Category: We Heart Health Literacy

Here at We ❤ Health Literacy Headquarters, we love to keep sentences and paragraphs short and sweet. But what happens when you really need a lot of words to communicate something clearly?

Our advice: if it’s a choice between brevity and clarity, choose clarity every time. Health information can be complicated! And sometimes you just need more words to tell your readers what they need to know.

Let’s look at a couple of examples. Which of these options works best?

• Your out-of-pocket maximum is the most you have to pay for covered health care services in a plan year.
• Your out-of-pocket maximum is the most you have to pay for covered health care services in a plan year. After you spend this amount on deductibles, copayments, and coinsurance for in-network care and services, your health plan pays 100% of the costs of covered benefits.

In this case, longer is definitely better, right? The second sentence (courtesy of HealthCare.gov) gives helpful context for a tricky health insurance-related term.

In general, it’s best to fight the urge to use a more jargony phrase just to lower your word count. Here’s another example:

• You may have swelling at the injection site.
• You may have swelling where you got the shot — usually on your upper arm.

Again, more words — but way clearer.

So remember, dear readers, a higher word count isn’t always the enemy. And you can still look for opportunities to break up longer sentences and “chunk” your content into bulleted lists or short paragraphs.

The bottom line: Sometimes, writing in plain language means using more words — and that’s okay!

Tweet about it: .@CommunicateHlth explains that sometimes clear communication means more words — and it’s okay! https://bit.ly/2KES4zJ #HealthLit

Picture this: a young surgeon dissects a cadaver in the basement of a teaching hospital. With his bare hands, he rummages around in decomposing organs, palpates the heart, and examines the brain. Then he wipes his hands on his bloody apron, walks upstairs to the maternity ward, and with those same hands… delivers a baby. Dun dun duuun!

That’s just one of many gruesome scenes in Lindsey Fitzharris’s book, The Butchering Art. Fitzharris shows us surgery in the bad old days before germ theory and antiseptics, tracing the path of medical progress through the central figure of Joseph Lister. That’s right — the man who inspired Listerine!

As Lister searches for a way to prevent post-operative infections, Fitzharris treats us to plenty of shocking historical details — including a surgeon who amputated a leg so fast he also lopped off a testicle. But what really stands out in this tale is the importance of 2 basic rules of public health:

• Use evidence-based practices
• Share information with partners

The case of Ignaz Semmelweis is a great example. Fitzharris explains that this doctor figured out how to prevent puerperal (or childbed) fever a full 20 years before Lister announced his antiseptic system. Semmelweis guessed that surgeons were transferring “cadaverous particles” from corpses to laboring mothers, so he set up a handwashing station. And boom! No more childbed fever.

But did Semmelweis become a public health hero? Was childbed fever a thing of the past? Sadly, dear readers, that’s a big nope. No one believed him, and he died in a mental institution “raging about childbed fever and the doctors who refused to wash their hands.”

Lister faced much the same resistance from the medical community when he introduced his antiseptic system, and way too many people died of preventable infections before the health care system got its act together.

The good news is, we can learn from this gory history lesson. Next time the evidence supports a new way of doing things (like, say, using plain language in your health communications), work with partners to create policies that fit the facts. It’s much more productive than putting progressive thinkers in an asylum.

The bottom line: Read The Butchering Art to learn how antiseptics made surgery a lot less disgusting.

Tweet about it: How did public health pioneers help surgery clean up its act? @CommunicateHlth reads “The Butchering Art” by @DrLindseyFitz: https://bit.ly/2LmsjsW

We’re always on the lookout for health literacy in the news. So earlier this month, we were psyched to see a joint statement on the term “chestfeeding” by La Leche League’s USA and Canada chapters. We got even more excited when we saw that they’re using tried-and-true health communication strategies to back it up.

“Chestfeeding” is a term that many transgender men and gender non-binary parents use to describe feeding their children with their bodies. It’s another word for the action more commonly known as “breastfeeding” or “nursing.”

As La Leche League explains, they’re not replacing the term “breastfeeding” with “chestfeeding.” Rather, they’re encouraging their volunteer leaders to tailor language to match the terms that parents themselves prefer to use. That’s right, they’re using the language their audience uses — and you know how much we ❤ that.

Gendered language can contribute to health disparities by making it harder for transgender and gender non-binary people to seek — and receive — quality care. We’ve previously written about other ways that health communicators can be welcoming and inclusive of transgender and gender non-binary audiences, like:

• Using the singular “they”
• Asking about gender the right way (or better yet, not asking at all!)
• Avoiding overly gendered design elements

We’re glad to see La Leche League recognizing the impact that language can have and taking steps to support transgender parents.

The bottom line: Kudos to La Leche League for putting parents first by adding “chestfeeding” to their vocabulary!

Tweet about it: Glad to see @LaLecheLeagueUS and @LLLCanada’s statement on #chestfeeding — #HealthLit principles and transgender inclusivity in action! https://bit.ly/2Lk08Kl via @CommunicateHlth

How are you reading this right post now, dear reader? On a laptop? A smartphone? Your refrigerator, perhaps? Okay, probably not on your refrigerator, but you never know. Much in the way we can’t predict a person’s health literacy skills, it’s pretty much impossible to predict the device that users will be accessing health websites on these days.

