sent the survey. Where The online survey can be filled in any place feasible to the participants. All they need is to have a device that is connected to the internet (i.e., computer, laptop, mobile phone) When and how much This survey will be delivered once, there will be no follow up of participants. Data will be collected at one timepoint. the expected average time to finish the survey 15-20 min. Tailoring The interventions will not be individualised (e.g., personal risk of having a certain outcome along the course of the disease based on certain prognostic factors). The surveys Participants of each trial will be randomised at the start to 1 of 4 groups: in each group participants will respond to a structured questionnaire starting by demographic questions (5 questions), baseline treatment decision intention (1 question), previous experience with the condition (1 question). Medical Maximizer-Minimizer scale (Scherer, Caverly et al. 2016) (1 question of 10 items), subjective numeracy scale (Fagerlin, Zikmund-Fisher et al. 2007, Zikmund-Fisher, Smith et al. 2007) (2 questions each has 4 items). This part will be the same for all the participants of one trial. Then each group will be presented by a specific intervention/control (e.g., text, bar graph, pictograph, or line graph) and then answer 6 comprehension questions. Then participants will respond to 2 questions about their treatment decision intention. Participants’ satisfaction with the presentation (i.e., the intervention they received) will be measured using 2 ranking questions. At this stage, all the 4 presentations (text, bar graph, pictograph, line graph) will be revealed to the participants and graph preference will be measured using 3 questions. After that, participants will respond to a graphic previous experience ranking question. At the end, health literacy level of the participants will be measured using the NVS health literacy scale (Weiss, Mays et al. 2005). The comprehension questions are the same for all the participants of one trial. Participants will be able to see the information while answering the questions by scrolling up and down. Participants will not be able to go to the previous page once they submitted their answers.