Category: We Heart Health Literacy

User Testing from a Safe (Social) Distance

Posted on by CommunicateHealth
Alt: A researcher doodle joins a video call from the couch, wearing a lab coat and bunny slippers. They say, “Can you hear me?”

Here at We ❤ Health Literacy Headquarters, we’re always stressing how important it is to test your health materials with your priority audiences. And during COVID-19, remote testing may be the only safe way to do it. So this week, dear readers, we’re sharing tips for successful remote user testing:

  • Work around WiFi barriers. Don’t let a lack of high-speed internet limit your pool of potential participants — there are ways around this common hurdle! You can talk to participants over the phone and avoid the internet entirely — or send session materials via snail mail to avoid screensharing issues. If your heart is set on high-speed internet sessions, try bringing the web to your participants! Find recruiters who can safely open their facilities for folks to join remote sessions. Or work with local community partners who can help provide internet access and distribute testing materials.
  • Mix up your methods. Now’s a great time to explore unmoderated forms of data collection, like a video diary activity or unmoderated click testing. Or try a mixed-methods approach with moderated and unmoderated activities — this will provide richer data and help you focus live sessions on your most important research questions.
  • Create a cozy remote environment. When possible, let participants join from whatever device they prefer — whether that’s a desktop, phone, or tablet. Do a tech check at the start of the session to make sure everyone’s comfy with the format. And take time to build rapport before diving into the subject matter. With the right approach, you can bring a cozy-living-room vibe to the sterile void of Zoom.
  • Plan ahead for success. Talk with your team about how you’ll troubleshoot throughout the session — like extending session times to account for technology problems, having someone on deck to help fix any issues that come up, or prioritizing your discussion questions in case internet woes cut your session short.

As you conduct remote studies, be sure to keep track of what does and doesn’t work for your team and priority audiences. If you don’t get it perfect the first time, you can apply your lessons learned to future studies!

The bottom line: Social distancing doesn’t have to ruin your user testing game — get user feedback with remote testing.

Tweet about it: #COVID19 throwing a wrench in your research plans? Don’t despair! @CommunicateHlth has tips to set you up for remote user testing success: https://bit.ly/3gVvHHZ #HealthLit

Things We ❤: ProPublica’s Plain Language Reporting

Posted on by CommunicateHealth
Alt: A doodle holds a newspaper that says “ProPublica” at the top.

Here at We ❤ Health Literacy Headquarters, we’re always singing the praises of plain language. And while we’re usually blabbing on about how great plain language is for health materials, its uses are so much broader than that!

That’s why we’re so excited about ProPublica’s plain language reporting initiative. As part of a recent story about disability benefits in Arizona, ProPublica published plain language “translations” alongside the original reporting on its site.

To make the story more accessible to people with intellectual and developmental disabilities, ProPublica used an ultra-accessible version of plain language that goes even farther in terms of simplifying sentence structure. Because too often, stories about people with disabilities aren’t written for people with disabilities.

Reporter Amy Silverman, who wrote the series, said her team was careful not to assume that readers with disabilities would prefer the ultra-accessible plain language version. They recognized that those readers might want to read the original — so ProPublica offered both options to everyone.

And that, dear readers, is the foundation of effective health communication: always put your users’ needs first. Those needs might not be the same for everyone in your audience, and they might change over time, too. And you know what’s great for figuring that out? Testing your products with your users!

The bottom line: ProPublica’s innovative plain language reporting and audience-centered approach show us how to make journalism more accessible — and we ❤ that.

Tweet about it: .@propublica’s #PlainLanguage reporting initiative is a case study in how to make journalism more accessible, says @CommunicateHlth: https://bit.ly/3qEsNvw #HealthLit

Explaining Vaccine Trial Phases

Posted on by CommunicateHealth
Alt: Two scientist doodles wearing masks stand in front of a sign that says, “Vaccine trials.” One of the doodles also wears goggles and holds up a pair of test tubes.

If you’re like us, dear readers, you’ve been eagerly following updates on COVID-19 vaccine trials. But of course, any benefit from a vaccine depends on people actually getting it. And the latest Gallup poll has the percentage of Americans who say they would do so at just under 60. So we’ve got some work to do on this front!

With the super speedy COVID vaccine development timelines, people may worry that experts are skipping safety steps. Often, we can stick to a simple key message to address this: “Experts are doing trials to make sure COVID vaccines are safe. By the time doctors start giving people a COVID vaccine, it will have been safety tested with thousands of volunteers — so we’ll know that it’s safe for the general public.”

