Alt: A doodle with baby doodle in tow pinches the cheeks of an older adult doodle, saying “Who’s my faaaaaaavouwit peppep?” — and a bunch of other baby talk babble.
Here at We ❤ Health Literacy Headquarters, we value health communication that shows respect for the audience — that goes for written materials and face-to-face conversations. So today, we’re offering tips to help you avoid a communication style that’s the opposite of respectful: elderspeak.
Elderspeak is an all-too-common, patronizing way of speaking to older adults. It uses:
Pet names, like “honey” and “sweetie”
“We” in place of “you”
Loud, slow speech with a high pitch
Imagine you’re at the doctor’s office and your doctor says to you, “Okay now, hun, we’re going to take this medicine twice a day, once when we wake up and once at beddy-bye. And don’t forget we need to drink water with it — right, sweetie?”
Now imagine your doctor says this instead: “Okay, Phyllis. You need to take this medicine 2 times every day with water — once in the morning and once at night. If you have any questions, feel free to give me a call.”
We don’t know about you, dear readers, but that second scenario would get a much better response out of us. An adult patient is far more likely to follow advice from a nurse, doctor, or other caregiver who treats them like, well, an adult.
So why all the baby talk? Some caregivers may think elderspeak makes it easier for older adults to understand complicated health information — especially patients who have cognitive disabilities, like dementia or aphasia. But there’s research about nursing home care that suggests otherwise — some studies link the use of elderspeak to resistance to care in older adults with dementia.
So, skip the elderspeak! And use these tips when speaking to older adults:
Treat older adults like…adults.Newsflash! (Hardly.) Just because someone is older doesn’t mean they want to be treated like a tiny baby.
Use the same tone of voice you would use with any adult. If you’re using the same voice with aging humans that you use with cute little puppies, you’re doing it wrong.
Check for understanding.Rather than assuming patients don’t get it, do a “teach back” to make sure you’re on the same page.
Match your communication style to the individual, not their age range. Diseases like Alzheimer’s may require special approaches to communication. But not every older adult has cognitive problems, and elderspeak is never the solution.
The bottom line: Skip the elderspeak to show respect — and improve health communication with older adults.
Alt: Several doodles with cat head, phones in hand, stand below text reading: “Most participants said they liked the new cat head management app’s interface.” One remarks, “That’s some smoooooth UX!” Another says, “Wow, this is hecka intuitive!” A final doodle with an angry looking cat laments, “Whyyy did I updaaaate?!”
We’ve written in the past about banishing some words (POBAs, to be specific) from your research reports. Today, we’re continuing the theme of word choice in research writing. Have you ever noticed how qualitative research reports use words that represent quantities — like many, some, several, few — and wondered why the writer didn’t just use a number instead?
Well, dear readers, that’s because the findings of qualitative research are just that — qualitative, not quantitative. Remember, this type of research looks at things like people’s beliefs, behaviors, and experiences. That’s pretty tricky to represent in numbers!
Let’s look at an example. Say you did a study with 8 participants, and you found that half of them understand how to enroll in Medicare. People reading that result may well assume that 50% of the millions of people eligible to enroll in Medicare already understand how to do so — which is definitely not what you’re saying! The numbers in a study like this aren’t representative of the larger population, which is why it’s not a good idea to report them.
Now this isn’t to say numbers are left out of the qualitative research party altogether. They can be super helpful behind the scenes during the analysis process — we can use them to help interpret the meaning of descriptive data, like what participants said or did during a study. But when it comes to reporting qualitative research, numbers generally don’t cut it.
So is it ever appropriate to report numbers in qualitative research reports? Occasionally! For example, you might use numbers to:
Emphasize an important outlier viewpoint (“At least 1 participant said they didn’t understand the main message”)
Describe the demographics of your study sample (“5 out of 8 participants were female”)
Report the number of participants who completed a task during usability testing (“4 participants failed to complete the second task”)
The bottom line: When reporting on qualitative research, use numbers sparingly — and only when they add nuance to your findings.
