Category: We Heart Health Literacy

Today, dear readers, we’re talking about something that’s hard to talk about: losing a pregnancy. As health communicators, it’s our job to tackle tricky subjects in a way that serves the user — who, in this case, may be grieving and looking for answers. So it’s important to get these materials right.

First, let’s clear up any confusion between these related terms. In the United States, we generally use the following definitions:

• Miscarriage is loss of a pregnancy before 20 weeks
• Stillbirth is loss of a pregnancy after 20 weeks

Well, that was the easy part. Now for the hard part — communicating about a topic that people might rather avoid. There’s no sugarcoating it: losing a pregnancy can be traumatic. But you can take steps to write about it in a useful way.

Try these tips:

• Normalize it. Because these experiences are hard to talk about, they can seem rarer than they actually are. But about 1 in 100 pregnancies ends in stillbirth, and as many as 15 in every 100 known pregnancies end in miscarriage. So when you write about losing a pregnancy, consider mentioning how common it is. That way, people know they’re not alone.
• Humanize it. Patient stories can help people see a way forward from a terrible experience. When you can, include quotes, photos, or videos from people who’ve been there — that’s often the best way to connect with people who are feeling isolated.
• Publicize prevention. Prenatal care and preventive services can help prevent some miscarriages and stillbirths. But, as always in pregnancy materials, be on the lookout for misogyny masquerading as medicine — working outside the home does not cause miscarriages, etcetera.
• Emphasize that it’s not their fault. Most miscarriages happen because of genetic problems, and many stillbirths have no known cause. So be careful not to lay the blame on women. Even when people follow all the prevention guidelines, these things still happen. It’s nobody’s fault. Full stop.

And as always, when you write about a subject that people may find traumatic, tell them where they can find support.

The bottom line: Don’t shy away from discussing pregnancy loss — provide clear, compassionate information about miscarriage and stillbirth.

Tweet about it: It can be hard to write about losing a pregnancy. @CommunicateHlth has #HealthLit tips: https://bit.ly/32pvCEi

As you may have noticed, we really ❤ research here at We ❤ Health Literacy Headquarters! We do user testing to keep our audiences at the center of what we do — and children, like any other audience, have the right to be active participants in research that could affect their health.

Testing with kids can be a lot of fun, but it also comes with unique challenges. Just try doing an eye-tracking study with fidgety pre-teens! Here are some tips to keep in mind when doing research with younger users:

• Choose kid-friendly words. As always, plain language is the way to go. And don’t be afraid to follow their lead — if they call the stimulus material “the dingle,” then you can, too. (But be careful not to patronize! Youngsters, just like older adults, can tell when you’re talking down to them.)
• Keep ’em engaged. Kids fidget, space out, and get distracted. (Well, so do adults. But that’s less relevant here.) Keep things moving, and design activities that help them express their attitudes, experiences, and perspectives. Try using creative testing techniques like design the box or collaging!
• Gather data with your ears and your eyes. Depending on their age, young children may not have the words to explain what they’re thinking. So pay attention to body language and facial expressions — or designate an observer to take notes only on these things.
• Remind kids that what they’re doing is super important. User testing can be a bit of an abstract concept for children to grasp. So take a moment to remind them that the awesome work they’re doing now will help others in the future.
• Have fun. Remember to smile and be friendly — and make sure the moderator takes time to answer the icebreaker questions and build rapport. Sure, you’re at work, but younger participants may respond better if you treat it more like play!

The bottom line: Children make great research participants when you use a kid-friendly approach.

Tweet about it: We believe the children are our future… research participants. @CommunicateHlth shares tips for user testing with kids: https://bit.ly/2Vwinz1 #HealthLit

If you’re a health nerd, you’ve probably done your fair share of academic writing. Maybe you’ve even presented a scientific poster. Bravo! The scientific community needs you. Health care professionals appreciate you. But does anyone outside those fields have any idea what you’re talking about?

We get it, dear readers. Academic research requires a ton of smarts — and it’s tempting to use all that smarty-pants language when writing up the results. But as plain language advocates and health literacy lovers, we declare that the time has come to apply our trusty best practices to academic writing.