In more detailed materials, it can help to lay out the phases of vaccine trials. Feeling unsure of the different steps yourself? Don’t worry, dear readers. We’re here for you with some plain language explanations! Use this cheat sheet to explain the phases of vaccine trials:

Phase 1

With a brand new vaccine, researchers start small. They give the vaccine to tens of people — usually 20 to 100. The key question here is: Is the vaccine safe?

Phase 1 trials also help researchers figure out the right dose (amount) for the new vaccine and find any serious side effects.

Phase 2

Once they know the vaccine isn’t likely to cause any serious side effects, researchers kick it up a notch and give it to hundreds of people. In this middle step, researchers ask: Does the vaccine work?

To answer this question, Phase 2 usually uses a control group — or a group that gets an older vaccine or a placebo (a shot with no vaccine at all) instead of the new vaccine. That way, researchers can be sure that the vaccine really works to prevent the disease.

Phase 2 also builds on what researchers learned about safety in Phase 1. Researchers learn more about any short-term side effects and keep homing in on the best dose to use.

Phase 3

Phase 3 is the big show — the last step before researchers apply for approval from the Food and Drug Administration (FDA) and start offering the vaccine to the general public. So they give the vaccine to thousands of people in order to answer the 2 key questions once and for all: Is the vaccine safe and does it work?

This phase always uses a control group. Researchers compare the number of people who got the vaccine and got sick with the disease to the number who didn’t get the vaccine and got sick with the disease. And that tells them how well the vaccine can protect us!

Because Phase 3 tests the vaccine in a much larger, more diverse group of people, it also finds less common side effects and confirms that it’s safe and works well for everyone.

Phase 4

This step happens after the FDA approves the vaccine. That’s right — even after researchers have answered the big questions, they keep studying the vaccine. They gather longer-term data to make sure the vaccine continues to work well and to learn more about any long-term side effects.

Combined phases and pauses

Sometimes when a vaccine is urgently needed, researchers may combine phases to speed up the approval process. But this doesn’t mean that they’re skipping important steps. It just shows that researchers and public health organizations are partnering on an extraordinary effort to get safe, effective vaccines to people who need them as quickly as possible.

Also, researchers may pause vaccine trials if there are issues along the way (this actually happened a couple times recently). And though it may seem scary, it’s a good thing. Why? It means the system is working to keep us safe.

The bottom line: Explain the phases of vaccine trials to boost public confidence in the process — and in a future COVID-19 vaccine.

Tweet about it: Want to build trust in the #COVID19 vaccine approval process? Start by explaining trial phases in #PlainLanguage. @CommunicateHlth has tips: https://bit.ly/37vPZ6p #communicateCOVID

Picture This: Using Pictograms in Health Materials

Posted on by CommunicateHealth
Alt: A doodle wearing a beret paints a pictogram on an easel. The pictogram shows a person sneezing.

Visuals are a powerful tool in our health communication toolbox. They help us convey big ideas in a way that transcends language and cultural barriers. And here at We ❤ Health Literacy Headquarters, we’ve really been digging a certain type of visual lately: pictograms.

A pictogram is a drawing or image that represents an idea in a simple, literal way. We can use pictograms to show recommended behaviors, symptoms, and other health concepts that can be tricky to explain. They’re especially useful for audiences with limited literacy skills, limited English proficiency, or cognitive disabilities. And as an added bonus, they help us reinforce key messages for all readers!

Try these 3 quick tips to create pictograms that will resonate with your audiences:

  1. Use literal representation instead of abstract symbolism. Some symbols or graphic conventions (like “Rx” for “prescription” or wavy lines to indicate heat) may not resonate across cultures. So it’s important to make illustrations as literal and concrete as possible. 
     
    For example, if you’re creating a pictogram to represent sneezing as a symptom, show a person actually sneezing — not just a tissue box.
Alt: 2 versions of a pictogram appear above text that says “Seasonal allergies can cause sneezing.” The first one is labeled “Instead of abstract symbolism” and shows a tissue box. The second one is labeled “Use literal representation” and shows a person sneezing.

2. Incorporate realistic details that aid understanding. Use realistic colors and include details that provide context to help people understand your pictogram. In the example below, we’ve put the thermometer in the person’s mouth and added flushed cheeks and sweat on the forehead to more clearly show that the person has a fever.

Alt: 2 versions of a pictogram appear above text that says “You may have a fever.” The first one is labeled “Instead of ambiguous visuals” and shows a person with a thermometer beside their head. The second one is labeled “Use realistic details” and shows a person with a thermometer in their mouth, flushed cheeks, and sweat on their forehead.

