October 2017 Issue

Get Creative With Graphic Design
By Verona M. Somarriba, MS, RDN, CDN
Today's Dietitian
Vol. 19, No. 10, P. 48

Building your artistic skills can improve the look of nutrition education materials and presentations, boost your business, and enhance patient care.

Have you ever wanted to make your counseling sessions, educational materials, and presentations easy to follow, memorable, and interesting? How about revamping your social media pages with a smart infographic or clever meme to broaden your audience? Well, you're not alone, and you aren't without help. This article will review how to achieve these goals and more by incorporating graphic design into your practice.

Graphic Design for Dietitians
Defining graphic design is straightforward. It's the practice of visual communication—a problem-solving tool that combines type, space, images, and color. The impact, influence, and role graphic design plays in our daily lives is undeniable. More importantly, some features of graphic design are ingrained in our culture, especially pertaining to food—so much so that it has become a standard that we expect from our providers of products and services. For example, graphic design is used universally from street signs to instructions on packaging, maps for driving, store layouts, and even recipes. It provides visual support to your overall strategy of communicating simply and efficiently.

However, despite the benefits of graphic design, it still isn't widely considered a necessary health care resource. Despite its low implementation, graphic design is a skill worth acquiring, especially since dietitians rely heavily on images and creative infographics to demonstrate serving sizes, show nutrition labels, and provide information to clients and patients who may find dietary information daunting to process, understand, and interpret. RDs can streamline communication and minimize confusion by designing concise, easy to comprehend, one-page graphics that won't overwhelm but will empower patients.

Graphic design empowers not only patients but also dietitians to create adaptive solutions to evolving problems. Design teaches RDs to experience the unique needs of each project and trains them to adapt to changes quickly, much as they do in daily practice with individual clients and patients. The profession has evolved over the years and will continue to do so, driving the practice quickly into the digital realm that prefers images and succinct visual messages over long-winded written documents. There's a reason why clients and patients resort to Pinterest and Facebook for advice rather than seeking out the experts—the messages are quick and easy to understand, although not always accurate. This is where dietitians need to be bold, step out of their comfort zones, and create user-friendly material with accurate information.

Health Literacy
Medical practices across all fields already are implementing visual aids to improve medication adherence.1 Visual aids help patients overcome language and literacy barriers by providing visual directions that help prevent confusion and overmedication. Dietitians can apply that same logic to nutrition; images can transcend language and literacy. This advantage becomes especially important when addressing high-risk populations that need it most: the elderly, non-English speaking patients, those with low literacy levels, and persons with mental disabilities.

Five Reasons RDs Should Embrace Graphic Design

1. Creating Memorable Messages
Graphics can convey a powerful and lasting message. Deep learning, or a person's ability to classify categories in their subconscious, is heightened when using visual images to deliver messages compared with written text.2 If a person has shown difficulty in retaining written information, switch the delivery method and cater to his or her visual literacy. Lynell Burmark, PhD, an education consultant in San Francisco, is a proponent of visual learning. Burmark explains that people cognitively process text by short-term memory, whereas images are processed through long-term memory.3 Using this cognitive paradigm, dietitians can improve message retention by targeting a person's visual literacy.

In fact, a blog post by Adobe emphasized that design-driven companies have consistently outperformed the S&P Index by 219% over 10 years. Business as usual no longer gets the job done, and design and innovation have become essential to help businesses adjust their thinking to differentiate themselves from competitors.4
Here's how the nutrition profession, specifically, can benefit from incorporating design:

• Clinical dietitians can simplify complex nutrition and supplement guidelines.
Benefit: increases patient understanding and adherence, enhances patient outcomes, improves communication between RDs and medical staff, creates trust between patient and provider, and decreases risk of complications.

• Culinary RDs can improve recipe cards, menus, instructional videos, and cooking directions.
Benefit: increases returning customers, improves social media reach, and creates branding opportunities.

• Dietitians in education can enhance their handouts and presentations.
Benefit: prolongs attention span and engagement, reduces literacy and language barriers, and improves likelihood of repeat encounters and speaking engagements.

• Community dietitians can improve their counseling sessions and attract more participants to local events.
Benefit: raises participation rate, improves education, reduces literacy and language barriers, and helps simplify instructions.

• RDs in management can create flow diagrams, charts, and instructions that are easy for their staff to follow.
Benefit: improves HACCP (hazard analysis and critical control points) compliance, minimizes chance for workplace-related injuries, improves workplace hygiene, boosts productivity, and provides reference points for frequently asked questions.

• Media dietitians can improve their social media pages, blog posts, newsletters, and videos.
Benefit: creates branding opportunities, improves social media reach, increases likelihood of word-of-mouth referrals, and decreases expenses from having to hire graphic designers (which can cost up to $5,000 per project).

While graphic design can benefit all areas of nutrition, it especially can benefit dietitians in private practice, those who are food product entrepreneurs, and media RDs looking to build their brands and businesses.

2. Branding
Branding relies heavily on graphic design. Through branding, dietitians create a set of expectations and messages, while building trust and inviting clients and patients to develop a relationship with them, establishing loyalty to their products and services in the process. When it comes to nutrition, trust should be part of the brand.

RDs don't have to limit themselves to Nutrition Care Manual handouts. They can create their own set of handouts that apply to their population, include their medical center's/company's logo, and even showcase their personalities and knowledge. These types of efforts help to improve patient outcomes and satisfaction by providing them with trustworthy material that's easy to understand. They also may share this material with others, which can lead to future referrals. One important task RDs should consider is creating digital, thus portable, documents for their audience. Digital documents, such as JPEGs and PDFs, can be shared and stored easily on smartphones; they're the perfect vessels for nutrition information that's user friendly, making them truly useful references that patients can access at any time.