Use the tips below when you write up your next batch of brilliant findings.

Set your content up for the web. It’s a good bet that your writing will appear online, so make it web friendly.

• Break up walls of text into short chunks so they’re more approachable
• Add descriptive headers to help readers skim for the info they need
• Use a bulleted list if you’ve got a bunch of items in a sentence

Choose your words carefully. In scientific writing, you’re gonna have some science-y words. But keep in mind that your readers may not know your lingo. So use words everyone can understand.

• Skip unnecessary jargon — for example, say “participants with high blood pressure” not “subjects with hypertension”
• Use necessary jargon terms once, then swap ’em out — if you write “We researched the Supercalifragilisticexpialidocious gene (also known as the Mary Poppins gene),” stick with “Mary Poppins gene” moving forward

Trim the fat. Gone are the minimum page requirements of your college years. So forget adding unnecessary words to hit the page count — in the real world, shorter content is often best.

• Ditch phrases for single words, like “weekly” instead of “on a weekly basis”
• Keep it to one thought per sentence — punctuation is your friend!

And a bonus tip for all you poster session presenters: make a #BetterPoster by stating the main point in a big, easy-to-read font.

The bottom line: Use plain language principles in academic writing — that way, people outside your field can understand it, too.

Tweet about it: Academic writing is full of #HealthLit no-nos. Make your research findings accessible with plain language tips for academic writing from @CommunicateHlth: https://bit.ly/2lOv3E5

When we talk about someone who died by suicide, we often say that they “committed suicide” the way they might “commit” a crime. But suicide isn’t a crime — it’s a public health problem like any other.

Deaths from suicide have a lot in common with deaths from heart attacks: they’re common, often preventable, and may be caused by underlying health problems. In the case of suicide, the underlying cause is usually mental illness. And we think you’ll agree, dear readers, that having a mental illness isn’t a crime. So why do we talk about suicide like it is?

People who have suicidal thoughts — or who have attempted suicide — already face tremendous stigma. When we criminalize suicide in our word choice, we stigmatize them even more. And when people at risk for suicide feel stigmatized by health materials, they’re less likely to find, understand, and use information about lifesaving mental health treatments.

We need to make a stronger connection between suicide and mental illness so that people can access the health services they need — no shame or blame required.

Try these tips when you write about suicide in health materials:

• Skip “committed.” Try the more neutral “died by suicide” instead.
• Go ahead and address common questions about suicide. But try not to linger on language that assigns blame, like “How could someone do this to their family?”
• When you talk about suicide, make sure you also talk about mental health treatment — and direct people to services.

The bottom line: Let’s stop treating suicide like a crime — ditch “committed suicide” and use “died by suicide” instead.

Tweet about it: Let’s stop talking about suicide like it’s a crime, shall we? @CommunicateHlth has thoughts: https://bit.ly/2lLAh33 #HealthLit

Here at We ❤ Health Literacy Headquarters, we ❤ a good, clear rule or best practice. You should know, dear readers, since we often share them with you! But the thing about rules is that they always have exceptions — and today we want to talk about one of those.

We’ve told you before that writing numbers as numerals is generally the way to go in plain language materials. So what’s the exception, you ask? Ordinal numbers! (And if you need a refresher on what exactly an ordinal number is, no worries — it’s coming.)

When you use numbers in health writing, you’re often describing an amount. For example:

• 3 doctors
• 1 in 10 children
• 33 people with cat head

But when you use ordinal numbers, you’re describing the position of something. For example:

• Second leading cause of death
• Sixth round of treatment
• First person to fully recover from cat head

In those examples you’re not describing an amount, so using the numeral might be confusing to readers who are quickly scanning text — as we know folks are likely to do. That’s why, in general, we choose to spell out ordinal numbers under 11.

Certain platforms and word processing systems can also make ordinal numbers harder to read when you go with the numeral approach. Try typing “2nd” into Microsoft Word, for example. Does the “nd” automatically change to superscript? Superscript might be too small for readers to easily see. And we don’t know about you, but we find it a bit distracting.

