Category: We Heart Health Literacy

It’s abundantly clear at this point, dear readers, that the reason we get along so well is that we have a lot in common. We’re all a bunch of health literacy lovers with passionate feelings about things like white space, plain language, and user testing. In short, we’re the coolest.

Unfortunately, not everyone shares our commitment to making health information easier to understand. And the reality is that even your own organization might be stuck in the Dark Ages (and in the Dark Ages, health literacy wasn’t a thing).

Well, grab a torch because it’s time for you to lead your colleagues into the light. Here are some tips you can use to advocate for a health literate organization.

Give the facts.
Explain how health literacy affects us all: 9 in 10 people have limited health literacy, which means they struggle to find, understand, and use health information. And research shows that everyone — not just people with limited health literacy — benefits from health content that’s clear and easy to use.

Dispel the “plain language is dumbing down” myth.
If we had a nickel for every time we heard this one, we’d be kajillionaires (and we’d use it to run as many focus groups as our hearts desire)!

Plain language does not mean dumbing down your content. It means thinking about your readers, telling them only what they need to know, and using simple language to communicate your message.

Make it personal.
Health information is powerful — it can make us feel scared and confused or informed and empowered.

Encourage your coworkers to think about their loved ones and how they might feel reading your materials. Would they want their grandmother to get a fact sheet peppered with impenetrable jargon? How would they describe the issue in a way that would instead put her at ease and help her take action?

Explain the return on investment.
Yeah, yeah, readable health materials help consumers — but what about the big guy? The truth is that health literacy benefits organizations, too. If you distribute clear information, your audiences will be primed to:

• Get the message without needing to call or email for clarification, which can save your company time and money
• Follow through on the actions you want them to take, like paying their bill or taking their medicine as prescribed
• Feel satisfied with your service, which can translate into greater loyalty

Share tools.
Like many of us, your colleagues may have learned early on that good writing is formal writing — or that there’s no significant difference between a website that’s user-friendly and one that isn’t. So give your colleagues a hand by sharing tools they can use on the job. Here are a few of our favorites:

• Health Literacy Online
• Ginny Redish’s Letting Go of the Words
• Steve Krug’s Don’t Make Me Think

Start small.
Begin with small steps — like getting folks to use contractions when they write or encouraging them to collect a few audience insights before developing a product. Even these small wins can have a big impact on your work.

Who knows? Before long your colleagues may want to join the We ❤︎ Health Literacy family (and we’d really ❤︎ that).

The bottom line: Advocate for health literacy within your organization — it’ll be a win for your audiences and a win for your company, too.

So, you’re building a website — congrats! But before you start designing, dear readers, we have something very important (and possibly surprising) to tell you: when it comes to designing a website, it’s best to be predictable.

Designing a predictable site helps users get where they need to go quickly and easily because they intuitively know where to look for important things. This is especially important for health websites, because users may be stressed out or otherwise not feeling their best when they’re searching for health information.

In Don’t Make Me Think, Steve Krug says: “When you’re creating a site, your job is to get rid of the question marks.” In other words, users shouldn’t need to ask themselves questions like:

• Where am I?
• Where should I begin?
• Where did they put _____?
• Why did they call it that?

Years of usability testing with all sorts of folks has taught those of us at We ❤︎ Health Literacy Headquarters some important lessons about how to design websites for predictability. Here are some tried-and-true tips:

• Make sure your site has a clear, simple navigation
• Put your logo in the top left corner (bonus points if clicking on your logo takes the user back to the homepage!)
• Put your search bar in the upper right corner
• Put your contact information in the footer
• Use visual cues — like breadcrumbs or highlighting — to remind users where they are on the site

And don’t fret, dear readers: predictable doesn’t mean boring! You can still dazzle your users with a gorgeously designed website that’s easy to use and great to look at.

The bottom line: Design your website to be predictable — your users will thank you!

In today’s fast-paced world, more and more people are getting their information from social media. And as you know, dear readers, it’s part of our job as health communicators to meet folks where they’re at.

Different forms of social media have different strengths, and we’ll talk about that in future installments of our social media series. But to begin with, we’re giving a shout-out to perhaps the oldest form of social media: the blog.

Why blog, you ask? Here’s why.