3. Use a consistent visual style. Did you know that our short-term memory can only hold a few visual elements at a time? Interpreting a series of images can be hard for anyone, and it’s especially tricky for people with limited literacy skills. To avoid cognitive overload (overwhelming viewers with too much information), use a consistent visual style and similar characters across all pictograms in a single material.

In the example below, we’ve used the same character and art style for all 3 images to help avoid cognitive overload.

Alt: 2 versions of a 3-part pictogram appear above text that says “Eat a healthy diet. Get 8 hours of sleep. Get active.” The first version is labeled “Instead of mixing it up” and uses 3 different visual styles to depict the 3 healthy behaviors. The second version is labeled “Use a consistent visual style” and uses the same style for all 3 behaviors.

The bottom line: Pictograms can help us communicate big ideas in an accessible way. Try these tips to create pictograms that resonate with your audiences.

Tweet about it: Pictograms can help us communicate big ideas in an accessible way. Try these tips to create #HealthLit pictograms that resonate with your audiences: https://bit.ly/35pn9ov

A Path Forward

Posted on by CommunicateHealth
Alt: A group of doodles follows signs that point toward “health literacy,” “health equity,” and “public health.”

In a departure from our regularly scheduled programming, we want to acknowledge that this week has been hard. Emotions are running high, many of us have been glued to our screens even more than usual, and voting (or doing anything, really) during a pandemic can be super stressful.

And the election results (or lack thereof) show that our country is still severely divided.

Here at We ❤ Health Literacy Headquarters, we talk a lot about embracing uncertainty. It’s a useful skill, but it sure isn’t easy. And as uncertainty goes, this current situation is not the type we prefer!

We don’t have all the answers (or even, you know, the results), but we do know this: we need to stay hopeful. There’s just too much at stake — like the very concept and practice of public health.

Now more than ever, it’s time for the public health community to focus on doing what we can to support health and well-being for everyone in this country. That could mean creating easy-to-understand health information, improving access to quality care, or working to dismantle the systemic racism that profoundly impacts health in so many communities.

The bottom line: These are tough times, dear readers. But we have important work to do.

Tweet about it: These are tough times. But the #PublicHealth community has important work to do, says @CommunicateHlth: https://bit.ly/2JFWOdv

The Truth Sandwich: A Better Way to Mythbust

Posted on by CommunicateHealth
Alt: A doodle looks at a truth sandwich. The sandwich is made of a lie between 2 slices of truth bread. The doodle says to the sandwich, “Hey, you’re full of baloney!”

We spend a lot of time over here at We ❤ Health Literacy Headquarters thinking about how to combat coronavirus misinformation. And lately, we’ve been looking around for more effective ways to mythbust.

What’s wrong with regular old mythbusting, you ask? Just picture this chilling chain of events:

  1. A user lands on a webpage designed to dispel myths about COVID-19.
  2. They skim right over the word “myth” and see: “Drinking bleach can cure COVID-19.”
  3. Then they get a text/their doorbell rings/their cat jumps onto their neck and they never make it down to the part of the page explaining that no, drinking bleach can’t cure COVID. But it sure can kill you!

This rather extreme example shows why we usually let the facts speak for themselves — and avoid restating dangerous myths in our health content. But when a truly treacherous piece of false information just keeps circulating, sometimes you’ve got to squash it head-on.

Enter: the truth sandwich.

Linguist George Lakoff described this approach as a better way for political journalists to report on, well, lies (can’t imagine why they’d need it!). But we think it’s also a great tool for particularly sticky health misinformation.

Here’s how the truth sandwich works in Lakoff’s own words:

  1. Start with the truth. The first frame gets the advantage.
  2. Indicate the lie. Avoid amplifying the specific language, if possible.
  3. Return to the truth. Always repeat truths more than lies.

And here’s an example of how it could play out in health materials:

Never drink bleach. You may have heard that bleach can kill the coronavirus, but this only works on surfaces — not inside your body. Drinking bleach can cause serious illness and death, and it doesn’t cure COVID-19.

And there you have it! A health communication truth sandwich.

The bottom line: When you really need to dispel a myth, try serving up a truth sandwich.

Tweet about it: Need to squash harmful health misinformation? @GeorgeLakoff’s truth sandwich might help, says @CommunicateHlth: https://bit.ly/3kHbhDo #HealthLit #communicateCOVID

Things We ❤: The National Medical Association’s COVID-19 Task Force

Posted on by CommunicateHealth
Alt: A doodle holds up a National Medical Association COVID-19 Task Force sign.

