In the COVID-19 pandemic, it is imperative that people understand and comply with self-isolation guidelines. We tested whether a simplified version of the guidelines and a simplified version with visual aids would affect comprehension and intention to self-isolate during the containment phase of the pandemic in the UK, in March 2020, compared to the standard guidelines.
We conducted an online, three-armed parallel randomized controlled trial. Participants were English and over 18. The survey software randomized them into conditions; they were blind to condition. The control group read the 7-page standard guidelines (the current version at the time of the trial). The intervention groups were given either a 3-page simplified version, with a summary box on the front page and numbered bullet points, or the same simplified version with pictograms illustrating the points in the box. Primary outcomes were comprehension of the guidelines, as measured by the number of correct answers given to six questions about the content, and the proportion who answered that they would \'definitely\' stay at home for 7 days if symptomatic.
Recruitment was from 13 to 16 March 2020, with 1845 participants randomised and all data analysed. The Control group averaged 4.27 correct answers, the Simplified 4.20, and the Simplified + visual aids 4.13, out of a possible total of 6 correct answers. There were no differences in comprehension in the unadjusted models; however, when the model was adjusted for demographic variables, there was lower comprehension in the simplified + visual aids condition than in the control, (ß = - 0.16, p = 0.04998). There were no statistically significant differences in intention to stay home: Control was 85%, Simplified 83%, and Simplified + visual aids condition 84%.
Simplified guidance did not improve comprehension compared to the standard guidance issued in the containment phase of the COVID-19 pandemic in March 2020, and simplified guidance with visual aids may even have worsened comprehension. Simplified guidance had no effect on intention to stay home if symptomatic. This trial informed COVID-19 policy and provides insights relevant to guidance production in the acute phase of a major public health emergency.

Learning from a text-picture multimedia document is particularly effective if learners can link information within the text and across the verbal and the pictorial representations. The ability to create a mental model successfully and include those implicit links is related to the ability to generate inferences. Text processing research has found that text cohesion facilitates the generation of inferences, and thus text comprehension for learners with poor prior knowledge or reading abilities, but is detrimental for learners with good prior knowledge or reading abilities. Moreover, multimedia research has found a positive effect from adding visual representations to text information, particularly when implementing signaling, which consists of verbal or visual cues designed to guide attention to the pictorial representation of relevant information. We expected that, as with text-only documents, struggling readers would benefit from high text cohesion (Hypothesis 1) and that signaling would foster inference generation as well (Hypothesis 2). Further, we hypothesized that better learning outcomes would be observed when text cohesion was low and signaling was present (Hypothesis 3). Our first experimental study investigated the effect of those two factors (cohesion and signaling) on three levels of comprehension (text based, local inferences, global inferences). Participants were adolescents in prevocational schools (n = 95), where some of the students are struggling readers. The results showed a trend in favor of high cohesion, but with no significant effect, a significant positive effect of cross-representational signaling (CRS) on comprehension from local inferences, and no interaction effect. A second experiment focused on signaling only and attention toward the picture, with collection of eye-tracking data in addition to measures of offline comprehension. As this study was conducted with university students (n = 47), who are expected to have higher reading abilities and thus are less likely to benefit from high cohesion, the material was presented in its low cohesive version. The results showed no effect of conditions on comprehension performances but confirmed differences in processing behaviors. Participants allocated more attention to the pictorial representation in the CRS condition than in the no signaling condition.

OBJECTIVE: The effects of text cohesion and added pictures on acquired knowledge have been heavily studied each in isolation. Furthermore, studies on the effects of specific characteristics of pictures, whether facilitating or hindering, are scarce. Schnotz\'s ITCP Model (2014) allows to formulate hypotheses regarding the combined effect of text cohesion and presence and level of detail of a picture. This study investigates these hypotheses in the case of children reading scientific texts.
METHODS: One hundred and one-second-, third-, and fourth-grade pupils with a mean age of 9 years, in the western United States.
METHODS: Data were collected over three sessions to encompass an understanding of each pupil\'s knowledge based on prior sessions.
CONCLUSIONS: Results showed a significant increase in pupils\' knowledge between pre-test and immediate post-test, but as hypothesized, no significant difference between levels of cohesion. No significant difference between types of pictures was detected. After 1 week, knowledge built with a high cohesive text significantly dropped with low-detail picture, whereas, with high detail, or no picture, there was no significant difference. Results suggested that when participants were given a low-detail picture with a low cohesive text, the integration process of the material was more restricted than with a high cohesive text.