| Sumario: | Icons are widely used in health communication because complex information can be conveyed rapidly and with minimal cognitive demand. The purpose of this study was to analyse the effects of icon design formats on matching performance across multiple preventive functions related to COVID-19. A total of 105 standardised pictograms representing 21 preventive functions were developed in five formats (image-related, concept-related, semi-abstract, word, and combined) and designed in accordance with ISO 9186-1:2014 to ensure visual consistency. Thirty adults completed a computer-based matching task in which each pictogram was linked to its intended function, with matching accuracy and response time recorded. One-way ANOVA showed that icon format significantly influenced matching accuracy but not matching time, whereas preventive function significantly affected both measures. Word and combined formats demonstrated the highest accuracy, followed by image-related and semi-abstract formats, while concept-related icons performed poorest. Confusion matrix analysis of icons with accuracy below 75% revealed systematic misclassifications caused by overlapping visual features and semantic similarity, particularly among closely related respiratory function. Design guidelines derived from the confusion patterns emphasise prioritising combined formats for confusable functions and avoiding concept-related formats for preventive behaviours. Overall, the findings provide an ergonomics-informed foundation for evidence-based redesign of safety-critical health pictograms.
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