Fortunately, there are things you can do to make sure your website will work well for all users on all their devices. Check out our tips.

• Test your site on a variety of devices. It seems like everything has a screen now (see above-referenced refrigerator) — and that means a lot of different screen sizes. Checking your site on a variety of screens can help troubleshoot problems before you get too far into site development.
• Content is king (and queen!). Remember that your content is the most important part of your site. So when you’re looking at your site on various screen sizes, pay special attention to how the content looks. Does anything important disappear on a small screen? Prioritize fixing that before fine-tuning the fancier design elements.
• Keep connection speed in mind. Internet speeds can vary a lot, so be sure to test your site with slower-than-ideal connection speeds. You don’t want someone to get frustrated and leave your site because the homepage is taking too long to load.
• Design for easy clicking. When designing buttons and links, remember that people might be clicking with lots of things — trackpads, mice (mouses?), tiny fingers, or giant thumbs. Will your elegant-yet-miniscule buttons be easy to tap on mobile screens? Probably not — so shoot for large, clearly-defined targets.

The bottom line: Design your website so people can read your content on a smart toaster in a remote mountain town. (We may get there sooner than you think.)

Tweet about it: 4 tips for making your #HealthLit site work for all devices: https://bit.ly/2uex3qc via @CommunicateHlth

True or false? As health communicators, it’s our job to clearly communicate what we know. Okay, that was a trick question. It’s true, of course — but it’s not the whole story. Why? Because it’s also our responsibility to clearly communicate what we don’t know.

In health communication, it can be tempting to steer clear of the unknown. When you want to be seen as an expert, putting what you don’t know in writing can feel a little “off script.” Public health authorities and organizations may worry that admitting what they don’t know will make them seem non-credible or untrustworthy.

But guess what? It’s actually the opposite! Being transparent and telling your audience what you don’t know can build trust in your health messages.

Say you’re writing a fact sheet with findings from a local environmental health assessment. Your audience is a community that’s located near a former factory, and residents have voiced specific health concerns that the assessment aimed to address.

In terms of results, you have a list of things you know for sure — for example, the water’s safe to drink. But the assessment also produced results that aren’t so clear — for example, it’s possible that the soil isn’t safe for growing food, and you need more tests to know for sure.

So, what do you say about those fuzzy findings? Just be direct: “We don’t have enough information to say for sure if the soil near the factory site is safe for growing vegetables. The health department wants to do more tests to find out.”

This kind of openness might seem radical — but in the absence of clear answers, full transparency is the way to go. So fight the urge to be vague or dodgy! Your audience will thank you for telling them the truth.

The bottom line: Transparency builds trust with readers — so embrace the unknown in your health writing.

Tweet about it: How do you talk about what you don’t know in #HealthLit content? Here’s @CommunicateHlth’s take: bit.ly/2Ms20O3

Today, dear readers, we’re talking about links in web content. Links make it easy for people to find more information about a topic of interest — and they can really impact how users navigate your website.

Here are our tips for creating effective links for your awesome plain language health content.

Make links easy to identify. Underlined blue text is the most obvious visual cue for a link. It’s okay to choose a different link design, but make sure it’s distinct from non-linked text — and use a single link design across your site. Don’t forget to choose a different color for visited links — that way, users can easily tell if they’ve already clicked a certain link.

Write helpful link text. The best link text gives users information about where the link will take them. That’s why we’ll ❤ you forever if you banish generic phrases like “click here” from your webcabulary — they tell users nothing about where a link goes.

Helpful link text is especially critical for users who are visually impaired and use screen readers to listen to a list of all linked phrases on a page. Can you imagine how (not) helpful such a list would be if every link said “click here” or “learn more”?

Pro tip: the best link text is both descriptive and actionable. What makes the user experience clearer than link text like, “Read more about diabetes”?

Use links strategically — and beware of link burnout. There’s no magic number for how many links are appropriate on a webpage, but be strategic and keep your users in mind. Try not to have so many links that the content starts to look wonky or difficult to follow.

Also, be mindful of how soon you send users to another page — while they’re reading the introduction of your content probably isn’t the best time for that.

Remember your friends on mobile (which is everyone). It’s always worth taking a look at how content will appear on mobile devices — this gives you a chance to make sure links appear in a way that lets mobile users navigate easily.

The bottom line: How you set up links in your web content really matters.

Tweet about it: Why “click here” just doesn’t click with users — and more #HealthLit tips for creating effective links: bit.ly/2K5zP77 via @CommunicateHlth

In this edition of the We ❤ Health Literacy Book Club, we’re talking about a book that challenges the way many people think about drug addiction and treatment.

Maia Szalavitz’s Unbroken Brain: A Revolutionary New Way of Understanding Addiction deconstructs the traditional addiction model. Szalavitz suggests that addiction is not actually a disease, but rather a learning disorder that’s shaped by a person’s environment, repeated behaviors, and genetic predispositions.

