On Warning Symbols,Text,and ‘getting it right’: The Iterative Refinement of a Teratogenic Pharmaceutical Label

Abstract

Several birth defects warning symbols identified as most successful in an earlier study (Mayhorn & Goldsworthy, 2007) were further modified and then evaluated within a nationally distributed field trial (n = 2773). A total of 11 warning labels were examined: 4 new symbols plus the existing baseline symbol, each in versions with and without text, plus a text-only condition. Participant interpretation accuracy and preferences were assessed. For symbol-only conditions, several candidate symbols outperformed the existing symbol, one substantially so. The effect of adding text to symbols varied significantly by symbol. Symbol+text and text-only conditions performed equivalently, generally exceeded symbol-only conditions, and often surpassed the ANSI benchmark of 85% accurate interpretation. Implications are drawn from the process and outcomes in relation to warning design, warning evaluation, and future research.

Get full access to this article

View all access options for this article.

References

American National Standards Institute (ANSI). (2002). Criteria for safety symbols, Z535.3-Revised. Washington, D.C.: National Electrical Manufacturers Association.

Daniel

Goldman

Lachenmayr

Erickson

Moore

(2001). Interpretations of a teratogen warning symbol. Teratology, 64, 148–153.

Goldsworthy

R. C.

Kaplan

(2006a). Warning symbol development: A case study on teratogen symbol design and evaluation. In Wogalter

M. S.

, Handbook of warnings. Mahwah, NJ: Lawrence Erlbaum Associates, pp. 739–754.

Goldsworthy

R. C.

Kaplan

(2006b). Exploratory evaluation of several teratogen warning symbols. Birth Defects Research (Part A): Clinical and Molecular Teratology, 76, 453–460.

Kalsher

M. J.

Wogalter

M. S.

Racicot

B. M.

(1996). Pharmaceutical container labels and warnings: Preference and perceived readability of alternative designs and pictorials. International Journal of Industrial Ergonomics, 18, 83–90.

Leonard

S. D.

Otani

Wogalter

M. S.

(1999). Comprehension and memory. In Wogalter

M. S.

DeJoy

D. M.

Laughery

K. R.

, Warnings and Risk Communication. London: Taylor and Francis, pp. 149–187.

Mayhorn

C. B.

Goldsworthy

R. C.

(2007). Refining teratogen warning symbols for diverse populations. Birth Defects Research (Part A): Clinical and Molecular Teratology, 79 (6), 494–506.

Perlman

S.E.

Leach

E.E.

Dominguez

Ruszkowski

A.M.

Rudy

S.J.

(2001). “Be smart, be safe, be sure”. The revised Pregnancy Prevention Program for women on isotretinoin. Journal of Reproductive Medicine, 46(2 Suppl), 179–85.

Roche Laboratories. (2001). System to manage Accutane related teratogenicity (S.M.A.R.T.): Guide to best practices. http://www.fda.gov/cder/drug/infopage/accutane/.

10.

Rousseau

G. K.

Wogalter

M.S.

(2006). Research on warning signs. In Wogalter

M.S.

, Handbook of Warnings. Mahwah, NJ: Erlbaum, pp. 147–158.

11.

Sanders

M.S.

McCormick

E.J.

(1993). Human factors in engineering and design, 7th Edition. New York: McGraw-Hill.

12.

Stewart

D. W.

Shamdasani

P. N.

(1990). Focus Groups: Theory and Practice. London: Sage.

13.

Wogalter

M. S.

Godfrey

S.S.

Fontenelle

G. A.

Desaulniers

D. R.

Rothstein

P. R.

Laughery

K. R.

(1987). Effectiveness of warnings. Human Factors, 29, 599–612.