Category: We Heart Health Literacy

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

Here at We ❤ Health Literacy Headquarters, we can get into zombies. There’s nothing like a horde of undead to spice up a chase scene — and they can even help us write more clearly! But did you know that zombie preparedness is now an accepted part of the health communication toolbox? That’s because if you’re talking about zombies instead of SARS or H1N1, people are more likely to perk up and learn something.

One zombie flick that really packs in the public health messaging is 2013’s World War Z. The heroes of this Hollywood blockbuster may be better looking than the average epidemiologist (ahem, Brad Pitt), but still — they’re public health professionals who collaborate across sectors and really save the day.

For starters, when zombies rudely interrupt Brad’s pleasant family outing, he gathers data (symptoms, incubation period, transmission vectors) to share with his buddies at the United Nations. Whether you’re faced with a nasty flu or a plague of corpses, sharing info helps you reach a solution faster.

Then, when the military runs out of options and all hope seems lost, what does our hero do? Why, he crash-lands a passenger jet full of zombies next door to a WHO facility, of course! Brad knows that in a pandemic, you want to talk to the people wearing lab coats — not flak jackets.

Here are a few more public health lessons from World War Z:

• Keep life-saving medicines with you at all times. A zombie apocalypse is no time to be without your asthma inhaler, but that’s the sticky situation Brad’s young daughter finds herself in. The family’s frantic hunt for albuterol in an overrun pharmacy serves as a reminder to check your supply of EpiPens, insulin, and any medicine that keeps you among the living.
• Be proactive. While most countries in the film brush off early reports of zombies as nonsense, Israel gets to work reaching out, gathering data, and preparing for the worst. In zombie movies, as in real life, it’s best not to wait around for Brad Pitt to tell you there’s a problem.
• Don’t build walls — build public health infrastructure. At first, Israel’s wall-building isolation strategy seems like a safe bet. But at some point, the zombies are coming over the wall. So ditch the flimsy fences and build the infrastructure that really guards against disease: strong public health organizations.
• Trust vaccines to shield you from diseases… and, you know, zombies. Brad’s final showdown with the zombies doesn’t involve weapons or gore. Instead, he shields himself with a vaccine — the only protection that can truly save us in a pandemic.

The bottom line: Watch World War Z to learn emergency preparedness (zombie-related and otherwise) and see why public health infrastructure is a real lifesaver.

Tweet about it: Why are zombie movies great for public health? @CommunicateHlth talks World War Z: https://bit.ly/2wuPJFr #HealthLit

Here at We ❤ Health Literacy Headquarters, we talk a lot about ways to communicate clearly. Usually, we’re talking about communicating health information to consumers. But sometimes, we like to explore how to apply the principles of health literacy to interactions in our very own workplaces.

In the first edition of Health Literacy in the Wild, we discussed giving clear feedback. This week, we’re tackling a common kind of communication that can also benefit from our best practices: email.

If you’re like us, dear readers, you spend a big chunk of your workday writing and reading (and occasionally ignoring) emails. To write emails that people will actually read and respond to, start by asking yourself these questions:

• What do I want this person to do? For example, if you need a colleague to review a document, plan to make a clear ask. Being specific about what you want will help you get what you need.
• Is email the right tool for the job? Sometimes, picking up the phone or sending an IM is a better way to communicate. This may be especially true if you need to discuss something sensitive or complicated.

When you’ve decided an email is the way to go, use these tips to write it:

• Make the most of your subject line. Write a brief, descriptive subject line. Want your reader to do something? Say it in the subject line — for example, “For your review: Awesome health literacy-related thingy.”
• Get right to the point. Say what you need in the first few lines of your message. Want a response by a certain date? Need an answer to a question? Take a hint from the health literacy playbook and put the most important information first.
• Keep it short. Stick with short sentences and short paragraphs (3 to 5 sentences max). If you’re struggling to write the email because you have so much to say, think about picking up the phone or setting up a meeting instead.
• Use bulleted lists. Don’t send a wall of text. If you need to include lots of details, list them out. This organizes the information so your reader can easily skim what you want them to know.
• It’s okay to repeat yourself. We empower you to repeat important phone numbers, dates, and times — ‘cause, you know, attention spans. (Pro tip: Consider bolding key elements for emphasis.)
• Take the time to proofread. Before you hit send, read your email all the way through. Check for typos or confusing sentences. Think about your tone, too — if your reader could misinterpret your intent or emotions, take the time to rephrase.

