( By International Federation of Red Cross and Red Crescent Societies )

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Appendix III: Guidelines for pre-testing health education materials


What is pre-testing?

Pre-testing health education materials means trying them out, before they are produced or printed, with members of the audience they will be used with. By doing this, you can find out:

If the materials are understandable. That is, if the message or idea is conveyed in the way it was intended.

If the audience likes the materials presented.

If the material offends or embarrasses the audience.

It will also introduce the idea that you are planning a health promotion campaign and that you want to involve the target audience from the start.

Therefore, pre-testing is a cost-effective way of preventing a widespread and expensive catastrophe from occurring. For example, if 10,000 copies of a teaching poster were sent out countrywide and you found out later on that the target audience did not understand or accept the poster, you would have made an expensive mistake.

Pre-testing will save:

time; and

Pre-testing may be done several times. The idea is to test while it is still possible to change the material after assessing the audience’s reaction.

For example, pre-testing a poster means taking the poster to members of the target audience when it is still in draft, i.e., pencil drawings.

A few examples of materials that you can pre-test are posters, pamphlets, comic books, radio programmes, video programmes, role plays and dramas.

Preparing your materials

Pre-testing pictures for a poster

People interpret pictures in different ways depending on a number of factors, such as:

their religious beliefs;
their environment and life experience; and
their education and employment.

You cannot assume that the pictures you have prepared will always be understood by your target audience. They may spend so much time trying to understand the picture that they might miss the message it is trying to convey.

Try to always be sensitive to the social, cultural and religious beliefs in your area. If the picture causes offence, the target audience may refuse to accept your message.

You also may have to consider the size or the colour of the pictures you present. They can be confusing or cause misunderstandings if they are not realistic.

For example, if your poster shows a mosquito that is much bigger than a real one people may think they don’t need to worry about the mosquitoes in their area as they are far smaller than the one in your picture.

If your pictures are accompanied by a written text, use simple language and, if possible, local terms for diseases. Use no language at all when your target audience is illiterate.

How to pre-test the materials

With whom will you pre-test the materials?

Who do you hope will use the materials you are designing? Identify a number of members of this audience in places where they gather (for example, in market places, discotheques, work sites, health centres, etc.) and ask them if they will answer some questions about your materials. Be sure to explain why you want the answers and what the materials will be used for in the future.

What do you want to find out?

Are the materials intended to inform people, teach them a skill or motivate them? Be clear about what you are trying to find out. Ask many questions about the materials in order to build up a picture of people’s understanding of the message you are trying to convey.

When do you pre-test materials?

As soon as possible! Once you have some basic ideas down on paper, start to pre-test. None of your materials may be understood. You have to be prepared to change them many times. When you have put a lot of work into preparing the materials, you may feel upset that people don’t understand. If you recognize this might be a problem, involve the community right at the beginning of the process, then you will feel happier about changes that need to be made. It will save you a great deal of time and money because the greatest cost is the final production stage, and you want to be sure by then that the materials will be a success.

How are you going to record the answers?

It may be simpler to have a questionnaire which just requires you to fill in ‘yes’ or ‘no’ answers, but the information gathered will not be complete enough for you to make a judgement about what changes need to be made. You may remember that someone did not like the picture, but forget why. You will find on page 146 an example of a questionnaire which requires more detail from the respondent.

How long will pre-testing take?

This depends on how much material you are pre-testing and how many people you are testing them upon. Experience shows it takes approximately 10 to 20 minutes to test a single picture. Remember to add on time for finding the respondents. It takes time to find whether the respondent is really interested in helping or whether they just want to find out what you are doing.

Conducting the interview


Choose a social setting where you won’t be disturbed by too many people. Respondents may become inhibited if you choose too public a place.


Be sure to introduce yourself and explain what you are doing and why. Always treat people with respect.

Let people touch the material

Another reason for starting to pre-test your materials when they are still in draft form is that people will want to touch the pictures and this may spoil them. It is important that the respondents feel that they can touch the materials. It will help you to build up a rapport with them.

Encourage people to talk

Take time over the interview. Encourage people to ask questions. Remember you don’t want yes/no answers to your questions; you want reasons why the respondent does or does not like or understand the picture.

Take a few materials only

Only take a couple of pictures at a time. This will allow plenty of time for answers and avoid both you and the respondent feeling pressured by time constraints.

Always make the respondent feel he/she has been helpful. Repeat what the pictures will be used for. Remember you may want his/her help again, and you also want to keep a good reputation in the community so that others will be willing to help.

Taking notes

Pre-testers, where possible, should work in pairs – one to conduct the survey and one to write the answers properly. Make sure you note the expressions people actually use and not your own interpretation; they may be useful as slogans on the pictures.

Suggested questions for a pre-testing interview

These questions are ‘open’ questions – they can’t be answered by yes or no and require an explanation.

Remember to introduce yourself and explain the reason for asking these questions.

What do you see in the picture?
What else do you see? (It may be necessary to discuss each part of the picture in detail.)
What does the picture mean to you?
What, if anything, do you find confusing?
Is the picture easy to understand? Why? Why not?
What is worth remembering about the picture?
What, if anything, do you like about the picture?
Is there anything in the picture that you particularly dislike or that bothers you? If so, what? Why?
In your opinion, is there anything in the picture that is hard to believe? If so, what? Why?
In your opinion, what type of person is this picture talking to?
It is talking to:

... someone like me?
... someone else, not me?
... everyone?
... everyone but especially the people in my community?

Which of these words or phrases best describes the picture?

... interesting ... not interesting
... informative
... not informative

Did you learn anything new about AIDS from the picture? If so, what?
Have you any other questions you would like to ask?


Once the materials have been produced and used for some time, you may want to conduct more interviews to see whether people actually liked the pictures, understood them, have changed their behaviour because of them, and what else they would like to have information about.

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