Szalavitz, who overcame cocaine and heroin addiction, describes her journey through a 12-step program, the traditional treatment route. While this program has historically been the sole solution for treating addiction, Szalavitz stresses that this one size does not fit all.

She highlights several harm reduction programs that are based on the idea that people who use drugs can learn to make better choices if they’re taught to — and if they have adequate support. For example, needle exchange programs focus on reducing the negative effects of drug use — not preventing use altogether. There’s also Washington State’s Law Enforcement Assisted Diversion (LEAD) program, which connects nonviolent drug offenders to housing and other services in an effort to keep them out of the traditional criminal justice system.

This topic is extremely timely given today’s opioid crisis, which presents an ever-growing need for innovative health literacy solutions — and, as Szalavitz argues, for evidence-based policies that address addiction. Now is the perfect time for all of us who work in public health to challenge ourselves to think outside the box when it comes to understanding and treating drug addiction.

The bottom line: Unbroken Brain offers a new perspective on how we define and treat addiction, with a strong emphasis on compassion and respect.

Tweet about it: Check out a new way of defining and treating drug addiction in @maiasz’s “Unbroken Brain”: bit.ly/2y44Eau #HealthLit

In a break from our regularly scheduled programming, we’re here this week to explain a recent change to our emails. You may have noticed that the alt text for our newsletter image now appears underneath said image at the top of each email, and we thought you might be curious about this change. (Worry not if you need a reminder about what alt text is — we got you.)

After all, one could argue that the new way looks a bit clunky — and we agree that it’s not the ideal alt text scenario. But here’s the thing: on Medium, the site we now use to host We ❤ Health Literacy, it’s the only option. Medium doesn’t offer the standard feature where alt text shows up when you hover over the image.

We don’t know why that is — and we’ve reached out to Medium to plug the importance of alt text capability. We sure hope they’ll add the alt text feature soon, but for now, we have to choose between making our content accessible to all users and living with a slight cosmetic inconvenience.

As you can imagine, dear readers, that’s a no-brainer for us.

The bottom line: Why has alt text started appearing at the top of our emails? Because accessibility, of course.

Tweet about it: Why you’re seeing alt text at the top of @CommnicateHlth’s #HealthLit newsletter: bit.ly/2J62d8k #a11y

Have you ever opened a piece of mail from your credit card company and come up against an impenetrable wall of words that no average person could understand? How about going online to see what is and isn’t covered by your health care plan, only to get lost in a maze of confusing webpages?

Of course you have, dear readers — and so have we! Experiences like these are all too common, which makes any letter or website (or brochure or app or email) that is clearly written and well designed shine like a lighthouse over stormy seas.

Wouldn’t it be nice if someone recognized these beacons of clear communication for the exemplars that they are? Well, guess what — someone has!

Earlier this month, the Center for Plain Language named 14 winners at the annual ClearMark Awards. These awards recognize effective plain language writing and information design that help people find information, understand it, and act confidently based on what they’ve learned.

This year’s winners include a range of communication materials, from a knee surgery decision aid to a law school’s bylaws — and a peppy little newsletter that has a serious crush on health literacy (aw, shucks).

We encourage you to check out this year’s winners — and consider submitting something of your own next year!

The bottom line: The ClearMark Awards showcase achievements in plain language and clear design — thanks to the Center for Plain Language!

Tweet about it: Check out this year’s #ClearMark winners from @plain_language ‏for some sweet examples of #PlainLanguage & clear design! via @CommunicateHlth: https://bit.ly/2LqTvTG

As you doubtless already know, dear readers, Twitter has gone through some ch-ch-ch-changes (go ahead, belt it out!) in the past year. Last November, after a brief pilot period, Twitter switched for good to a higher character limit. This means we all have 280 characters available per tweet — instead of the original 140.

When this change hit, plenty of organizations pondered the implications of the added characters for their Twitter strategy. How would they approach this new limit? Were all those hours spent crafting 140-character tweets in vain? What did it all mean?!

Since then, it’s become clear that the expanded character count hasn’t affected much — at least when it comes to, well, character count. According to a recent remark from Twitter’s CEO Jack Dorsey, the average tweet length has remained basically the same since the change. This isn’t very surprising, since Twitter’s original trial of the new limit showed that only 5% of users took advantage of it.

But, Dorsey said, it looks like the expanded character count has positively affected engagement. With this bit of added breathing room, users are engaging more — for example, including more mentions. Since the switch, users are getting more followers and returning to Twitter more often. It’s the best of both worlds: tweets remain brief (which is what makes Twitter great!) and people are using the platform more.

So what’s a Twitter-using health communicator to do now? First, keep thinking of Twitter as a good way to share information and connect with your networks. And when it comes to writing tweets, take your cue from the general Twitter population: just because you can use an extra 140 characters doesn’t mean you should. Channel your pre-November 2017 self and keep your tweets short whenever you can.

The bottom line: Keep using Twitter to share important messages — and keep doing it with as few characters as possible.

Tweet about it: Let’s talk about those extra 140 characters. @CommunicateHlth has thoughts: bit.ly/2wQG3pb #HealthLit