3. Amplification
Good graphics accessed on smartphones or other portable devices will spread like wildfire because people will share what they find useful. And, more than likely, they'll share them on social media via Facebook, Twitter, Instagram, Pinterest, Yummly, and YouTube. What these platforms have in common is that the driving force behind their popularity is specially crafted, high-quality visuals and images. Embrace this form of communication, and use it to your advantage to spread interesting and accurate nutrition information.

4. Creating a Need
Recently in my practice, I designed a newsletter for patients. As many dietitians know, newsletters provide a secondary opportunity to share ideas, recipes, and solutions that RDs don't always get a chance to discuss with patients during appointments. The newsletter is simple: It includes a few tips, attractive images, a clean layout, some recipes, and even supplement suggestions. What makes this tool a success is that it's easy to read, it's conveniently sent to the patient's inbox, and it's downloadable and printable.

I shared the newsletter with other MDs, RDs, and patients in our health system, and several of them shared it immediately on social media. In a matter of hours, the newsletter received triple the views I had anticipated. Several providers within our system whom I didn't think would see the newsletter shared it with their patients as well. The response was impressive, and the unexpected benefit was that the response demonstrated a real need for the newsletter; I received feedback from other practicing RDs within our health care system who told me there were other areas of wellness that could benefit from the newsletter. Needless to say, it's now essential to my practice.

5. Ease of Use 
The process of learning how to design graphics is interesting and fun. It can be time consuming, but it becomes easier with practice. There are free online tools and apps that make designing quick and efficient without the need for an artistic background. Canva and Piktochart are two free websites that provide designed templates that are easy to modify. This is a simple and effective way to create infographics, posters, presentations, newsletters, logos, and much more. Spark Post Pro is a design app suitable for those who use social media and need to build websites. The app helps you create modern images easily with preselected typography. One other option is to collaborate with other dietitians who are already doing this as part of their practice. Many have embraced their inner designers and have become experts at visually communicating nutrition messages.

Nutrition Design
Content
What a dietitian designs is successful when it's driven by content. The design has to convey a direct and specific message that must be clearly identified before beginning.

1. Identify the most important aspect of the message (eg, avoid sodium, drink supplements, count your carbs, exercise more).
2. Edit the content. Include only the points that are necessary, and eliminate excess content. This editing process may continue as the design is built.

Designing
It's important to note that the message will drive the design. There are five aspects of nutrition design to consider. The first is context: Consider who will use the design and how they will use it. Is the user an older adult who needs larger typeface? Is the user a child who responds well to bright colors? Is it meant to be stored on a phone? Is it going to be printed and posted in a kitchen? Will it be the size of a postcard or a large poster? These factors will facilitate the design process, but keep in mind they also may change as you build the design.

The next concept to consider is hierarchy, which organizes the important points of the message. This helps guide the reader's eye in the intended direction.

The third aspect is visual thinking. Make suggestions with images rather than with words. Use graphics and images that support the message, and let them speak for themselves. Select images purposefully. Don't select an image because it's "pretty," choose it because it illustrates the point. Stock photos are ideal when creating graphics. Purchased stock photos include a license of use, which enables the RD to trademark or copyright their work. However, if borrowing images from a website, magazine, or inspiration board, make sure to give credit where it's due. A simple "Photo by Jane Doe" strategically placed under the image will do the trick.

In addition, consider color when designing, since color can make or break a graphic. Select colors that are pleasing to the eye, help set the mood, and bring out the importance of the type. Colors can take a simple design and change its intent drastically.

The fifth aspect to consider is white space. In design, less is always more. White space is space that's unmarked or unused in a graphic. It could include margins or the space between elements in the design. White space is essential in creating visually engaging content. It prevents overcrowding, which can make a graphic unappealing and difficult to read. If there's little white space, the eyes will get strained and won't know what to focus on. So keep the design simple; make your graphic two pages long if necessary.

Take-Home Message
Dietitians are versatile practitioners who must adopt a multitude of skills as part of their ongoing training. Design is a resourceful skill that will help RDs be effective. Use design to expand your current resources. Use the wheel, don't reinvent it. Technology is on your side, and with it you can create the necessary visual aids to deliver the most accurate and memorable nutrition information for clients, patients, and customers. The goal is clarity—create simple instructions that are easy to follow.

— Verona M. Somarriba, MS, RDN, CDN, is clinical nutrition coordinator for the department of general surgery at the Icahn School of Medicine at Mount Sinai. Somarriba uses graphic design to create educational material for her practice. She graduated from Parsons School of Design with a BFA in architectural design and worked as a designer before becoming a dietitian.

References
1. Pratt M, Searles GE. Using visual aids to enhance physician-patient discussions and increase health literacy [published online June 1, 2017]. J Cutan Med Surg. doi: 10.1177/1203475417715208.

2. Li N, Zhao X, Yang Y, Zou X. Objects classification by learning-based visual saliency model and convolutional neural network. Comput Intell Neurosci. 2016;2016:7942501.

3. Schaffhauser D. Picture perfect: teaching to visual literacy. THE Journal website. https://thejournal.com/articles/2012/12/19/picture-perfect-teaching-to-visual-literacy.aspx. Published December 19, 2012. Accessed July 24, 2017.

4. Harmer T. 4 key stats on the importance of design for business. Creative Connection by Adobe website. https://blogs.adobe.com/creative/design-advantage/. Published October 14, 2015. Accessed July 24, 2017.