Category: We Heart Health Literacy

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

We’ve already talked about all things #Twitter in our social media series. But today, we’re taking a deeper dive into a powerful Twitter feature that we really ❤︎: #hashtags!

Why are hashtags so powerful, you ask? They may seem merely decorative, but they’re actually key to how Twitter curates its content. Hashtags direct users to related topics and events. And when users search a hashtag that you’ve used, they can see your content — even if they’re not following you on Twitter! (Mind: blown.)

So if you want to increase your reach and optimize your Twitter content, use hashtags! Follow these tips to up your hashtag game:

• Choose relevant hashtags. Sure, using random, popular hashtags might drive a few eyeballs to your post. But if the tag doesn’t fit, you risk disappointing people and losing potential followers. No one wants to search for #HealthLit and find, you know, unicorns.
• Aim for 2 hashtags max in a single tweet. Research shows that crowding tweets with a million hashtags means less engagement, not more. It gets tiresome quickly — #just #look #how #annoying #it #is #to #read #this. There may be times when it makes sense to use more than 2 (like if you’re participating in a Twitter chat with multiple hashtags), but 2 is a good rule of thumb to prevent hashtag fatigue.
• Search hashtags before you tweet. Search on Twitter and Google to make sure your hashtags are credible, current, and popular. Tweeting about the #flu? Check which hashtags CDC is using! And searching also helps you make sure your hashtags don’t pull up unintended stuff in the Twitterverse. (Because you really might be surprised by hashtag search results. Like, really surprised. We sure have been.)
• Capitalize each new word in a hashtag. This helps keep things #EasyToRead in hashtags with multiple words.
• Check the Twitter trending topics. If you’re looking for hashtag inspo, find out which ones are trending in your area. Just remember: only use hashtags that are relevant to your content!

Now, dear readers, take this #TwitterWisdom out into the world and do great Twitter-related things!

The bottom line: Use relevant hashtags to engage with audiences on Twitter — and get the most out of your #HealthLit tweets.

Tweet about it: Check out @CommunicateHlth’s tips for using #hashtags responsibly in #HealthLit tweets: https://bit.ly/2JFQ3WJ

Let’s say you’re creating a complex health communication product, like a website with health content for patients, doctors, and researchers. That’s quite the task! Each of those user groups might come to your site looking for different kinds of information — and it’s your job to make sure the site meets each group’s needs.

So how do you start? We’ve talked before about our love of personas to keep users’ goals top of mind. In this week’s installment of We ❤ Health Literacy, we’re adding another tool to your health literacy toolbox: user need statements.

User need statements (also called user stories) help define the big-picture problem you’re trying to solve on behalf of your users. And they’re a key part of the user-centered design process.

Follow these tips to craft a great user need statement:

• Focus on what, not how. Keep the statement focused on the problem you’re trying to solve — and don’t skip ahead to half-baked solutions.
• Be specific. Vague, amorphous user statements beget vague, amorphous products. The more specific your statement is, the better!
• Make it actionable. Point your team toward the must-solve problems with direct, actionable language.
• Ground it in user research. Whenever possible, base your user need statements on insights from focus groups or in-depth interviews.

Got it? Great! Now… what exactly do these fancy statements look like? User need statements have 3 components: user, action, and reason. They look like this: “As a [user], I want to [action], so that I can [reason].”

Ready to see some user need statements in action? Try these on for size:

• As a parent, I want to find activities my family can do together so that we can be healthier and my kids will put down their electronic devices.
• As an older patient, I want to easily find contact information for my doctors so that I can ask follow-up questions.
• As a project director at a county health department, I want to know how other communities are combatting tobacco use so that I can build a successful anti-tobacco program in my county.

The bottom line: Write user need statements to define the problem you’re trying to solve — your users will ❤ you for it!

Picture this: you’re 36 years old, you’re pregnant, and you’ve already got plenty of things to worry about. Will your future child get into a good college? Require expensive orthodontia? Fall in with a bad crowd and bring shame upon the family?

