Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.

A Study of Pictorial Representation (Mind Map) To Convey Health Education on Osteomalacia to People with Low Language Literacy Skills.

Adebajo5,  Adewale O., Walker3,  David, Robinson4,  Sandra, Singh3,  Yogenjagat, Helliwell2,  Philip, Rahman1,  Anisur

University College London, London, United Kingdome
University of Leeds, Leeds, United Kingdom
University of Newcastle, Newcastle, United Kingdom
University of Newcastler, Newcastle, United Kingdom
University of Sheffield Medical School Sheffield United Kingdom, Sheffield, United Kingdom


It is well recognised that health education needs to be provided in different ways to match different learning styles and literacy skills in order to ensure effective patient education for everyone. In order to acheive this, we have through an iterative process and in partnership with Arthritis Research UK developed a Mind Map based on pictorial representation which provides health education on the topic of osteomalacia. We were particualrly keen to ascertain whether this novel health education tool was acceptable to ethnic minorities who originate from the South Asian Sub Continent and particualrly those wih low language literacy skills. Against this background we have performed this ethnicity study using this Mind Map.


In depth studies were carried out amongst ten English speakers, six Bangali speakers, ten Gujerati speakers, ten Hindi speakers, ten Punjabi speakers and ten Urdu speakers (N=56). Participants were given sample images from the Mind Map and asked to comment on meaning to ascertain suitability, effectiveness and potential to cause inadvertant offence.


Overwhelmingly, the respondents felt that the Mind Map was an effective and appropriate way of communicating health education on osteomalacia, particularly for those people with low language literacy skills. The Mind Maps were also felt to be of particular benefit to those ethnic minorities, for whom English is not their first language.

Cultural specific comments were made in relation to the depiction of food with 4/20 Gujerati and Hindu speakers saying that the picture should represent what they eat, for example depicting a vegetarian diet. Appropriateness responses divided into those which are generic and would apply to anyone, and those that were culturally specific. The general comments were that the bone metabolism depiction could be confusing (31/56), the muscle weakness could be confused with knee pain (16/56), the mending and cracking bone was confusing (22/56) and the picture of a man with bone pain could be confused with toochache (21/56). Inadvertent offence was felt to be highly unlikely and only related to the picture of an old lady in a bed (1/56) and venepuncture (2/56).


Our study indicates that the use of pictorial representation (Mind Maps) are an effective way of achieving patient education. Specifically our study has shown this novel health education tool to be considered appropriate and effective by participants from several ethnic minority groups arising from the South Asian Sub Continent. We recommend Mind Maps as part of the range of tools available for Health Care Professionals to provide health education about musculoskeltal conditions, espeically for people who have low language or literacy skills.

To cite this abstract, please use the following information:
Adebajo, Adewale O., Walker, David, Robinson, Sandra, Singh, Yogenjagat, Helliwell, Philip, Rahman, Anisur; A Study of Pictorial Representation (Mind Map) To Convey Health Education on Osteomalacia to People with Low Language Literacy Skills. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :2082
DOI: 10.1002/art.29847

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