The bottom line: Put your health literacy skills to work when writing emails. Your colleagues will thank you!

Tweet about it: Want to write emails that people actually read and respond to? @CommunicateHlth draws inspiration from the #HealthLit playbook: https://bit.ly/2I0HYJJ

Remember when you were young and people would tell you, “Don’t roll your eyes or they’ll get stuck up there!” That, dear readers, is a classic example of a fear appeal.

A fear appeal is a persuasive message that emphasizes the potential risk or danger of an action (or a non-action) in order to inspire behavior change. Aside from classic “parent-isms,” these types of appeals are commonly used in political campaigns, marketing efforts, and — you guessed it — public health!

The overall impact of fear appeals is up for debate — and it can be really tricky to use fear appeals effectively in a public health campaign. After all, we’ve definitely seen a few cases of fear-based messaging gone wrong.

Take the abstinence-only sex education programs that used to be popular in the United States. These programs were created to keep teens from having sex and to lower teen pregnancy rates. They used fear-based tactics to try to scare teens out of having sex (think: alarming photos of STDs). In the end, abstinence-only programs weren’t effective at delaying youth sexual activity or reducing teen pregnancy rates.

But not all fear-based messaging has been such a flop. The Centers for Disease Control and Prevention (CDC) tobacco education program Tips From Former Smokers® has proven to be extremely impactful. It’s definitely one of the more effective fear-based messaging campaigns we’ve seen in a while.

Studies like this one help explain why some fear-based campaigns are more effective than others. Fear appeals have more success when the messages:

• Recommend a one-time behavior, like quitting smoking
• Emphasize risk severity — for example, “Smoking can cause serious, immediate damage to your body and it shortens your life.”
• Include the benefits of taking action, like: “Quitting now helps you prevent serious health problems.”

At the end of the day, dear readers, the fear factor conversation is complex. So if you’re thinking of using a fear appeal, make sure it’s the right fit for your messaging — and execute it effectively.

P.S. We’re interested in your thoughts on this issue! Please let us know what you think about fear-based messaging in the comments or on Twitter.

The bottom line: Fear can help motivate behavior change when used effectively — but it’s not always the way to go.

Tweet about it: Should fear be a factor in #PublicHealth messaging? @CommunicateHlth weighs in: https://bit.ly/2qregoI #HealthLit

Today, dear readers, we’d like to bring to your attention a fascinating book that investigates vaccines and the fears that make some people hesitant to get them.

Part memoir, part historical and cultural study, On Immunity: An Inoculation by Eula Biss documents the author’s decision-making process as she considers whether to get the recommended vaccines for her newborn son. After asking other new moms for advice, Biss learns just how nervous many of them are about vaccines. So, she examines these anxieties — including the harmful myth that vaccines cause autism — and asks why some fears persist even when they’re proven untrue.

Biss takes a closer look at the blind spots in the anti-vaccine movement. She compares a spreading disease to a vampire to remind readers how powerful fear can be. But people who fear vaccines so much, she explains, often forget about the danger of the diseases they prevent. We can all carry and spread diseases — so our own bodies can be as dangerous and scary as any monster.

To address the fears surrounding vaccines, Biss offers an appeal to public well-being. If our bodies can be dangerous, she says, they can also be protective. When we get vaccines, we act as shields, protecting others who can’t get vaccinated. And she isn’t merely being philosophical — she’s talking about herd immunity! (Just don’t call it that in your plain language materials.)

Biss ultimately chooses to get her son the recommended vaccines — and she says that she’s not just doing it for her own family’s safety, but for everyone’s. Now that’s the kind of thinking we ❤.

The bottom line: Check out On Immunity for an exploration of how to rethink the fears that surround vaccines.

Tweet about it: With #COVID19 vaccine development underway, @CommunicateHlth’s We ❤ #HealthLit Book Club revisits “On Immunity: An Inoculation” by Eula Biss: https://bit.ly/2Gmbeg8 #communicateCOVID

Here at We ❤ Health Literacy Headquarters, we get really excited about innovative research methods (Design the Box! Collaging! OMG see?!). So this week, we’re plugging another technique that falls a bit outside of the norm.

Photovoice, created by Caroline Wang and Mary Anne Burris, is a research technique that encourages members of a community to document and discuss their values, needs, and behaviors using original photographs.

The idea is simple: enough with outsiders barging in and assessing the needs of communities they don’t really understand. Instead, if you ask people to show you what’s going on for them, you’ll get better information about their everyday lives.