Alt: A designer doodle speaks to a small crowd of overwhelmed doodles. He says, “…So as you can see, I chose a pristinely kerned font family with perfect x-height and expertly applied, staggeringly precise leading and tracking — then meticulously hand-curated artisanal imagery to create an aesthetically pleasing experience for all users with nary a widow or orphan in sight…”
Ever had that moment when you’re talking about a product with a designer and you feel like you’re speaking a different language? Well, that may be because you sort of are! But never fear — we’re here to help you find your way out of design lingo (or limbo).
We ❤ working with designers to create beautiful health literate products here at We ❤ Health Literacy Headquarters. Recently, we talked about how to give designers helpful feedback. Today, we’re digging into some design-related terms that you’re likely to run into if you work with designers on the reg.
There’s a lot of design jargon out there, so we’ll start by breaking down a few of the most common terms related to typography.
Font families are collections of related fonts within a single typeface that have a variety of styles and weights. For example, Cooper Hewitt is the name of a typeface, and its font family includes Cooper Hewitt Thin, Light, Book (sometimes Roman or Regular), Medium, Semibold, Bold, Heavy, and Italic. And keep in mind that these days, the term “font” refers to the actual file that contains the typeface, not necessarily the typeface itself — interesting, right?
Leading (say “ledding,” not “leeding”) is the space between lines of text. You may also hear people refer to it as “line height.” When leading is tight, your content gets hard to read because it looks cramped. But content with too much line spacing can be problematic, too, because readers may get lost. So try to strike a good balance. Standard leading is 120% of the text size, but it’s okay to go beyond that if you think your content needs a bit more room to breathe.
Tracking refers to word spacing, and kerning refers to the space between individual letters. You may hear these terms when a design team is working on something like a logo because they’ll want lots of control over the typeface. Adjusting spacing can drastically change the overall appearance of the text and really help sell the aesthetic of a piece. That said, any typeface worth its salt will have the tracking and kerning adjusted to complement its aesthetic, so it’s generally A-OK to use the typeface in its natural state.
Widows and orphans (no, not those widows and orphans) are single words that end up as the only text at the beginning or end of a column or page. Designers try to avoid these stragglers since they leave too much white space and can interfere with reading flow between pages. Luckily, they’re pretty easy to get rid of by realigning the page margins or making very minor content tweaks.
There you have it, dear readers! Understanding these terms can help you collaborate with your design team and create super awesome health communication products.
The bottom line: Wrapping your head around some typography-related design jargon can prove quite useful when collaborating with designers.
Alt: A phone screen shows a video of a doodle sharing a news story with their audience. The caption says, “Peep this new health guideline!”
Here at We ❤ Health Literacy Headquarters, we’re always looking for engaging ways to share health information on social media. And one of the best ways we’ve found to connect with people is through videos.
Want to explain a complicated thing like, you know, health stuff? Put it in a video! If you haven’t heard, video content is the best-performing type of content across all social media platforms. That means it’s the most viewed and most shared type of content on Facebook, Instagram, Twitter, and — more predictably — Snapchat and YouTube.
We’ve shared tips for creating videos for health information in the past. But what if your budget doesn’t include creating videos the old-fashioned way? Well today, dear readers, we’re chatting about a couple features that allow you to add video content to Facebook and Instagram — for free!
Tell your users a story
Both Facebook and Instagram now have video features called Stories — and people just ❤ them. With Stories, you can post short videos (15 seconds on Instagram, 20 seconds on Facebook) that disappear after 24 hours. Stories are great for sharing timely content and connecting directly with users. Oh, and both platforms let you play around with stickers and music to jazz up your Stories and increase reach.
So, new key health guideline just released? Let people know your 2 cents in a story!
Pro tip: Facebook Stories lets you put these videos on event and group pages, which means you can get your content in front of niche groups of Facebook users.
Go live
Facebook Live and Instagram Live both let you livestream content and interact with users in real time for a longer period of time (up to an hour on Instagram, up to 1.5 hours on Facebook). Both platforms notify your followers when you’re live and let them like and comment as they watch.
Facilitating a Q&A with experts on a health topic and want your users to tune in and participate? Live is your best bet for real-time engagement with users.
Pro tip: Facebook lets you save Live videos on your page so you can use them again (and again and again…).
The bottom line: Use cost-effective social features to make videos and increase engagement on social media.
Alt: A doodle presents another doodle with a box of chocolates, saying, “I love you with my WHOLE cardiovascular system.” This text is accompanied by the disclaimer, “NOT how people talk.”
