Category: We Heart Health Literacy

If there’s one thing that public health professionals talk (and write and meet and tweet) about constantly, it’s healthy eating. This is a high-stakes issue, and it’s complicated — which means that figuring out ways to help folks make healthier food choices can be tricky. Also, as you surely know, access to healthy foods is a major piece of the puzzle.

When families who want to eat healthy foods may have trouble getting them, the messaging becomes extra important. But never fear, dear readers, we’ve got tips to help you create compassionate, empowering messages about healthy eating for communities that might be affected by limited food access.

• Keep things positive. It’s easy to get lost in the land of negative framing when communicating about food access issues. Just take the common public health term for communities where it’s hard to find healthy foods: “food deserts.” Hello, negativity. We prefer to talk about “food access and security” because we want to help families and communities focus on what they can do to eat healthier, not leave them thinking about what they don’t have.
• Be honest. Know your audience. If transportation is an issue for your community, acknowledge that. If fresh veggies are hard to find, help folks feel understood — like they’re not alone in dealing with this problem. Talking about the reality of food access issues can help build trust and increase your credibility with readers, making it more likely that they’ll read and act on your recommendations.
• Offer realistic suggestions. When writing about healthy food options, make sure to include tips that are accessible and affordable for your audience. We ❤︎ these MyPlate tips for families on a budget — check it out to get ideas for healthy suggestions that won’t break the bank (like buying frozen veggies and fruits instead of fresh). And if you’re including a healthy recipe, make sure the ingredients are things your audience can find.

The bottom line: When writing about healthy eating, acknowledge food access issues when you need to — and keep your messages positive and realistic.

So, you’ve chosen the platform you’re going to use to build your own website, you’ve written some content, and you’re ready to put it all together. How can you help people navigate around your oh-so-engaging and informative webpages?

Never fear, dear readers! We’ve got some tried-and-true tips for you.

First, think about where your content will go and how you’ll organize it. Pro tip: card sorting is a great way to do this.

Next, pay attention to how a URL will look before adding content to a new page. Most website platforms let you control how the link appears. Instead of a gibberish-y collection of numbers and characters, it’s better to have “pretty permalinks” that contain actual words from the title of a webpage. URLs like these are easier to find and share.

It’s also important to design your website so users will know where they are on every page. This is especially helpful when users land somewhere on your site through a search engine (instead of starting on the homepage). You can do this by:

• Adding breadcrumbs (a descending list near the top of the page that shows where a given page is in the overall site structure)
• Designing an active state for navigation menus (for example, highlighting the current page title in the menu)

Finally, once you have well-organized webpages with clear content, link them to each other! Help your readers learn more by adding links to related pages. Keep in mind that this isn’t a substitute for good navigation — but it’s a helpful practice that will encourage readers to dig deeper into your site.

The bottom line: No webpage is an island — so give your users a clear map and multiple ways to get around.

Here at We ❤︎ Health Literacy Headquarters, we’re just crazy about focus groups. One of our favorite things about focus groups is that they’re super versatile — you can use them throughout the entire product development process. We really ❤︎ that.

But let’s back up a minute to cover the basics.

In a focus group, you get a group of participants together to answer questions and talk about a particular topic. Focus groups can provide valuable insight into participants’ knowledge, attitudes, behaviors, beliefs, and information needs. And the group setting is key because each participant’s comments can stimulate and influence others in the group to think and share more. The result? A dynamic, insightful conversation that can give you a lot of information.

In the early stages of a project (sometimes called the discovery or formative research phase), focus groups let you get to know your audience. Say you’re developing an app for kids with diabetes. You could recruit actual kids with diabetes and ask them questions that get at their beliefs about healthy eating, challenges or frustrations they’re having managing the condition, or how the app would work in their dream world. You could then use the insights gained from the focus groups to shape your product’s technical requirements, design direction, and communication strategy.

(Pro tip: consider souping up your formative focus group with a collaging activity.)

Once you’ve started creating your product, you can use focus groups to explore how well it fits what your audience wants and needs. At this point, you would show participants some components of what you’re working on (like sample messages, design sketches, or a draft material or prototype) and get their reactions. Then you would use this feedback to refine your product to better meet your audience’s needs.

What’s not to ❤︎?

The bottom line: Use focus groups throughout the development process to help you create a product that’s right for your audience.

