Overview of the chosen leaflet
The PIL under discussion is printed by Sports Medicine Australia and is targeted at teenage girls in Australia. The main objective of the leaflet is to provide teenage girls with information on how to deal with the challenges and changes of adolescence using physical exercise. There is little evidence of bias in the leaflet, and the authors have a disclaimer at the front page clearly stating that the leaflet is not meant to offer any advice regarding any particular matter of interest to the group.
The overall DISCERN score of the leaflet based on my evaluation was 45 thus, giving it an average score of 2.68, which means that the leaflet is partially successful in passing the information it is intended to pass but has some shortcomings. The leaflet has little focus on the information on physical exercise it intends to provide and instead ends up providing general information about adolescence.
Current areas where the PIL uses psychological theory
The leaflet makes relatively little use of psychological theory in its presentation of information, but there are instances in which the Health Belief Model (HBM) is used. The aspects of HBM mostly used are the appeal to health motivation and benefits of adopting a lifestyle of daily physical exercise. The benefits listed are maintaining healthy body weight, strengthening bones and muscles, improving cardiovascular health, and offering a chance for fun interaction with loved ones.
One of these benefits i.e. improving cardiovascular health can also be analyzed as having aspects of showing the severity and susceptibility to heart disease. Heart diseases are on the increase, and anyone who lives an unhealthy lifestyle is susceptible to cardiovascular diseases, which are serious and often fatal. It is noteworthy that these latter two aspects of HBM are implied rather than used explicitly.
There are also calls to action as the leaflet has clear suggestions to increase physical activity without necessarily taking up competitive sport. Some of the activities suggested are dancing, skateboarding, hiking, and bike riding; all relatively fun activities that do not require one to engage in competition.
PIL improvements
The first aspect about the leaflet I would change is to clearly show the detriments of living a life of physical inactivity. These detriments would logically be followed by the benefits of physical exercise, obstacles to exercising, and several suggestions on how to overcome these obstacles. In this case, obesity would be an example of a medical condition that I would put in the leaflet to show the adverse effects of not exercising. I would then indicate the benefits of exercising and maintaining a healthy BMI then offer suggestions on how to start exercising e.g. walking and taking the stairs. I would use statistics and scientific evidence from national medical bodies to support the information as well as give it credibility instead of just offering it as advice like the leaflet seems to do.
The leaflet is not oblivious of the social aspects of exercise but instead of using this to encourage physical exercise, the leaflet offers other intervention (contrary to the objectives of the leaflet). Using the principles of the Theory of Planned Behaviour (TPB), I would use the leaflet to provide knowledge on physical exercise to change teenage girls’ outlook towards physical exercise. This would in turn change their attitudes towards exercise thus, resulting in more teenage girls taking up exercise. An example of an approach I would use is to provide information on mundane activities, like walking, that count as exercise and try to foster a positive attitude towards them e.g. walking offers more social time with friends. This then would lead to the targeted audience of the information taking up and adhering to the healthy behavior suggested in the leaflet.
Overall appraisal of leaflet and changes
The changes made to the leaflet make it more focussed on the goal of providing information on physical exercise. This would make for a shorter leaflet that only concentrates on the provision of information on exercise and exclude information that is not relevant to the immediate objective. The reliance on statistics and scientific evidence to communicate information would make the leaflet more reliable as a source of health information and show the relevance of the information1. The leaflet would also have a more logical flow with problems, obstacles, and possible solutions all provided, making it easier to comprehend2.
The PIL without the changes suggested is not good as I feel it does not stay true to the objectives it purports3. It reads more like a self-help guide to teenage girls on how to cope with the changes of adolescence rather than a leaflet that provides and encourages teenagers to explore and take up physical exercise and the changes suggested would help refocus the PIL.
The lesson picked from this exercise of reviewing a PIL is that PILs need to be focused and relevant to their objectives to effectively communicate information4.
References
D. Fitzmaurice, and J. L. Adams. ‘A systematic review of patient information leaflets for hypertension.’ Journal of human hypertension, vol. 14, 2000, pp. 259-262.
D. Dickinson, D. K. Raynor, and M. Duman, ‘Patient Information Leaflets for Medicines: Using Consumer Testing to Determine the Most Effective Design.’ Patient Education and Counseling, vol. 43, 2001, pp. 147-159.
T. Kenny, R. G. Wilson, I. N. Purves, J. Clark, L. D. Newton, D. P. Newton, and D. V. Moseley. “A PIL for every ill? Patient information leaflets (PILs): a review of past, present and future use.” Family Practice, vol.15, 1998, pp. 471-479.
M. Dixon-Woods, ‘Writing wrongs? An analysis of published discourses about the use of patient information leaflets.’ Social science & medicine, vol. 52, 2001, pp. 1417-1432.