This week, we’d like to have a heart-to-heart about… hearts. That’s right — we’re returning to our “use simpler words” series to have a little chat about “cardiovascular.”
Why? Because, dear readers, this 6-syllable (!) word is medical jargon — and most of the time, there’s a better alternative.
If you’re talking about cardiovascular health, you’re talking about heart health. And if you’re talking about a specific type of cardiovascular problem, well, there’s a specific name for it — like “heart attack” or “stroke.”
So instead of:
Getting 150 minutes of physical activity each week promotes cardiovascular health.
Smoking puts you at risk for cardiovascular problems.
Write:
Getting 150 minutes of physical activity each week helps keep your heart healthy.
Smoking puts you at risk for having a heart attack or a stroke.
That said, there are situations where it’s helpful to use and define the more complex term — like if you’re writing content for people who’ve just been diagnosed with cardiovascular disease. They’re sure to hear it again and again.
But even then, take a moment to make sure you’re using the best term. Sometimes, you may want to get even more specific for your audience and say something like “coronary artery disease.” If so, be sure to include a clear, plain language definition — for example, “Coronary artery disease happens when a fatty material called plaque builds up in the arteries (tubes) that carry blood to your heart.”
The bottom line: For most audiences, skip “cardiovascular.” Say “heart” instead — or get more specific.
The main message of any communication material is the one thing you most want your readers to remember. So how do you keep them from whizzing right by that important information? Here at We ❤️ Health Literacy Headquarters, we’ve got a few tricks up our sleeves that we use to emphasize a main message. And today, dear readers, we’re sharing them with you.
Put it first. Never make people hunt for the main event! Instead, structure your content so the main message comes first. Many people only read the first few words or sentences before deciding if they’re going to keep going. So help your readers get the most important information even if they don’t read all of your content. And by telling people the main point right away, you may even get them to keep reading.
Use visual cues to draw readers to it. You can help emphasize the main message with things like bold text, a larger font, or a call-out box. These visual cues say, “Hey! Look over here! This is important!” Just make sure that any images you use are accessible to all your readers — for example, by using alt text.
Use visuals that support it. This sounds similar to the second tip, but it’s actually not the same. A visual that supports the main message helps drive the message home — as opposed to simply calling attention to it. This could be something like a photo of someone doing a recommended behavior or an infographic that communicates why the main message is so important.
Let’s play out these tips with a quick example. Imagine you’re writing a fact sheet about breast cancer screening.
You put your main message — “If you’re age 50 to 74, get screened for breast cancer every 2 years” — at the very top of the material, emphasized with bold text and placed in a shaded box. Then you add an image of a person in that age range getting ready to have a mammogram. The photo complements the emphasized main message, and you’re winning at the main message game.
The bottom line: Emphasize your main message by putting it first, using visual cues to draw readers to it, and supporting it with images.
Alt: Below the words “10 years,” a doodle party for CommunicateHealth’s birthday is in full swing. The CommunicateHealth principals are there, celebrating with a large group of doodle characters.
Put on your party hats and grab some cake, dear readers — it’s CommunicateHealth’s 10th birthday! We’ve officially been in the business of health literacy and clear communication for a full decade, and we couldn’t be more excited.
You know we love a good statistic here at We ❤ Health Literacy Headquarters, so here’s an interesting one. According to the Bureau of Labor Statistics, only 3 in 10 businesses make it to their 10th birthday. We’re so proud to be one of them, and we can’t wait to see what the next decade brings. Of course, we’d be nothing without our fans and supporters — that’s you! Your devotion to our shared cause truly inspires us every day.
We ❤ Health Literacy is our very favorite way to keep in touch with plain language enthusiasts like you — so if you want to hear our thoughts on a certain topic, just let us know! It’s all we want for our birthday. Well, and for you to encourage your fellow health literacy geeks to sign up. Oh, and… just kidding. We wouldn’t want to get greedy.
The bottom line: On our 10th birthday, we send huge thanks to our supporters — we couldn’t champion health literacy without you.
Alt: Doug Doodleman, eating a sandwich, sits behind a talk show host desk that says “HL Live!” Leslie O’Flahavan is in the hot seat, waving.