This week, we’re thrilled to add to our frequently asked question series by answering a great question that came from one of our regular readers: What do you think of the term “layperson”? (The context here, in case you’re wondering, is the difference between a health care professional and a consumer.)

You may not be too surprised, dear readers, to find out we’re just not that into “layperson.” First, it’s a weird word. There’s nothing intuitive about it — and it’s not used all that often anymore. It also hits a vaguely religious note, which usually isn’t necessary when it comes to health information.

Finally, the word epitomizes the relationship that we try not to establish between health information communicator and health information consumer — that is, we (health communicators) are the in-the-field experts and you (consumers) are the outsider non-experts. That is something we do not ❤︎ at all — and it flies in the face of some of our core plain language principles, like writing in familiar language and avoiding condescending language.

Those are our thoughts on the term itself — but our inquisitive reader, perhaps anticipating our feelings about “layperson,” also asked if we could suggest some alternatives. And in another perhaps not-so-shocking turn of events, we’d say that answer comes down to knowing your audience.

The tips we offer from We ❤︎ Health Literacy Headquarters mostly apply to content for consumers. So our approach is generally not to label the consumer audience with anything beyond the second-person “you” — for example, “Treatment for Diabetes: What You Need to Know,” not “Treatment for Diabetes: What Consumers (ew)/Laypeople (ick!) Need to Know.” We’d be more likely to call out a resource that’s not meant for consumers — like if we created one for professionals: “Treating Diabetes: Information for Professionals.”

From our perspective, then, it’s generally not necessary to call laypeople “laypeople” at all — or “consumers” or “the public” or whatever other term you can come up with to distinguish consumers from non-consumers. But if you write mainly for a professional audience and you do want to distinguish the consumer audience, “patient” is probably a safe bet overall. You may also be able to specify within a consumer audience depending on the topic (like “pregnant women”).

Either way, we empower you to skip “layperson.”

The bottom line: Forget about the term “layperson” in your health communication materials. (And if you already have, pretend we didn’t remind you!)

Sometimes, in internet-land, users go to a website with the express goal of just poking around — you know, e-wandering until they find something they’re interested in (or until they don’t and move on). But when it comes to health content, people are usually looking for something specific — like information about a recent diagnosis.

And that, dear readers, is when a well-designed search function can make all the difference.

So, when you’re building a website (or improving an existing site), how can you make sure the search function will improve the user experience? Here are a few best practices that can help.

• Make the search bar prominent. Putting it at the top right of the page is still best, since that’s where users expect to find it. But the days of teeny-tiny search bars hidden in the corner are over. Make sure the search bar is big enough to spot easily — and keep it free of visual clutter.
• Help people out. We ❤︎ autocomplete! Set up the search function to provide spelling suggestions or display common search terms once a user starts typing. This can be especially useful for health content, since some of those medical terms can be hard to remember — and tricky to spell.
• Keep it relevant. A search bar is only helpful if the search results are relevant. This is where “best bets” come in. Best bets allow you to pair specific search terms with key resources. In other words, they let you set which resources display first in the search results.
• Test, test, and test some more! No one knows what your site needs better than your target audience. Getting feedback on your search function is key to understanding which features are the most (and least) desirable to your users.

The bottom line: An effective search function can go a long way toward making your health website easy to use.

Does the term “collaging” ring any bells for you, dear readers? From grade-school art class, perhaps? Maybe you pasted together images to represent your hopes and dreams, and they told a clearer story than you could have communicated with words alone.

That’s also the idea behind collaging as a testing technique! Collaging is an innovative way to learn things that participants aren’t likely to come out and say directly.

According to Dr. Gerald Zaltman, who founded the technique (also known as the Zaltman Metaphor Elicitation Technique) at Harvard Business School, collaging helps you learn “what people don’t know they know.” A lot of our thinking happens at the subconscious or unconscious level, and images can help these hidden thoughts surface.

Collaging uses images to draw out participants’ values, emotions, and mental frameworks. It works best as a formative or exploratory research activity — when you want to find out what people need or how they think about a particular topic. And since the focus is on images instead of words, it’s especially useful for participants with limited literacy skills.

