Category: We Heart Health Literacy

This week, we’re weighing in on one of the great debates of our grammatical lifetimes: do you use a single space or a double space after the period (or other punctuation) at the end of a sentence?

Fortunately, the answer is simple. Single space, dear readers. One. Space. Only. There’s absolutely zero need for double spaces anymore.

Did that come through clearly enough? Great. Now here’s why.

Using double spaces after a sentence was originally used to improve readability, particularly when typing on a typewriter. Typewriters use a monospaced font — meaning each character has the same width. So the extra spaces were useful — they helped clearly separate sentences from each other.

Nowadays, our computers use proportional fonts (fonts in which characters have different widths) — and that makes it easier to see where one sentence ends and the next one begins.

So. Why. Write. Like. This?

When. You. Can. Write. Like. This!

If that’s not convincing enough, the industry standard is to use a single space after a sentence. Happy single spacing!

The bottom line: Double spaces after a period = too much space between sentences.

The AMC TV series The Walking Dead (in which people try to survive a zombie apocalypse) can certainly be a lesson in zombie preparedness. But did you know it can also teach us about writing for health literacy? Here are 10 lessons in plain language survival.

1. Stick together. In a post-apocalyptic world, going it alone rarely works out. The same goes for developing original health content. Before you start, find out what else is out there, what works, and what doesn’t. This information can make a big difference, so fight the urge to go rogue.
2. Get organized. Any group navigating a zombie hellscape knows that organization — Who’s leading? Who’s prepping meals? — is key. And in health communication, well-structured content is a necessity. Put the most important information first, and use bulleted lists, headers, and short sections to present information clearly.
3. Know the difference between a walker and a biter. In other words, know your audience. What do they call walking corpses with an insatiable taste for human flesh? Lamebrains? Lurkers? Rotters? Be sure to use terms consistently and define them as needed — for example: “Learn to fight zombies (lamebrains).”
4. Clear the area. Zombie survivalists know better than to get comfortable somewhere without first finding and killing any lurking zombies. What does this mean for you, dear readers? Cut out the fluff! Find and remove unnecessary details, jargon, and technical terms from your health materials.
5. Bury your dead. Kill off clichés, that is. If you’re tempted to use a phrase like “think outside the box,” think again. Bury that cliché and replace it with something more straightforward. Do you mean, “be creative?” Write what you mean.
6. Be aware of your surroundings. This is pretty obvious when zombies are around — and it’s just as important for writing effective content. What is your audience looking for? What challenges might they face? Remember, context is your friend.
7. Don’t make noise. Zombies aren’t too smart, but they do know that where there’s noise, there’s food. You can pass the plain language test by being quiet. Use simple, transparent terms and only say what you need to. Complex language could bring an undead horde to your door — or, worse, confuse your readers!
8. Be active. We’ve said it before, and we’ll say it again: active is better than passive. Any character who has made it through 7 seasons of The Walking Dead has done so by facing dangers head on. And in clear writing, the active voice is essential.
9. Keep a lookout. Even when you find a safe place to wait out the apocalypse, don’t relax without putting someone on guard duty! No matter how carefully you craft your content, an editor is essential. Don’t skip the second set of eyes.
10. Be human. After all, what’s the point of surviving in a world of zombies if you’ve lost all connection with people? Whenever possible, write how you speak.

The bottom line: Look no further than The Walking Dead for some excellent lessons for health communicators.

As health communicators, we know it’s our responsibility to choose our words carefully — especially when we’re tackling topics like gender or disability. This goes for race and ethnicity, too. But not to fear, dear readers — we’re here to clear things up!

First things first: although they can overlap, race and ethnicity aren’t the same thing, so you can’t just use the words interchangeably. It’s also important to note that these words can mean different things to different people depending on their experiences. Here’s our take:

• Ethnicity is a social construct. It’s how people identify with their culture, including its religion, traditional practices, and language — regardless of where they were born or how they look. For example, you could say someone’s ethnicity is Chinese or Irish.
• Race is also a social construct — and a complicated one at that. But unlike ethnicity, it’s based on generalizations about physical features like skin color. For example, you could say someone’s race is white, black or African American, or Native American.