We’re back with a new installment of “Health Lit Live,” where our illustrated host Doug Doodleman interviews movers and shakers on the health literacy scene. This week, Doug chats with Leslie O’Flahavan about her “bite, snack, meal” approach to writing for the web. Leslie is a writer, writing teacher, plain language advocate, and owner of E-WRITE.
Doug: Hello, readers! Welcome back to me, and welcome to my guest, whose name I have here somewhere… Aha! Why, it’s the creator of a tasty little concept we in the biz call “bite, snack, meal” — a certain Leslie O’Flavor-han.
O’Flahavan: Hello, Doug. Lovely to be here.
Doug: Now, Leslie, these snacks and these bites. Tell me, just what kind of celebrity gloop cleanse are you selling? Will it purge my toxins? Tidy up my colon?
O’Flahavan: Actually, Doug, “bite, snack, meal” is a metaphor I developed in 1996 to explain an approach to web writing. It describes a user-centered thinking process in which we acknowledge that different readers are interested in different amounts of information. So we need to do them the service of offering them content in various sizes.
Doug: No diet tips, then?
O’Flahavan: Sorry, but no. The metaphor of content hunger is saying, “I understand you, readers. You’re not all the same, and each of you is not the same every time you engage with the content. So I’m going to alter the way I write my content to meet your needs in all their variety.”
Doug: Ah, I see! Tricky, tricky. So you start off with your tease-y bites, when all the while you’re laying a delicious trap — whetting the appetite, if you will. And before they know it, readers have gobbled up the bite, the snack, and the whole darn meal. Ingenious!
O’Flahavan: That would be cunning of me, Doug. But the point here isn’t to trick the reader. You want to let readers choose. If they’re full after reading the snack and they skip the meal, it’s all good. Or maybe they read the bite and the snack one day, and come back for the meal another day.
Doug: I don’t want to brag, Leslie, but I’ve been told my meals are phenomenal. Life altering. Not to be missed. How do I get my readers to linger at the table over digestifs and a cheese course? Do I torture them with tiny amuse-bouches of content? Save the real conversation for dessert?
O’Flahavan: Withholding the main message is never the right approach. Take a common type of content like Terms and Conditions — that’s a case where the content provider withholds the content until you read and agree to something. And we click “accept” without even reading said terms and conditions! Withholding content is a mean thing to do to your reader — and it doesn’t even work.
Doug: So, let me clarify: You expect me to cook up a beautiful 3-course content menu, and then let the reader gobble up the apps and ditch the entrée? Where’s your sense of leisurely, sophisticated dining? Haven’t you been to France?
O’Flahavan: I can see you’re a doodle of refined sensibilities, Doug. But the idea that we can make people read the whole thing if they don’t want to is just wrong. We can’t. What we can do is engage them so that they read as much as they need. So we entice — with the bite and the snack.
Doug: Saucy! I like it. But seems to me you could say all that without the fancy metaphors. Why’d you start using all the food words? Were you very hungry?
O’Flahavan: I teach writing to people from many different fields. Engineers, actuaries, communication professionals — and they all approach writing differently. When you’ve got them all in one room trying to learn, the metaphor helps everyone connect. And “bite, snack, meal” sticks. People understand it right away, it’s memorable, and it provokes behavior change in writers. And, sure, I was probably a little hungry.
Doug: Engineers? Actuaries? What’s the point of teaching numbers people how to write?
O’Flahavan: People in every field deserve support when their work calls upon them to grow as writers. Writing for online readers can be hard!
Doug: I don’t know, Leslie… web writing seems pretty simple to me. A little clickbait here, a couple hyperlinks there…
O’Flahavan: Well, when I started teaching in the ’90s, the web was a lot of “Click here” and then you’d get a 99-page PDF. I thought, we need to explain that there’s a better way.
Doug: The ’90s, you say? What with kids these days and all the hip new websites, aren’t these snackeroos a little past the sell-by date? [Exaggerated wink.]
O’Flahavan: Actually, “bite, snack, meal” is very relevant today because of the changes around responsive design. Sites present content in tiles that can shrink down to mobile sizing — and the bite and snack are great content units for small screens.
Doug: Personally, when I surf the World Wide Web on my cellular phone, I’m on the hunt for one thing: cat videos. But only when they walk upright like people. How does “bite, snack, meal” apply to cool stuff like cat memes?
