Schmidt and colleagues combine graphic design and public health research to promote smoking cessation

Using pictorial warning labels for prevention

Dr. Michael Schmidt, associate professor, Art and Affiliate Faculty, Public Health), recently published Graphic Design in Public Health Research: A Multiyear Pictorial Health Warning Label Initiative and Recommendations for Sustained Interdisciplinary Collaboration, per invitation from the design field’s oldest peer-reviewed journal, Visible Language. Written with coauthors Dr. Taghrid Asfar (University of Miami) and Dr. Wasim Maziak (Florida International University), the article provides novel ideas for employing graphic design in scientific research—observational and experimental—particularly where the graphic design outcome, in this case pictorial health warning labels for waterpipe smoking prevention and cessation, is the health intervention. The article also examines the challenges the team faced incorporating graphic design processes within multiple scientific study designs over a multiyear, National Institutes of Health (NIH)-funded collaboration led by Drs. Asfar and Maziak.

The research studies discussed in the article have advanced empirical knowledge regarding the effects of pictorial health warnings (labels using images in addition to words) on attention, recall, emotional and cognitive reactions, and harm perception among waterpipe smokers and nonsmokers in the US, Lebanon, and Tunisia. Crucially, the team’s mixed-methods studies have revealed important requirements—within and across cultural contexts—for the effective design of pictorial health warnings. These results and Schmidt’s dozens of label designs have been disseminated through top-ranked journals and international conferences. The labels also have been shared with other international teams, including, by request, the World Health Organization’s Jordanian office. Moreover, the team’s research has expanded to include vaping, or nicotine electronic delivery systems (ENDS), recently garnering the collaborators a second five-year NIH grant, with Schmidt as UofM principal investigator. Additionally, the team’s partnerships with Golin and the Truth Initiative will soon help translate several years of research findings into national smoking prevention campaigns. Further to that end, Drs. Schmidt and Asfar recently created opportunities for their graduate students from graphic design and public health, respectively, to collaborate on translating study findings into print, video, and social media messaging as part of a pilot study.

The pictorial health warning labels Drs. Schmidt, Afar, and Maziak describe in Visible Language have already dissuaded many study participants from initiating waterpipe smoking and encouraged others to quit. Given waterpipe smoking’s association with heart disease, several forms of cancer, and many other illnesses, the team’s successes thus far portend important societal benefits through improved public health. The team’s newer work to reduce vaping, particularly among younger smokers, promises to further extend the positive health impacts of pictorial health warning labels.

At the heart of the article is a call from the authors to bridge art and science, generally, and graphic design and public health research, specifically. Schmidt and his colleagues point to the benefits: innovative research ideas and study protocols leading to federal funding, research dissemination and publication, and positive societal impacts. The authors also explain the challenges, i.e., employing study methods and developing study instruments and procedures that yield useful data for both statistical measurement and design decisions (e.g., visual concepts and communication devices, tone, form, and aesthetics). Schmidt’s terminal degrees in graphic design and social and behavioral sciences, as well as prior collaborations with medical doctors and health researchers, helped the team establish a common research language and shared priorities. Likewise, Drs. Asfar and Maziak brought prior experience with and a deep interest in graphic design, which proved critical to incorporating both design processes (e.g., ideation, evaluation, and synthesis) and concerns (e.g., usability criteria) into the team’s research plans.

Schmidt credits Dr. Ken Ward, Professor and Social and Behavioral Sciences (SBS) Division Director in the School of Public Health, for the opportunity to work with Drs. Asfar and Maziak. He also credits Dr. Satish Kedia, Professor and SBS Doctoral Program Coordination in the School of Public Health, for providing crucial mentoring and additional research opportunities. Likewise, the Department of Art and the College of Communication and Fine Arts have encouraged their faculty researchers, including Dr. Schmidt, to collaborate with colleagues in other disciplines, whether across campus, in the community, or at other institutions—in the US and abroad. Indeed, the interests shared by artists and scientists at The University of Memphis and the institutional encouragement they receive to collaborate make the benefits of transdisciplinary research possible. Schmidt has witnessed this time and again. Over the past twenty years, Schmidt has explored various intersections of graphic design and health, working with St. Jude Children’s Research Hospital, Duke Children’s Hospital, The Shelby County Office of Early Childhood and Youth, and Unicef Canada, among others. Each of these efforts required teams composed of researchers from very different fields to contribute complementary skills. They also required, however, a common process tool, iteration, which the authors explain in Visible Language:

One important way we have maintained our collaboration … is by developing a series of study designs that facilitate iteration. This structure serves both scientific and design requirements for success. It also facilitates the consistent engagement of our designer throughout the project, creating a more integrated team environment. Critically, iteration makes research science more like design and design more like research science.

For more information about the article or Schmidt’s research, email mschmidt@memphis.edu.