FIP Side Effects Pictogram Survey Paper version

FIP Side Effects Pictogram Survey –Paper Version ‐ English
FIP side effects pictogram survey –paper version
The International Pharmaceutical Federation (FIP) is a global federation of national associations of pharmacists and pharmaceutical scientists in official
relations with the World Health Organization (WHO). The FIP supports a number of initiatives worldwide, including the use of pictograms for health
literacy. Pictograms can be used to communicate health information to people with language barriers or limited health literacy levels. Pictograms for
use in the dispensing of medication have been developed and validated to communicate information such as dose, route, frequency, and precautions
for medications. In addition to this information, it is important to communicate potential side effects of medications to patients.
Through a partnership with Algonquin College, potential pictograms for 28 side effects have been developed.
In order to collect survey responses in areas of the world that do not have ready access to the internet, a paper version of the survey has been
developed. The aim of this survey is to evaluate which pictogram best represents each of the different side effects. This survey should take
approximately 15 minutes to complete. Please answer every question and select only one answer for each question.
After you have completed the demographic section of the survey you will be presented with different options for symbols. The meaning of these
pictograms is given in the black box. For each pictogram, please indicate which you believe would be best understood in your surroundings.
Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable
answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.
Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and
will remain confidential.
There are 3 ways to submit your survey responses:
1. Mail the completed survey to:
2. Email or fax your responses to:
Dr. Régis Vaillancourt
Director of Pharmacy
Children’s Hospital of Eastern Ontario
401 Chemin Smyth Road
Ottawa, ON, K1H 8L1 CANADA
Fax: (613) 738‐4206
E‐mail: rvaillancourt@cheo.on.ca
3. Have a health care provider or a representative of your choice enter the responses using the online survey tool on your behalf:
http://www.surveymonkey.com/s/sideeffectspictograms_english
If you have questions at any time about the survey or the procedures, you may contact [Régis Vaillancourt] at [+1 (613) 737‐7600 Ext. 2231] or by email at
[rvaillancourt@cheo.on.ca]
Thank you very much for your time and support.