You can do collaging as a 1-on-1 exercise or in a focus group setting. Here’s how it works:

• Participants get a collection of images (all participants get the same ones)
• The moderator asks participants to create a collage that represents their values, beliefs, or desires related to a particular topic
• After about 20 minutes, participants share their collages and talk about what each image represents for them

And while this technique works great in person, it’s easy to adapt for remote formats, too. Platforms like Aha! Live Conversations let you move the whole collaging process online.

We see collaging as a win-win: it can empower participants to share stories and make connections they’ve never thought about — and reveal insights that researchers never knew to ask about. Yes, please!

The bottom line: When words aren’t quite getting you there, try collaging as a testing technique.

Tweet about it: Looking for creative testing techniques for your #HealthLit materials? Try collaging — and use images instead of words to tease out what people think: https://bit.ly/3bzrgAg

In our first social media installment, we discussed the blog — one of the very first forms of social media. Today, we’re going to talk about a platform that’s a little newer to the scene (though it may not feel very new at this point): Twitter.

Twitter has been shaking up the social media game since 2006. It’s taught people how to make an impact in 140 characters or less — which we definitely ❤︎. Seriously, a platform that actually requires you to be concise in your communication? Sign us up. (Just kidding, we’re already there! #FollowUs)

Twitter offers easy access to the latest news, gossip, and clearly written, actionable health updates (of course) — all in real time. But as awesome as that is, it can be a little bit overwhelming. So, where to start? How can you make your content stand out in the literally endless stream of tweets flooding folks’ feeds?

Not to fear, dear readers! We have some tried-and-true tips to help you make the most of those 140 characters.

• Show your personality! Use an informal, friendly tone so users will want to hear more from you.
• Reel ’em in. Lead with a strong hook so they’ll be dying to read your whole tweet and visit the page you’re linking to.
• Write actionable content. Use phrases like “Check this out!” or “Learn how you can…” to encourage people to tune in.
• Include relevant hashtags (#) so users can find your tweets as they search — it can get you double the engagement of a tweet without hashtags.
• Use no more than 2 hashtags in a tweet. You know what they say: too much of a good thing can be bad (and it can decrease engagement by 17%).
• Add visual interest with photos, videos, and GIFs. Tweets with images get 150% more retweets.

Now, flap your wings and tweet away!

The bottom line: Make your 140 characters count. The ingredients for a perfect tweet include: a little personality, some visuals, and the right hashtag.

No doubt you know by now, dear readers, how important it is to keep your health content clear, simple, and direct so it’s easy for people with limited literacy skills (and everyone else) to understand. What you might not know is that cognitive scientists have an explanation for why some of our favorite plain language guidelines make such a big difference: something called working memory.

Working memory is the brain function responsible for storing, organizing, and using information. It’s where we keep facts and details, do equations, and form new thoughts — all key pieces of understanding written information. But our working memory only has a finite amount of storage space, and it’s “temporary storage” — like a scratchpad that’s only so big.

One thing we know about audiences with limited literacy skills is that they’re likely to have more issues with working memory than their higher-literacy counterparts. That makes them more likely to get distracted, reread words, or lose their place — and perhaps give up reading altogether.

So what’s the savvy health writer to do in order to keep readers, well, reading? Enter cognitive cues. Cognitive cues are strategies for designing and arranging content in ways that hold your reader’s attention. Think of them like visual signals that help emphasize important content — and minimize distracting content — to support readers’ working memory.

Check out these examples of some plain language standbys in the context of cognitive cues.

• Use boldface and other visual cues to call out key messages. This can help your readers find — and remember — the most important information on the page.
• Use images and graphics to support your text. Just steer clear of images that are off-topic or overly complicated — they can be more distracting than helpful.
• Give context first. Giving context at the beginning of a sentence helps readers know whether or not content applies to them, so they can skip it if it doesn’t — leaving a little more room in their working memory.
• Break paragraphs into small chunks or lists, and group similar information. Presenting content in small chunks or groups of like information — with lots of white space — is less likely to overwhelm a reader’s working memory.
• Replace jargon terms with plain language alternatives. Readers who struggle with working memory may have trouble remembering the meaning of a word they don’t know — even if you’ve defined at the beginning of the material.

Sure, you’ve heard us give tips like these before — but don’t they take on some new meaning now that they’re in context? We just ❤ that.

The bottom line: Use cognitive cues to create health content with your readers’ working memory in mind.