Perils of providing visual health information overviews for consumers with low health literacy or high stress

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Abstract
This pilot study explores the impact of a health topics overview (HTO) on reading comprehension. The HTO is generated automatically based on the presence of Unified Medical Language System terms. In a controlled setting, we presented health texts and posed 15 questions for each. We compared performance with and without the HTO. The answers were available in the text, but not always in the HTO. Our study (n=48) showed that consumers with low health literacy or high stress performed poorly when the HTO was available without linking directly to the answer. They performed better with direct links in the HTO or when the HTO was not available at all. Consumers with high health literacy or low stress performed better regardless of the availability of the HTO. Our data suggests that vulnerable consumers relied solely on the HTO when it was available and were misled when it did not provide the answer.