Last month, we talked about preparing for effective COVID-19 vaccine communication. And as we continue to think about this vital conversation, one thing becomes more and more clear: health communicators will need to tackle coronavirus vaccine hesitancy head-on, using evidence-based strategies tailored to specific audiences.

That’s why we were excited to see the National Medical Association (NMA), a nationwide organization of African American doctors, announce its plan to review clinical trial data and release independent assessments for new COVID-19 treatments and vaccines that get emergency approval from the FDA.

Recent polls show that only 1 in 4 Black Americans would be willing to get a COVID-19 vaccine. That’s not surprising, given the history of medical exploitation and experimentation on Black Americans, the pervasive racial bias and discrimination in our modern health care system, and the political undertones surrounding COVID-19 vaccine development in an election year.

NMA’s task force approach confronts these fears directly, laying the groundwork for trusted experts to reassure people about a future vaccine — and to communicate quickly, clearly, and honestly about any potential safety or efficacy concerns.

The bottom line: NMA’s task force is a case study in how to build marginalized communities’ trust in a future COVID-19 vaccine — and we ❤ that.

Tweet about it: .@NationalMedAssn’s plan to independently assess #COVID19 vaccine data could help build vaccine confidence & address #HealthDisparities among Black Americans, says @CommunicateHlth: https://bit.ly/3mcQKHd #communicateCOVID

COVID Comm Lessons from the Safer Sex Toolbox

Posted on by CommunicateHealth
Alt: A doodle looks at a text conversation on their phone. Their friend asks, “Wanna hang today?” The doodle responds, “Yeah!! You cool with keeping masks on?” “For sure! I’d feel safer outside too,” says the friend.

As health communicators, we know that harm reduction is key to preventing the spread of COVID-19. But helping people choose safer ways to socialize is only part of the equation — we also need to help people communicate with friends and family about these social choices.

And lucky for us, the public health toolbox has tips for this situation all ready to go! That’s because there’s a lot of overlap in communication strategies for safer socializing and safer sex. Let’s start with this one: both scenarios require open communication — and both work out a lot better if everyone gets on the same page before anyone’s in the heat of the moment. That’s why conversation tools can be so helpful in both situations.

So this week, we want to help you help your audiences have the talk. Share these tips and talking points for navigating tricky COVID chats:

  • Start with questions. Try asking your friends how they’ve been socializing and what level of contact they’re comfortable with. That way, you can work together to set group boundaries — and take each person’s risk of COVID exposure into account. Try: “Have you been hanging out with friends outdoors? How would you feel about going on a masked hike together this weekend?”
  • Use “I” (not “you”) statements. With these kinds of touchy topics, it’s best to avoid making people feel defensive. So instead of leading with assumptions or demands about the other person’s behavior (“You’d better put your mask back on as soon as you’re done eating”), frame it in terms of your own perspective and behavior (“I’ll feel safer if we all keep our masks on when we’re not eating or drinking”).
  • Share why it matters to you. If others aren’t taking the risks as seriously as you are, try explaining why safety precautions are important to you. “This can be deadly, and I’m not willing to take unnecessary risks. So I’m only comfortable seeing you outdoors.”
  • Be firm about your boundaries. It’s great to be as polite and friendly as possible when starting these conversations — but don’t compromise on your safety. If you can’t agree on reasonable safety rules, feel free to call off your plans and explain why: “It sounds like we have different comfort levels around socializing right now, so I’ll have to skip it. I just don’t feel safe spending time indoors with such a large group.”

And remember, even if these tips seem obvious, all this social distancing has really eroded our social skills. So concrete talking points can go a long way.

The bottom line: Take a page from the safer sex communication playbook to help your audiences navigate social situations during COVID-19.

Tweet about it: How do we help people socialize safely during COVID-19? Take a hint from safer sex communication, says @CommunicateHlth: https://bit.ly/3jIj0AP #communicateCOVID

Communicating About Correlation and Causation

Posted on by CommunicateHealth
Alt: A newscaster doodle on TV says, “Studies show that putting a cat on your head causes cat head!” A doodle watching TV at home puts a cat on its head and looks confused.

Here at We ❤ Health Literacy Headquarters, we love to back up our health advice with solid research. And that means we’re always on guard against mistaking correlation for causation.

Of course, as health communicators, we like to think we can spot the difference a mile away. But let’s be honest: it’s easy — and even tempting — to conflate them. Spend enough time mining a broad data set, and you’ll see all sorts of tantalizing correlations that are just too good to be true. Red wine linked to heart health! Chocolate associated with winning Nobel prizes! And before you know it, you’re trying to guzzle and munch your way to a tip-top ticker and a major academic award.