Disclaimer: this rule (or exception, rather) is a product of our informed opinion, not user testing. But try it out — your readers just might thank you!

The bottom line: Part of clear communication is making text easy to look at, so take it easy on your readers’ eyes and spell out ordinal numbers under 11.

Tweet about it: Spelling out ordinal numbers can make ’em easier on the eyes, says @CommunicateHlth: https://bit.ly/2ZzuY4T #HealthLit

If you’re a fan of The Office, you’re familiar with Michael Scott’s antics as regional manager at Dunder Mifflin Paper Company. Whether he’s grilling his own foot while cooking bacon in bed or running down a coworker in the parking lot, Michael’s always good for a laugh. But what if a lesson from Michael Scott could improve your health writing?

Stick with us, dear readers, and picture this scene:

It’s Michael’s birthday, and he’s so excited to celebrate at work. But no one at the office is feeling festive because Kevin, the accountant, is waiting for his skin cancer screening results. Then, great news! Kevin’s test came back negative. Everyone cheers! Except for Michael, who thinks Kevin just received a death sentence.

Eventually, Michael figures it out: “Apparently, in the medicine community, negative means good, which makes absolutely no sense. In the real-world community, that would be… chaos.”

Michael, you are so right! (Never thought you’d hear that, did you?) Let’s save the whole “positive” and “negative” approach for things that are actually — wait for it — positive or negative. In the real world, positive means good. But when a test comes back “positive” for a disease, most folks aren’t exactly jumping for joy. Here at We ❤ Health Literacy Headquarters, we call that a recipe for unnecessary confusion.

Fortunately, there’s a simple alternative: just be specific when writing (or talking) about test results! Instead of:

• “If your test comes back positive, your doctor will talk with you about treatment options.”
• “Your test came back negative.”

Write:

• “If the test shows that you have [whatever thing you have], your doctor will talk with you about treatment options.”
• “The test results show that you don’t have [whatever thing you don’t have].”

So take a tip from The Office and avoid the chaos. Michael Scott — and the rest of the real-world community — will thank you.

The bottom line: When writing about test results, skip the topsy-turvy “positives” and “negatives” — just tell people what they really need to know.

Tweet about it: Michael Scott’s got a tip for #HealthLit writers everywhere! @CommunicateHlth explains: https://bit.ly/2HkKfQO

Here at We ❤ Health Literacy Headquarters, we’re all about the tools that empower people to take control of their health. Today, we want to chat about why these tools are especially important for older adults.

As a group, this crowd has some complicated health care needs: they have more chronic illnesses than any other age group, which means they need a lot of health care. And unfortunately, they’re more likely than any other age group to have low health literacy. According to the National Assessment of Adult Literacy, only 3 percent of older adults have proficient health literacy skills.

Plus, unlike wine and cheese, vision and hearing generally don’t improve with age — and vision and hearing loss can make it harder to find and understand information. In a nutshell, older adults need more health care and they’re likely to have a harder time accessing it.

And that means our job as health communicators becomes extra important. Of course all the regular suspects apply — write in plain language, provide a clear main message… you know all the things, dear readers. But keep these specific tips in mind when writing for older audiences, too.

• Make your content extra easy to see and read. Choose fonts with good contrast, consider using a larger font size, and increase leading.
• Prioritize images. Visuals are great for helping people remember things, so make sure to use plenty of relevant images to support your main message and hold folks’ attention.
• Think about print. Older adults are less likely to have internet access, and they may be less comfortable reading online. So try getting your message out the old-fashioned way, too. And if you’re writing online health content, make sure it’s print friendly!
• Use teach-back and show-me. When communicating in person, check for understanding by asking older patients to explain or demonstrate the thing you’re trying to communicate.
• Skip the elderspeak. We had to write a whole post on how not to talk to older folks. So yeah, just don’t do that.

The bottom line: Older adults need (and deserve!) information about health and health care that’s clear, accessible, and respectful.

Tweet about it: This week from @CommunicateHlth: #HealthLit tips for communicating with #OlderAdults: https://bit.ly/2Z80zue

Have you ever met someone and just clicked with them right away? Don’t you love that feeling of instant understanding and connection?