O’Flahavan: Well, since the snack is likely to be visual content now, the bite has to carry the weight — er, the message. We can’t have a bite that says “Webinar recording 2019” (or just, you know, “Cats”) and make people watch a 45-minute video to figure out the main message. The “bite, snack, meal” concept stands the test of time because people’s needs haven’t changed, even though we’re presenting content differently.
Doug: What was that? Sorry. I was watching a video montage of cats wearing pants. But thanks for talking with us, Leslie! And readers, head over to E-WRITE and check out the article that started it all: The Bite, The Snack, And The Meal.
The bottom line: Use the “bite, snack, meal” approach to help readers find the serving size of information that’s right for them.
Alt: A designer doodle gazes with delight at a computer screen, and wonders aloud, “Is this what pure joy feels like?” A small crowd of non-designer doodles in the background are giving feedback on the design: “Rad!” says one. “I really, really like this image!” says another.
We’ve talked from time to time about how important good design is for creating effective health materials. And, as it turns out, giving and receiving feedback is a crucial part of the design process. But discussing a design can be tricky if you’re not a designer yourself.
That’s why this week, we’re bringing you tips for giving helpful and effective feedback to your more visually inclined colleagues.
Give feedback early and often. By weighing in early in the design process, you help the designer know they’re heading in the right direction. In other words, don’t wait until most of the work is done to announce that you want to prettify your health content with icons instead of photographs.
Keep it positive. Designers spend a lot of valuable time thinking through tons of different options before sharing the first draft of a new design. Keep that in mind and lead with positive comments — this tells the designer you understand how much time and effort goes into creating an original design.
Identify the why. Resist the urge to simply state a solution (like, “Make the title font larger”). Designers also need to hear why you think a change is important. And when you explain your rationale, you give the designer an opportunity to apply your feedback to other aspects of the design, too.
Get specific. It turns out that designers aren’t so fond of quips like “It doesn’t look right,” or “I’m not feeling these colors.” Before you make comments like those, think about which specific things aren’t working — for example, would you like the colors to look more vibrant or more subdued? This type of feedback will help the designer figure out where to go next.
Ask questions. It’s okay if you don’t have a solution in mind — that’s why you’re working with a designer! Asking thoughtful questions can help create space for a new approach if it’s needed.
In the end, if language fails and you just can’t get to the root of what you want, try sharing visual examples that show what you mean. (You can even take a crack at sketching something yourself!) Or get a second opinion from a colleague. Remember, effective feedback pushes work forward. It’s always better for the project — and the project team — to hear and consider different perspectives.
The bottom line:Keeping design feedback positive and specific means a happier team and a better finished product.
Alt: A small crowd of doodle nurses cheer on their doodle patient. One shouts, “You rock!” In the background, a doctor doodle is yelling, “You can do it!”
In one study of doctor-patient interactions, half the participants could remember a time when a visit to the doctor made them feel ashamed. Obviously, shame and guilt are feelings that we generally try to avoid. So if your experience with your doctor makes you feel ashamed about a health problem or a not-so-healthy habit you’ve picked up, how motivated will you be to keep going to that doctor for help?
Whether a condition or risk factor is minor or life-threatening, anything involving our bodies is inherently personal. And even things that may be easy for some people to do (John really didn’t have a problem ditching his soda habit for seltzer!) can be really difficult for others (Moira got so stressed trying to give up soda that she doubled her intake!).
That’s why it’s best to motivate your readers to make a positive change by showing them that it’s possible, not by rehashing ad nauseam all the reasons why what they’re doing is bad. (Spoiler alert, lots of people already know.)
We’ve shared advice on making your health messages positive and writing about sensitive topics before. Here are some of our favorite tips for positive and encouraging health writing:
Acknowledge your readers’ emotions. Fear and shame can keep people from making healthy choices, but you can help your readers by acknowledging how they feel.
Consider the differences between these 2 statements:
“If you don’t start getting more physical activity, you’re going to keep having [insert various health problems here].”
“Lots of people have trouble finding time to get physical activity. Try taking a short walk every day after dinner — even 5 minutes of activity can boost your mood and energy!”
Enough said, right?
The bottom line: Positivity and empowerment are more motivating than shame and guilt when it comes to encouraging healthy change.
