Previous research found a current pharmaceutical warning label ineffective and subject to harmful misinterpretation. The present research examined symbol interpretation and acceptability among adolescents for a series of candidate teratogen warning symbols. 200 subjects were randomly assigned to 1of 4 symbols, following a modified ANSI z535.3 protocol for symbol evaluation.

  Image1                  Image2             Image3                         Image4

Symbols 2 and 4 elicited the highest percentage of fully correct interpretation; 96% and 86%, respectively. 90% of responses regarding Symbol 2 identified the meaning as “do not take while pregnant” but none made references to caution, danger, or some kind of warning. 18% of those who viewed Symbol 1 gave answers that were incorrect, ineffective, insufficient or wrong.  Symbol 2 had the fewest such incorrect responses, at 4%. Content analysis of responses indicated Symbol 3 had three times more responses relating to “causes birth defects” than the other symbols. Labels containing Symbol 2 (42%) and Symbol 1 (22%) were chosen most frequently as most effective. Rationale for label selection formed six primary clusters: (1) Universal recognizability, (2) Clarity, (3) Depiction of pregnancy, (4) Depiction of womb/baby, (5) Communication of Caution, and (6) A. Results differed from previous findings with adult populations. Accurate warning symbol interpretation is a key element in hazard avoidance. Warning symbol interpretation and effectiveness is an important, under-examined, aspect of adolescent health, and the results underscore the importance of further work to understand message reception among the audience.  Funded by grant # DD000001-01 from the CDC/NCBDDD.