eng Science and Education Publishing American Journal of Educational Research 2327-6150 2016-04-08 4 5 371 377 10.12691/education-4-5-2 EDUCATION2016452 article Marziyeh Hasani 1 Narges Khanjani 2 Mohammad Reza Mahmoodi 3 Mohammad Mehdi Fadakar mmfadakar@kmu.ac.ir 4 Abedin Iranpour 4 Mohammad Hossein Gozashti 5 Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran Cardiovascular Research Center, Institute of Neuropharmacology & Department of Nutrition, School of Health, Kerman University of Medical Sciences, Kerman, Iran Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Endocrine and Metabolism Research Center, Institute of Basic and Clinical Physiology Science, Kerman University of Medical Sciences, Kerman, Iran Introduction: The compliance of low literate and illiterate patients might be improved and disease complications prevented by using pictographs. This study was carried out using qualitative methods to design pictographs for increasing adherence in low literate and illiterate patients with diabetes mellitus. Material and methods: An action research was carried out after facing compliance problems in illiterate diabetic patients. A professional graphic designer designed pictographs under the supervision of health education, endocrinology and nutrition specialists, in two cycles and after conducting interviews with 23 low literate and illiterate patients. The data was analyzed by qualitative methods. Results: After a long and durable process and 23 interviews [with 16 illiterate and 7 low literacy persons[ and 2 cycles, 10 pictographs for correct medicine consumption, 8 for foot care, 4 for diet, 113 for food substitutes and 1 for physical exercises were created, which were acceptable and understandable for most patients. Conclusion: Pictographs might be helpful for increasing adherence in illiterate or low literate patients who have problems with written instructions. In the present study we designed some pictographs to help these patients. It is necessary to carry out studies to prove the efficacy of these pictographs in improving patient adherence through quantitative methods. http://pubs.sciepub.com/education/4/5/2/education-4-5-2.pdf pictographs low literate illiterate diabetes mellitus adherence