Despite being social constructs, race and ethnicity are very real — and in public health, we often need to talk about them. So what’s a health communicator to do? Here’s our advice:

Don’t ignore it. Of course, there are plenty of times when race just isn’t relevant. But if it is, go ahead and say so. For example, if you’re writing about high blood pressure, it makes sense to note that African Americans are at higher risk.

Provide context. If you’re writing about a health disparity with a known cause, consider mentioning it. For example, if you say that black children are more likely to be suspended from school than white children, put that information in context by also noting that teachers often suspend black children more quickly than white children for the same behavior.

Be as specific as you can. Check out these 2 sentences:

• Age, race and ethnicity, and weight can increase your risk for developing high blood pressure.
• Some groups of people are more likely to have high blood pressure, including African Americans, people age 40 or older, and people who are overweight.

The first sentence leaves the reader wondering who is actually at higher risk, while the second one gets right to the point — and you know how much we ❤︎ that.

Follow the golden rule. Treat others as you’d like to be treated. In this case, that means referring to racial and ethnic groups using the terms that they prefer.

The bottom line: When writing about race and ethnicity, give it the extra thought it deserves.

As a health literacy superstar, it’s your job to give people the right information in the right way. But sometimes it can be tough to know what the right information is. Seasoned public health professionals would say: when in doubt, look to the data. We say: okay, but don’t stop there.

Many public health communication materials are developed because studies have identified a serious health problem or risk. For example, if a survey shows that there are high rates of smoking in a given population, a public health agency might develop smoking cessation ads aimed at that audience. But the truth is, dear readers, data don’t always tell the whole story. And that can lead to a disconnect between what public health agencies say — and what people need to hear.

Take herpes, a common STD that can cause really uncomfortable genital sores or blisters. Herpes isn’t life threatening like some STDs — and it tends not to cause serious complications. So, with a lot to say and limited time and money to say it, most public health agencies choose to focus their communication efforts on other STDs.

But the fact remains that a lot of people have herpes — and there’s lots of stigma and fear associated with it. That’s why we’d argue that thinking about what kind of information your audience may need about herpes is totally worth it. For example, we know that folks struggle with how to tell their partners they have herpes. Maybe they need a really awesome, compassionate conversation tool to help them out!

The point is that herpes is worth talking about, even though it isn’t a particularly serious STD (medically speaking). Why? People want to know about it — and that’s seriously important.

The bottom line: When deciding what to communicate about, look beyond the data to your readers’ concerns.

Nerd alert! Imagine there’s an outbreak of 4 new deadly viruses, and you and your friends are a team of public health specialists. If your outbreak response strategy succeeds, you eradicate the viruses and save the world. But if it fails, the viruses take over the globe and humanity is wiped out.

That, dear readers, is the premise of the board game Pandemic. The game unfolds across a map of the world, and you make moves — like building a research station or eradicating the disease in a particular city — to contain the outbreak. But all the while, you and your fellow geeks (er, teammates) draw cards that worsen the outbreak and “infections” build up in different cities.

Pandemic is a cooperative game, meaning everyone works together to win. Players take on roles with special skill sets — dispatcher, medic, scientist, researcher, or operations expert — and strategize with other team members to win. But biology and time are working against you — if your team can’t contain the outbreak quickly enough, you all lose the game. Oh, and the human race is lost to a pandemic.

Besides being a fun game to play, Pandemic is also a nice reminder of what successful public health initiatives look like. Public health is an interdisciplinary field — and most of the successes we’ve seen have been the result of true collaboration and effective teamwork. After all, improving public health requires education, medical care, policy, communication, outreach, research…

And you know what they say about the spelling of the word “team.”

The bottom line: Play Pandemic to appreciate how much of a team effort public health strategy really is — you just might save the world.

In this week’s edition of our “use simpler words” series, we’re talking about “substance.”

“Substance” is one of those vague words that may not need to be simplified as much as it needs to be clarified. After all, a substance is pretty much anything that takes up space. And do you know, dear readers, how many substances exist out there? We actually don’t either, but there must be a lot.

In our experience here at We ❤︎ Health Literacy headquarters, the word “substance” tends to pop up most when writing about 2 topics: environmental health and drug and alcohol use.

Consider these examples:

• Talk with your kids early and often about substance use.
• Studies show that contact with these substances can cause serious health problems.

What exactly are we talking about here? Alcohol? Drugs? Asbestos?

