Category: We Heart Health Literacy

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.

We see the words “hazardous” and “hazard” all the time. Journalists ❤︎ them, and with good reason — they tend to get our attention and keep us reading. But there are, ahem, hazards to using these words — namely that they’re often vague or misleading. After all, a hazard could be anything from a joke to something really awful!

So, why take “hazard” out of your health content? Because, as health communicators, our goal is to share clear information without causing panic or confusion.

Here’s what we see as the perils of these fearsome words.

• They’re vague. Readers may miss out on key information and either underestimate a serious risk or get worried about something that’s not a big deal.
• They’re misleading. Leave the clickbait to Buzzfeed. Using attention-grabbing words like “hazardous” may get people to read your content, but it’s not great at building trust.
• They’re usually not necessary. If you can’t be more specific, use a word that’s easier to understand — like “danger.”

Check out these examples:

• Many Americans live just a few miles away from a hazardous waste site. (Vague.)
• Alcohol can be hazardous to your health. (Still vague!)
• Hazards ahead for your healthy habits this holiday season! (Vague and misleading.)

Instead, consider:

• Many Americans live close to sites where harmful chemicals were used in the past.
• Drinking too much alcohol can cause serious health problems, like liver damage.
• Many people have trouble sticking to physical activity and healthy eating routines during the holidays.

The bottom line: In plain language writing, there’s usually a better way to go than “hazard” or “hazardous.”

Here at We ❤︎ Health Literacy Headquarters, we’re big fans of a team approach to creating great health communication products. Each member of the team — writers, designers, researchers, user experience wizards — brings their own skills, perspective, expertise, and approach. And as countless children’s television shows and popular board games teach us, teams need to work together and communicate well to be successful.

One great tool to help teams communicate is sketching. That’s right, drawing with a pen and paper the old-fashioned way. This can be super helpful when it’s time for writers to hand off content to designers.

The next time you’re ready to pass content to a designer, take a few minutes to visually capture anything that goes beyond the words. Working on a webpage? Sketch out where you think the images or call-out boxes should go. Writing content for an app? Draw how you envision the text fitting into the different screens.

Sketching can do a lot more than you may think. Here’s why we ❤︎ it.

Anyone can do it. You don’t need to be a design genius or know how to use a fancy wireframing program — just grab a pen and paper, and you’re off to the races!

It’s fast and cheap. Fancy wireframing programs have their place — but often, they’re more than you need. With sketching, you can explore lots of potential ways to structure your content without sinking a ton of time into each one.

It helps you see how your content will look. Ever spent hours crafting a brilliantly detailed intro paragraph before learning that there’s only space for 20 words? Sketching while writing helps you develop content within its visual context.

Designers ❤︎︎ it. Obviously, designers are visual people. Instead of a document with paragraphs upon paragraphs of explanations, try giving them a sketch!

“A stitch in time…” Sketching can help you and others on your team get on the same page quickly and avoid misunderstandings — saving everyone time, money, and frustration.

The bottom line: Sketching is a great way to communicate visual ideas — and anyone can do it. What’s not to ❤︎?

As much as we ❤︎ the English language, dear readers, we also feel haunted by the vague, archaic, jargon-y, and generally unhelpful words that often sneak into health communication. (You may recall our rants about exceeding preventable substances. Well, not quite — but you get us.)

The ghost we want to exorcise today? “Healthful.” Shudder.

Some people think “healthful” is just a dressed-up version of “healthy” — but that’s not totally true. Technically, “healthful” means “promoting good health” and “healthy” means “in good health.” So, according to conventional grammar rules, you’d describe a diet or lifestyle as healthful — not healthy.

That’s all well and good, but here’s our technical analysis of the word “healthful”: it sounds weird. As you probably know by now, best practices for health literacy tell us to write the way we speak, which makes your content easier to understand and less distracting. And most people just don’t talk about things being healthful.

We recommend sticking with “healthy,” even when it’s not the grammatically correct choice (don’t worry, we won’t tell your 7th grade English teacher). For example, we give you permission to say: “A healthy diet can help lower your risk for chronic health problems like heart disease.”

The bottom line: “Healthful” isn’t helpful — as a general rule, opt for “healthy” instead.