Interpretation of way-finding healthcare symbols by a multicultural population: Navigation signage design for global health

• Comprehension of healthcare symbols increases with literacy and decreases with age.
• Symbols for abstract referents (such as oncology and diabetes education) are more difficult to interpret correctly.
• Healthcare symbol design should consider cultural factors as may they may influence comprehension.

The interpretation of way-finding symbols for healthcare facilities in a multicultural community was assessed in a cross-sectional study. One hundred participants recruited from Al Ain city in the United Arab Emirates were asked to interpret 28 healthcare symbols developed at Hablamos Juntos (such as vaccinations and laboratory) as well as 18 general-purpose symbols (such as elevators and restrooms). The mean age was 27.6 years (16–55 years) of whom 84 (84%) were females. Healthcare symbols were more difficult to comprehend than general-purpose signs. Symbols referring to abstract concepts were the most misinterpreted including oncology, diabetes education, outpatient clinic, interpretive services, pharmacy, internal medicine, registration, social services, obstetrics and gynecology, pediatrics and infectious diseases. Interpretation rates varied across cultural backgrounds and increased with higher education and younger age. Signage within healthcare facilities should be tested among older persons, those with limited literacy and across a wide range of cultures.