Then your doctor gestures at your midsection and refers — in a casual, chummy sort of way — to your “geriatric” pregnancy. Say what? The word “geriatric” tends to conjure nursing homes, not nursing mothers. But doctors commonly use it to describe pregnancies in women over age 35.

Even if you steer clear of “geriatric,” the other options aren’t much better. “Advanced maternal age” and even “older moms” send the same misleading and derogatory message: you’re too old to be pregnant. So, dear readers, what’s a better way to talk about age and pregnancy? Use neutral language and stick to the facts.

Instead of this:

• Advanced maternal age is tied to increased risk of gestational diabetes.
• Extra screenings are recommended for geriatric pregnancies.

Try this:

• If you’re over age 35, you’re at higher risk for gestational diabetes.
• If you’re over age 35, ask your doctor about extra screenings you may need.

Problem solved? Not so fast! The judgment fest doesn’t stop after the birth. If your baby is on the low end of the growth charts, doctors may call it “failure to thrive.” That’s right, babies can fail at growing up, just like their moms can fail at… staying young.

Terms like “failure to thrive” may be convenient catchalls for insurance-coding purposes, but they’re no help at all to anxious new parents. Instead, address the specific problem head on: “If your baby isn’t growing quickly enough, take these steps to help them gain more weight.” See? That’s one parental panic attack averted.

The bottom line: Give pregnant women and tiny babies a break — skip the judgy medical terms and use plain, neutral language.

Tweet about it: Did you hear the one about the geriatric mom-to-be and the baby who failed at life? No? Well, it wasn’t funny anyway. @CommunicateHlth talks terms to avoid when talking moms and babies: https://bit.ly/2KDPf6t #HealthLit

If you’ve done any spring cleaning lately, chances are you got some inspiration from tidying expert Marie Kondo’s KonMari method. Kondo encourages people to jettison objects that don’t “spark joy” and embrace a simpler, tidier lifestyle. This week, we’re applying Kondo’s rules to another space that may be in need of some decluttering: (y)our beloved health websites.

That’s right, dear readers, it’s time to sweep out the cobwebs and take out the trash before your website devolves into a hoarder’s paradise. Effective content maintenance doesn’t just mean updating and adding pages — it means retiring content that’s outlived its usefulness.

Here’s our spin on Kondo’s 6 basic rules of tidying, web content edition:

1. Commit yourself to tidying up your web content. Don’t let maintenance slide when shiny new projects come along. Implement a regular content maintenance schedule and stick to it.

2. Imagine your ideal website. When deciding whether to keep or kill content, it’s important to have a guiding vision in mind. Make sure you’re working toward well-defined goals for your site, and not just retiring pages willy-nilly.

3. Finish discarding problem content first. We’ve all seen it: the site that invests in flashy new homepage content every week, but clearly hasn’t done a full content inventory since the early 2000s. Remember, users could end up anywhere on your site — so prioritize weeding out content you don’t want them to see.

4. Assess content by category, not just by location. Kondo says to tidy up category by category, not room by room. And looking at content by type rather than by location on your site can help identify miscategorizations, duplications, and content areas that are turning into silos.

5. Follow the right order in your content process. It can be tempting to jump right in and start tossing troublesome pages down the trash chute of web history — but skipping steps can lead to wasted effort. Make sure you have buy-in from all your stakeholders before you start making updates.

6. Ask your users if the content sparks joy. You may squeal with happiness over your content, but does it send your users into similar fits of ecstasy? Without user research, you can’t know for sure. Investing in user research will help you make informed decisions about your content and ensure that it sparks joy for the end users — not just for the content creators.

The bottom line: Tidying up your website means figuring out what sparks joy for your users — and letting go of content that sparks… less joyful feelings.

Tweet about it: Does your web content spark joy? @CommunicateHlth shares @MarieKondo-inspired tips for tidying up your #HealthLit website: https://bit.ly/2Kvaebt