Here’s our advice: instead of leaving it at “substance,” tell us more about what the substance is. And if you can, just name it!

For example:

• Talk with your kids early and often about alcohol and drug use.
• Studies show that contact with these chemicals can cause serious health problems.

Simple, right?

Of course this method isn’t one-size-fits-all. Sometimes, “substance” really is the best word to describe, well, a substance. But try to be as specific as possible — so your readers don’t accidentally think you’re talking about, you know, polybrominated diphenylethers. (Granted, that’s not a very likely scenario. But you get it.)

The bottom line: When you can, skip “substance” and just name what you’re talking about.

If you’re anything like us, dear readers, you still shudder thinking about the awkward videos from 7th grade health class. You remember them: cheesy tales of peer pressure on prom night that left everyone sweaty palmed and wondering how to apply these lessons in real life.

Thankfully, videos about health have come a long way since those days. And, when done well, they can be effective tools for sharing your health messages online.

Videos command attention in search results, boost email click-through rates, and increase conversion rates (the number of visitors to your website who take action on the site). Plus, by sharing videos through social media, you can get even more eyes on your content.

But before you buy a black beret and join the Screen Actors Guild, first things first — since video is a visual medium, it works best when you have something to show.

Consider using video to:

• Illustrate a process, like how climate change affects health
• Model good behavior, like how to talk to kids about sex
• Share testimonials, like about the Affordable Care Act’s impact on Americans
• Provide expertise, like from scientists or government officials
• Tell a story, like about a school gardening project

In terms of budget, a big one gives you a lot of options — for example, you can hire a crew or an animator. But remember, we ❤︎ a good shoestring project. If you’re tight on resources, use your phone to shoot an interview or partner with a local clinic to serve as your set.

We must, of course, remind you that health literacy best practices apply to videos — so be sure to:

• Write dialogue that’s conversational and snappy
• Opt for plain language instead of jargon
• Keep it short and to the point

Finally, as with everything you put online, it’s important to make videos accessible to everyone. Add closed captions (visible text that captures dialogue) so people who are deaf or hard of hearing will get the message — and consider adding audio description (narration that describes the action) for users who are blind or visually impaired.

The bottom line: Video isn’t just a thing of health classes past — it’s a great tool for communicating important health information online.

Have you ever wished you could spend 2 whole days learning about plain language, health literacy, and design principles? (It’s been our dream since childhood, obviously.) If that sounds like you, please join us for Plain Language for Health: A Writing and Design Workshop on March 16–17, 2017 in Boston, MA. The workshop is co-sponsored by CommunicateHealth and the Tufts Health Literacy Leadership Institute.

In this workshop, you’ll learn new skills, gain valuable tools, and make lasting connections with other motivated individuals and teams who are committed to communicating health information in ways that people can understand. Visit the website to learn more.

Here’s what some of last year’s participants had to say:

• “Loved this workshop! Very informative and practical for everyday use.”
• “Very helpful and interactive. The group activities were great for collaborating and building up ideas.”
• “This workshop was great! It was obvious that the presenters put a lot of effort into understanding their audience. Thank you!”

Here’s a completely unsurprising statement: at We ❤︎ Health Literacy Headquarters, we’re big fans of catering to users’ needs. But here’s where things can get tricky: if you’re building something complex, like a new health website, you might have several audiences with different goals.

How can you be sure you’re meeting all of their needs? That’s where personas come in.

Personas are composite users — in other words, they’re fictional characters based on insights from real users. They’re very useful for keeping the focus on your audience(s). Here’s what personas can do:

• Creating web content? Personas can remind writers to tailor health content for readers.
• Working on layout? Designers can use personas to develop a look and feel that will resonate with all audiences.
• Thinking about site structure? Personas can help your team organize the site according to users’ priorities.

You get the picture: personas are useful for the whole team. So put them to use, dear readers!

Here are some tips for developing great personas:

• Create personas to represent your main audiences — for example, if you’re building a website that will have vaccine information for parents and pediatricians, make a persona for each of those groups.
• Base your personas on research with actual users — like usability testing, interviews, and focus groups.
• Include each audience’s goals for the website and what they’ll expect when they land on your site.
• Make ’em short, sweet, and realistic — and include photos to help bring your personas to life.

The bottom line: The next time you’re building a website, use personas to keep your team on track and your users’ goals in mind.