Using Cartoons to Transfer Knowledge Concerning the Principles of Work Disability Prevention Among Stakeholders Marie-Elise Labrecque 1 • Marie-France Coutu 1 • Marie-Jose ´ Durand 1 • Jean-Baptiste Fassier 1,2 • Patrick Loisel 3 Ó Springer Science+Business Media New York 2015 Abstract Purpose This study assesses how well two cartoons transfer knowledge of principles of work dis- ability prevention among stakeholders, according to their level of experience. We also document stakeholders’ per- ceptions of the usefulness of the cartoons. Method We performed a descriptive study. Two groups of stakeholders were recruited: (1) experienced (working for more than 2 years in work disability), (2) non-experienced (in train- ing). A self-administered questionnaire with open-ended questions documented stakeholders’ understanding of each cartoon box and their perception of the possible usefulness of the cartoons. We transformed qualitative responses into quantitative responses for descriptive purposes. We per- formed independent t tests to compare the groups’ level of understanding, and content analysis for the perception of usefulness. Results Overall, 149 stakeholders (50 experi- enced and 99 non-experienced) participated and identified 79.4 and 61.4 % of all principles presented in each of the two cartoons respectively. Experienced stakeholders iden- tified more principles compared to non-experienced stakeholders (p = 0.007). Both cartoons were perceived to be useful for knowledge transfer. Conclusions Principles were generally well identified in the cartoons by all par- ticipants. Cartoons can be used as an effective tool among stakeholders to achieve a common understanding in order to coordinate their actions. Keywords Stakeholders Á Cartoons Á Vocational rehabilitation Á Sick leave Á Knowledge translation Introduction Cartoons play an important role in patient education by influencing their compliance and prognosis [1, 2]. Cartoons are a ubiquitous method of visual communication [3]: they are produced on a daily basis, require small demands on the reader’s attention and intellect [3, 4], and are not time consuming [1]. Furthermore, cartoons are rich in ideas and simple to understand [5]. Moreover, patients prefer receiving health messages in picture form because they have a representation of themselves [1]. A picture can influence cognitive and emotional aspects; as a result, it can increase memory and influence behavior [6]. Because reading and viewing activate different information pro- cessing systems in the brain, it has been observed that a combination of text and pictures facilitates understanding [7], as it enables association between new information with existing knowledge [8, 9]. Delp and Jones [2] observed that, among patients coming to an emergency room with lacerations, those who received illustrated treatment instructions accompanied with text were significantly more compliant to treatment. These patients remembered more information than those who received it only in text format. Illustrative strategies were also found to be efficient for improving understanding of cancer prevention behaviors among women who received a brochure with pictures on cervical cancer prevention, as compared to those who just received text (65 vs 53 %) [10]. Based on a review of the & Marie-France Coutu Marie-France.Coutu@usherbrooke.ca 1 Hopital Charles-LeMoyne Research Center and School of Rehabilitation, Universite ´ de Sherbrooke, 150 Place Charles- lemoyne, Longueuil, QC J4K 0A8, Canada 2 Hospices Civils de Lyon/UMRESTTE, Universite ´ Claude Bernard Lyon 1, Lyon, France 3 Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada 123 J Occup Rehabil DOI 10.1007/s10926-015-9595-0