What is the best way to clearly communicate necessary healthcare information? ‘Got It?’ is a health literacy project by collaborative artists Rowena Keaveny and Julie Spollen, funded by The Community Foundation for Ireland’s Advocacy for Older Persons’ Fund, and created in partnership with Anam Beo arts and health organisation, and Offaly’s Public Participation Network.
Health Literacy is defined as the degree to which individuals can obtain, process, and understand basic health information and services needed to make appropriate decisions regarding their health.
The artists consulted with interested parties and advocates for older people in the community, Age Action, Age NI and Age and Opportunity, Offaly Public Participation Network and Offaly Older Persons Forum. The artists attended Age Friendly Strategy Offaly, the Healthy Offaly Strategic Plan County launch and Community Foundation for Ireland Network Meets.
Participants, staff and group leaders came from Birr Active Retirement Group; the Irish Wheelchair Association; Active Age Groups from Ballinagar, Ballycumber, Birr and Crinkle; Riada House Residential and Day Care; Clara Day Care Centre and Birr Mental Health Group.
The artists believe that a picture combined with readable type may counteract information overload to allow focus on healthcare narratives. They aimed to test this hypothesis by asking 'What is the best way to clearly communicate necessary healthcare information?' A common response emerged: ‘Too much information crammed into leaflets and not everyone can read the font.’ Even for the most capable person, health information can be particularly difficult to understand and act upon.
Julie and Rowena collectively activated a space for critical thinking with older people about challenges for everyday living within the context of health information.
Artists Rowena Keaveny and Julie Spollen have been collaborating with older people since 2005 and this body of work is the latest in their ongoing research on how art and design benefits and nourishes society. When we get older, our learning and memory may affect our ability to absorb content. Therefore, the way information is presented needs to accommodate the cognitive and physical changes that often accompany the ageing process.
In consultation with older people's groups, networks and agencies, the artists responded to repeated concerns about how health information is communicated to elderly people within health systems and care facilities.
Rowena and Julie began by giving focused presentations about visual communication followed by discussions around health literacy themes. Participants were invited to give feedback before creating their own responses in their chosen art form, individually or with support as capabilities varied widely. The workshops engaged older people by listening and with artistic exchanges without defined art outcomes. Art forms included printmaking, stencilling, graffiti, portraiture, painting, collage, the written word, music, dance and movement.
Music was thoughtfully researched and personally chosen by the participants so it was not just background sound but an active support to encourage individualism, communication and expressive movement within a care centre. Staff were very helpful during the 'life-sized process'. Using large sheets of paper and black markers, participants created outlines of each other's physical representations while communicating a physical response to their music.
Within the groups there was deep listening and conversations. Local or well-known similes were written down which grew in volume within a few sessions e.g. 'as sick as a dog' and 'not as green as cabbage lookin'. By printing them out and displaying them as quotes, active participants and others reflected on their meanings, what was being communicated and how they may be interpreted. This process created a strong group atmosphere and engagement for open discussion. Once this vocal freedom was established, a dialogue around health literacy themes came into play to produce text for postcards. Postcards were created using this voiced feedback and responses from simple questionnaires, asking about colour, size and typeface, what worked and how to improve on healthcare information.
'A drop of ink, may make a million think'
'The text is too small'
'I'm not online or inaline'
'You cana see me because I'm blind'
Presentations, networking events and a collective conversation enabled an active practice for engagement, self-expression, critical thinking, creative place-making, personal narratives and a voice for older people. The project culminated in a series of artworks informed by the collaboration with participants during workshops.
'I did that and I did it my way, I do believe this has done my brain good, kept it active, age has nothing to do with life, it has to be lived.' - John (95) from Clara, Offaly
Artistic outputs included:
- Reassembled art collages that demonstrated collaborations, interactions and conversations
- Life-size music & dance collective mark-making templates
- 50 postcard dialogues
- Collaborative artistic imagery for 100 postcards with outcomes and project information
- 5 A0 art posters.
The artwork and printed outcomes were exhibited at Áras an Chontae, Tullamore in October 2018 and in Tullamore Library in January 2019. Further showings will take place in 2019, working with Offaly and regional libraries.
A mixture of qualitative and quantitative methods were used throughout the project. These included conversation, deep listening, questionnaires for ongoing participants and staff feedback. The artists had reflective meets at the beginning and the end of three focused phases. Progress reports were issued to the Community Foundation for Ireland. Responses were also gathered from networking and feedback events.
The artists consulted with a panel of interested parties and advocates for older people in the community from Offaly Public Participation Network, Offaly Older Persons Forum and The Irish Wheelchair Association. They presented a large body of participants' collaborative artistic outcomes and a PowerPoint presentation of the project for further feedback. It was here that the decision was made not to print another leaflet but to produce postcard packs with necessary health literacy information and imagery that would appeal to a wider community.
Project outcomes were included in the Anam Beo Annual Report 2018.
As a process-driven project, 'Got It?' allowed the artists to expand their ongoing research into older people's societal engagements, health experiences and the implications of bad communication.
Participants took part in reflective and independent thinking to become active creatives rather than passive recipients of information. Encouraging questioning in both individual and group scenarios, there was critical thinking in relation to the potential outcomes of visual communications, applying standards to readability and how they could offer their voices and self-expression as a means to transform knowledge around healthcare information. The dialogues for the postcards became an essential characteristic of active engagement for the outcomes, creating a link between self-expression, communication and good design, and that, reasonably, people are not at fault for not always fully understanding the healthcare information given to them.
'They assume you understand the meanings of words'
'Don't blind us with science, keep it simple'
'Too much information crammed into leaflets'
'Once you're in the system, but getting into it, that's hard'
The project outcomes highlight the need for greater care and thought towards how important health information is relayed to older people. There is a need for outreach materials to be conscious of changing vision, information accessibility and readability for an ageing population with a learned knowledge that if it works for older people, it will work for everybody.
We learned from participants that basic principles of good design, visuals and communication need to be followed and information with type should be:
- Precise and keep it short.
- Easy to understand.
- Readable: a font size of 16 or above.
- Legible with shorter sentences.
- Guided by good colour contrast.
- Clear with impactful design and simple layout.
'Through dialogue and creative practice, barriers to Health Literacy were explored. Working with art and design media, the project offers interpretations and visual representations of what it can feel like to be disempowered when information on health becomes inaccessible.' - Ann Lawlor, Anam Beo.
'This has been the best ever, we never get to sit down and just talk to each other like this; it's fun but it also got us thinking about things we know [and] never really thought about ... I really loved it, having an input, it just moved it on and made it more real that our opinions, what we know and think, matters.' - Patricia Mc Evoy, The Irish Wheelchair Association, Ballinagar.
Documentation & Dissemination
The project was documented through photography and has been featured to date in regional and local papers, regional radio, and Midlands Art and Culture Magazine.
Packs of postcards were distributed to all involved and at exhibition sites.
The Tullamore Library exhibition in January 2019 included a special viewing with the artists and an opportunity to discuss themes arising from the project.
Date of Publication
September 2017 - November 2018
Anam Beo, Arts & Health Organisation
HSE Dublin Mid-Leinster
The Community Foundation for Ireland's Advocacy for Older Persons' Fund, Anam Beo, Offaly Public Participation Network, HSE Dublin Mid-Leinster, Offaly County Council.
Julie Spollen, Rowena Keaveny
Community Health, Health Literacy, Health Promotion, Older People
Nature of Project
Collaborative/ participatory, Exhibition, Research