Well today, dear readers, we’re talking about a different kind of first impression — the first impression your health content makes on your users. If you go to a new health website and you’re greeted by gobs of confusing information and TEXT IN ALL CAPS, it doesn’t make for a great first impression.

But an especially nasty type of bad first impression in health communication is due to a lack of cultural competence. We’ll sum that term up like this: cultural competence is the ability to meet patients’ social, cultural, and language needs.

So what does a cultural competence fail look like? Imagine a non-binary person going to a new doctor and filling out an intake form with only 2 checkboxes: “female” and “male.” Not only could that make them feel invisible, it might cause them to doubt the quality of care they’ll get — and rightly so. So how could the doctor’s office make a better first impression? Easy! By making the intake form inclusive and welcoming for everyone.

First impressions aren’t just about words — design matters, too. Picture this: a black woman searches online for information about breastfeeding. On the first site she visits, all the images show white parents and babies. She may wonder if the information is really for her, and she’ll likely move on to a site that makes her feel represented and included.

So don’t get off on the wrong foot with users! You can start learning about cultural competence at HRSA’s Culture, Language, and Health Literacy site. But you can’t just read about cultural competence and be done with it — it’s a continuous process of checking in with your audience (and yourself) to make sure you’re not making harmful assumptions or missing important cultural context.

When you’re assessing your materials for cultural competence, ask yourself questions like:

• Who am I trying to reach?
• What do I know about my audience’s culture, language, and beliefs?
• How can I get feedback from my audience to make sure I’m on track?

Improving cultural competence can go a long way toward creating health content that makes a great first impression — and starts a healthy, lasting relationship with your audience.

(Also, if you’re looking for a beach read, the We ❤ Health Literacy Book Club really enjoyed Anne Fadiman’s The Spirit Catches You and You Fall Down. It touches on some of this good stuff — check it out!)

The bottom line: Brush up on cultural competence to make a better first impression in your health materials.

Tweet about it: You know what they say: first impressions count! @CommunicateHlth shares how #CulturalCompetence gets your #HealthLit content off on the right foot: https://bit.ly/2TeGvVA

Chances are you’ve heard of the “war on cancer.” Maybe you’ve written about someone who “beat” their disease — or “lost the battle.” Doctors, patients, and health writers use militaristic language all the time. But today, dear readers, we’re calling for a ceasefire in health materials.

Why? Because the connotations of these words can affect the health decisions people make and the way they feel about their health. Say someone dies of cancer and you write that they “lost their fight.” Could that imply that they didn’t try hard enough? That dying of cancer was somehow their fault? Ugh.

Research has shown that patients who use negative metaphors like “enemy” to describe their disease are more likely to feel depressed and anxious. And militaristic language doesn’t just affect current patients. Studies show that framing cancer prevention as a fight against an enemy can make people less likely to take steps to reduce their risk of cancer.

As health communicators, it’s our job to think about these things. And there are plenty of ways to write about serious diseases without firing off fightin’ words.

Follow these tips to (mostly) avoid militaristic language in health content:

• Be direct. It’s okay — good even — to just write about “having cancer” (or whatever you’re writing about). These words are simple, accurate, and easy to understand. No need for “fighting,” “battling,” or “waging war.” People have cancer. Period.
• Consider other metaphors. Metaphors can be super useful when communicating about health — they can help people understand complicated topics and make emotional connections. So try other options on for size! For example, you could frame a disease as a journey that patients experience or a puzzle that researchers are trying to solve. You’ll get the point across without the war words.
• Take your cue from your audience. You may not need to eliminate militaristic language from your health writing lock, stock, and barrel (see what we did there?). Some people with cancer or other diseases may find militaristic words motivating and empowering. If that’s the case, then great! Let’s just call this reason 348,578,756D to test your health materials with your target audience.

The bottom line: As a rule, leave the war words to the war correspondents — and out of your health content.

Tweet about it: Don’t surrender to the urge to use militaristic language in #HealthLit content. @CommunicateHlth explains why to avoid words like “battle,” “war,” and “fight”: https://bit.ly/2JUE9sd