The semantic and pragmatic comprehension of visual rhetorical codes by literate and illiterate adults in a health communication setting

Abstract

The focus of the study was on the comprehension of visual rhetoric in printed health learning visuals by literate and illiterate adults. The broad aim of the study was to establish whether visual rhetorical codes, which usually perform a strong phatic function, constitute a significant readability barrier in an illiterate adult target group. The literature investigation of the study covered (1) a semiotic perspective of the distinction between visual and verbal texts, (2) visual rhetorical articulation for closed visual texts and (3) the readability of development visuals with the emphasis on health education. The design of the empirical component of the study involved the production of three health education posters with a Tuberculosis theme which were encoded with varying degrees of visual rhetoric taking existing guidelines for the design of development visuals into account. In order to measure the semantic (or literal) and pragmatic (or figurative) comprehension of the visual rhetoric, 300 voluntary, confidential, structured interviews were conducted with clinic patients attending Primary Health Care clinics in the greater Bloemfontein area following the refinement of the test visuals and questionnaires during a pilot phase. The mainly Sesotho speaking and pre-dominantly female study population consisted of 150 literate adult patients (>21 years of age, 12 years of formal schoo.ling or higher) and 150 illiterate adult patients (>21 years of age, 6 years of formal schooling or lower and the demonstrated inability to read and understand the full text of an acronym). The working hypotheses of the study, which read that (1) on the semantic level, the comprehension of visual rhetorical codes in a closed visual text does not differ between literate and illiterate adults, and that (2) on the pragmatic level, the comprehension of visual rhetorical codes in a closed visual text differs between literate and illiterate adults, were both accepted following chi-square analysis which tested for independence of the literate and the- illiterate study population groups. Flowing from the result obtained, design guidelines for the utilisation of visual rhetorical codes in a development communication context, as well possibilities for further research, were formulated.