Let’s say people in a community are worried about air pollution and want to show policy makers how it affects their lives. Here’s an example of how you could do photovoice with them:

• Start by giving participants a brief rundown of ethical considerations around visual research
• Encourage them to spend 1 to 2 weeks taking photos of pollution’s impact on their lives
• Gather everyone together to share their photos and discuss common themes
• Display or present the photos to policy makers or other groups
• Write up the study findings based on the community’s discussions and presentations

Like other research techniques, photovoice has limitations. (After all, if a perfect method existed, we’d be using it all the time and our Testing Techniques series would be really short.)

In this case, photovoice’s greatest asset can also make it tricky to pull off. Since photos can be so personal — and, ultimately, an outsider will be writing up the research results — community members may not always feel comfortable with the approach. For example, some communities may be reluctant to take photos related to things like mental health or substance abuse.

But when it works, dear readers, the results can be pretty amazing. Getting an actual snapshot into the lives of community members we’re trying to reach? Yeah, we really ❤ that.

The bottom line: Photovoice empowers community members to show us their lives and communicate what matters to them.

Tweet about it: Use photovoice to get a snapshot into people’s everyday lives and needs: http://bit.ly/2DsuQZX #HealthLit

When the weather outside is frightful, we like to get cozy with a good public health book. In this edition of the We ❤ Health Literacy Book Club, we’re curling up with Adventures of a Female Medical Detective by Dr. Mary Guinan, a memoir reflecting on her remarkable career in public health.

In 1974, Dr. Guinan began her stint in the Epidemic Intelligence Service (EIS), a prestigious training program at the Centers for Disease Control and Prevention (CDC). She describes being the only woman in her class of medical detectives (or “epidemiologists” in public health speak). And that wasn’t the first — or last — time in her career that she smashed a glass ceiling!

She became a true public health pioneer, remaining at CDC to help eradicate smallpox in India and to serve on the front lines of the early HIV/AIDS crisis. The latter even landed her a role in another book we ❤: And the Band Played On.

Along with describing these historic events, Dr. Guinan discusses the role of communication and the media in public health. She laughs about interview gaffes and recalls being misunderstood or misquoted (read the book to find out how she won the nickname “Dr. Herpes”!). Our favorite: the watershed moment in 1987 when CDC hired a communication expert to teach scientists about main messages and simple writing.

This collection of public health tales — some inspiring, some frustrating, some hilarious — weaves together the personal reflections of a medical detective solving serious public health problems. And we really ❤ that.

The bottom line: In Adventures of a Female Medical Detective, a public health pioneer shares stories and wisdom from her remarkable career.

Tweet about it: The We ❤ #HealthLit Book Club reviews “Adventures of a Female Medical Detective”: http://bit.ly/2tv1JFH via @CommunicateHlth

This week, we’re answering one of the great grammar questions of our time: to Oxford comma, or not to Oxford comma?

This tiny punctuation mark, also called the serial comma, comes before the “and” or “or” in a list of 3 or more things. Simple enough, right? Not so fast, dear readers!

The Oxford comma may seem straightforward, but it gets grammar nerds up in arms. Different style guides either take it (Chicago) or leave it (we’re looking at you, AP Stylebook). Americans use it more than Brits. It even has its own pop song (warning: explicit lyrics).

Fortunately, we’re here to put an end to this controversy and say unabashedly that the answer is clear: always use the Oxford comma — especially in plain language writing.

Why, you ask? To avoid (often hilarious) misunderstandings, of course!

You may have heard the classic, and likely fake, example of a book dedicated to “my parents, Ayn Rand and God.” Without the Oxford comma, the author is stuck with an atheist and a deity for a mom and dad. They do make a good comedic duo, but clearly that’s not the intended meaning.

And that’s nothing compared to the fate of poor Merle Haggard. A newspaper article describing a documentary about the famous country singer skipped the Oxford comma and spiced up his life story: “Among those interviewed were his two ex-wives, Kris Kristofferson and Robert Duvall.”

Still not convinced of the Oxford comma’s super powers? Then consider the 2017 court case decided on the absence of a single Oxford comma in a Maine state law.

So keep those Oxford commas handy — they’ll make your language plain, clean, and clear!

The bottom line: When writing lists in plain language, always use the Oxford comma.

Tweet about it: In #HealthLit and in life, @CommunicateHlth loves the #OxfordComma. Find out why: http://bit.ly/2FmTYnw