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Table 9 Suitability Assessment Materials (SAM) evaluation criteria, young adults’ feedback and changes made to leaflet

From: A tailored intervention to promote uptake of retinal screening among young adults with type 2 diabetes - an intervention mapping approach

Sample pilot questions

Young adults’ feedback

Changes to leaflet

Content: Do you think that this leaflet achieves the purpose of the project?

• Did you learn anything new?

“Key information came through really clearly. I didn’t know that early DR doesn’t have any symptoms…the doctors tend to focus on blood glucose, so I knew the 7% (HbA1c) but I didn’t know what the cholesterol target and normal blood pressures were.” ID32

“This leaflet improved my intentions. (DR) is not something you would think could happen to young people.” ID32

“‘Protect your sight for life’ is a powerful statement.” ID36

Make ‘Protect your sight for life’ a stand-alone statement and place at top of panel 2, which signposts location of more information

Literacy demand: Was the length of the leaflet acceptable to you?

• How about the number of words?

• How easy was it to read and understand the information in the leaflet?

• Are the words used simple, clear and informal?

• Were medical terms defined adequately?

“It only took about 5 minutes to read.” ID33

“Language is pretty relaxed which is good for young people.” ID40

“The only thing that caught me was ‘DR’. Did you mean ‘doctor’ or ‘diabetic retinopathy’? I think you should bold it when it is first defined.” ID32

Discuss whether to include ‘DR’ in leaflet. By consensus, a decision was made to include it, but to bold initial definition of diabetic retinopathy and DR acronym at top of panel 4.

Graphics: What do you think of the front panel image?

• Are the other images and graphics ‘friendly’ and relevant?

“Very professional. Looks like it’s targeted at my demographic.” ID36

“Maybe bold ‘When diabetes is first diagnosed’ so that you hammer home that it’s never too early to have an eye check.” ID32

“I’ve never really looked at a graph in a pamphlet. It might appeal to some people, but I don’t know…” ID40

Bold text ‘When diabetes is first diagnosed’ in panel 5.

Remove graph, which depicted rate of DR progression over time.

Layout and typography: What do you think of the sequence of information?

• Is the text type size and font easy to read, or could it be easier?

• Is the information in the leaflet well-spaced, or does it appear cluttered or confusing?

“Main headings need to be in a larger sized font and bold, and sub-headings in smaller font. Keep the blue colouring.” ID39

“Is there a way that you can make more white space? The different colours are more attractive.” ID33

 

Learning stimulation, motivation: Thinking back to when you first were told that you had diabetes or when you learnt that diabetes could affect the eyes – would the leaflet have met your information needs at that time?

• Do you feel that the leaflet is friendly or formal?

• Do you feel like you want to read it now or later? Why?

“Jenny’s story is a good thing to have in there. Including name, age and diabetes duration makes the quotes more meaningful.” ID39

“Wow, that looks awesome…I didn’t expect to see two smiling faces on the front because most diabetes things are all doom and gloom, they’re so terrifying and then you don’t want to read them. Whereas, I read this and thought, this was a reminder for me to book in for my eye check.”ID40

“I loved the ‘What happens if I had DR’ section. I kept putting off an eye check because I was scared of what would happen. Can you add more about what the treatment is?” ID32

Revisit Performance Objectives to include understanding the treatment options (PO.4.2), populating this through the matrix of Change Objectives and into the leaflet content. Add more treatment detail to panel 8.

Cultural appropriateness: Do the quotes represent key emotions or experiences that you have felt about eye examinations? Was the language used throughout the leaflet familiar and culturally appropriate to you?

• Were there any sections that you found confusing or were unsure about?

“I love the pictures; they speak to different cultural backgrounds.” ID32

“English is not my first language, but I didn’t have any problem reading the leaflet.” ID33

Retain multicultural imagery.