Let’s start with a quick refresher of the difference between causation and correlation:

  • Causation means we know that X causes Y to happen. In health research, demonstrating causation is a pretty big deal.
  • Correlation means there’s a relationship between 2 things, but we don’t know what kind. Is X causing Y? Is Y causing X? Is there a sneaky Z factor waiting in the wings to muck up the whole equation?!

Before we move on, it’s important to keep in mind that showing causation can look different depending on what researchers are studying. The gold standard here is a randomized controlled trial, but those aren’t always possible. Take smoking and lung cancer — asking an experimental group to smoke so we can see if they get cancer would be wildly unethical! And yet, we know that smoking causes lung cancer. Because at the end of the day, overwhelming observational evidence can get us to what’s called causal inference. (Especially astute readers will notice this is part of what tripped us up in our first attempt at tackling this topic.)

Now, there are 2 main things to keep in mind when you’re writing about cause and effect in health materials. First, check the original source. Online news is notoriously click-baity when it comes to reporting the latest health-related studies. So don’t take someone else’s word for it! Instead, look at the original study and other sources to confirm whether experts agree that it’s cause and effect.

This may well send you down an internet rabbit hole here and there, but it’s well worth it to make sure you’re not accidentally leading your dear readers astray, dear readers. (And this type of dutiful sleuthing can also help you avoid falling prey to pseudoscience.)

And once you’re sure you know what you’re working with, choose your words carefully.

  • If you’re writing about causation, knock yourself out with strong verbs like “X causes Y.”
  • If you’re writing about correlation, try something like “X may help lower the risk of Y” or “X is linked to Y.” (Don’t be alarmed — we know it’s passive voice. But every once in a while, the dreaded passive can serve a purpose.)

And while you’re at it, be upfront about any uncertainty. It’s better to tell your readers that experts just aren’t sure than to have to pull a U-turn in your health advice later on.

The bottom line: When writing about cause and effect in health materials, keep the distinction between correlation and causation in mind.

Tweet about it: When writing about cause and effect in health materials, keep the distinction between correlation and causation in mind, says @CommunicateHlth: https://bit.ly/34xQsDK #HealthLit

Unlocking Content Strategy with Key (and Sample!) Messages

Posted on by CommunicateHealth
Alt: A doodle wearing a “key message” sign and another wearing a “sample message” sign hold hands and skip together.

This week, we want to bring your attention to a content strategy nugget that we’ve been mulling over lately. It’s a bit nerdy, but we figured our fellow content strategy fanatics out there would be interested. So let us talk, dear readers, about the lovely symbiotic relationship between key and sample messages.

First, quick refresher on key messages. A key message is a short sentence or 2 that conveys exactly what you want your audience to know. Your elevator pitch, so to speak. Every communication product (or campaign or what have you) needs at least 1 key message — otherwise, we’d all just be blathering into the void.

Here are some examples of key messages:

  • The We ❤ Health Literacy newsletter offers practical guidance for making health information easy for people to understand and use.
  • Wearing a mask whenever you’re around other people can help slow the spread of COVID-19.
  • Cat Heads Across America is uniting stakeholders nationwide to find a cure for the curse of cat-covered craniums.

So once you’ve got your key messages nailed down, your work is done, hey? Well, not so fast. Because depending on the project, it may also be helpful to develop some sample messages at this stage. That way, teammates and partners can easily jump in and use these sample messages for specific channels, activities, or audiences — and you can rest assured that your key points won’t get mangled in a game of telephone.

Here are 3 potential sample messages for the key messages above:

  • Calling health literacy advocates everywhere! Sign up for our newsletter today to get tips for creating easy-to-understand health information.
  • Help #SlowTheSpread of #COVID19 by wearing a mask every time you need to be around other people.
  • We’re committed to finding a cure for cat head by 2030. Check out our Cat Heads Across America campaign to join the conversation!

See how the key and sample messages join forces to flesh out in more detail what you’re working with? The sample messages may home in on different situations, audiences, and platforms — but they all clearly map back to the original key messages above.

Sample messages are especially useful in planning outreach campaigns. They can help stakeholders and collaborators get on the same page and understand how you’ll actually use your key messages to communicate with your audiences across channels.

The bottom line: The next time you’re developing key messages as part of your content strategy, think about inviting some sample messages to the party, too.

Tweet about it: #ContentStrategy nerds unite! @CommunicateHlth explains why key and sample messages are a match made in #HealthComm heaven: https://bit.ly/3iHatO5 #HealthLit