• Blogs are content driven. Without character limits or formatting constraints, you can use blogs to really dive into an issue.
• Blogs let you be you. Compared to most social media platforms, blogs offer more options for branding and customization — so you can let your organization’s personality shine.
• Blogs and other social media platforms are a match made in heaven. Once you’ve gotten your audience’s attention with a snappy tweet or cute Instagram photo, they may want to dig deeper. Enter your blog!
• Blogs get people to your website. Once you’ve engaged readers with an awesome blog post, they’re more likely to visit your website for all the details.

Of course, there are fewer things sadder than an old, abandoned blog — so make a plan to post regularly and be sure to respond to comments as they come in.

Now go forth and blog!

The bottom line: Blogging is a great way to build your brand and engage with your audience.

So you’ve decided to put your super awesome, totally health-literate material on the web so it’s available to internet users everywhere. Wahoo!

Now you have to choose a format, and it really boils down to 2 options: webpage or PDF. What’s a health writer to do? Let’s discuss!

Webpages
At We ❤︎ Health Literacy Headquarters, we generally prefer webpages. Why?

• They’re easier to update than PDFs — no need to go back into the source document and re-export! That’s a big time (and money) saver.
• Webpages tend to be easier to access and use. Anyone with a web browser can view them — and they’re easier to search.
• They offer more opportunity for interaction. Check out this interactive graphic from HealthIT.gov’s Patient Engagement Playbook for an example — something like that wouldn’t be possible in a PDF.

And let’s do a little myth busting: lots of folks think that you have to choose PDF if you want your material to be printable. But that’s just not true — webpages can be printer friendly, too! See Health Literacy Online to learn more about printable webpages and to check out an example — users can print the full document or specific sections, just like a PDF.

PDFs
One of the main cases for PDFs is that they’re downloadable, so it’s easy for users to save and share them. But what if people don’t have the right software to open the PDF after they’ve downloaded it? Without a program like Adobe Acrobat or Preview, they could be out of luck — and miss out on your masterpiece. (We don’t ❤︎ that, dear readers.)

If you ask us, the time to go PDF is when you’re creating a material that’s getting professionally printed — like a book or brochure. With a PDF, you lock in the appearance — including layout and style elements — so it will always look just how you want in print.

The bottom line: Want your online health material to be flexible, easy to use, and easy to update? Make it a webpage instead of a static PDF.

In 2014, more people died from drug overdoses than any other year in American history. Over half of these deaths involved an opioid — and about 78 people die from an opioid overdose in this country every day.

With numbers like these, it’s no wonder that CDC has declared an opioid overdose epidemic in the United States. And so it follows that health communicators may be getting a lot of work related to opioid abuse and overdose (we certainly are).

Opioids can be a tricky topic to cover — and it’s extremely important that health professionals of all disciplines are giving the overdose crisis the attention it deserves. So here are a few things to consider when writing plain language content about opioids and opioid overdose.

Keep your tone empathetic. If ever there’s a topic that reminds us how important empathy is in health writing, this is it. At all costs, avoid sounding condescending or judgmental. Remember how stigmatized people struggling with addiction are likely to feel — and use that to give your content the compassionate tone that will keep your readers, well, reading.

Use person-first language. Rely on phrases like “people who use/abuse/are addicted to opioids” or “people with opioid addiction.” Skip terms like “addicts” or “users” that imply folks’ addiction defines who they are.

Prioritize need-to-know information — really. When you’re writing for people who may be using drugs (or may have recently stopped using drugs), it’s extra important to keep content brief. Your readers may be high, sick, scared, or all of the above. Since illness and anxiety affect health literacy skills, skip anything that’s nice to know — critical information only.

Check your (community-specific) facts. A lot of the response to the opioid overdose crisis is happening at the community level, so beware of simply pulling information from national websites, however credible they may be.

For example, the cost of naloxone (a drug used to reverse opioid overdose) may be different depending on where you are — and the medicine kits themselves may look different. So, before you give instructions for how to buy or use it, make sure you know what your audience is likely to encounter.

You may also want to do a little research into legal matters. Are you writing a material encouraging people to call 911 if they witness an opioid overdose? If your state has a Good Samaritan law, you might want to mention it — but make sure you know what the law actually says before you do.

Remember friends and family. It’s hard to know how to help when a friend or family member is struggling with addiction. So, if it’s appropriate, consider creating some content for friends and family, too. Their support can go a long way in helping people who are addicted to opioids kick the habit for good.

The bottom line: The stakes are high for health communication materials about opioids and opioid overdose — so give this topic extra thought before you write.

This week, dear readers, we’re tackling a topic that often comes up in our work: gender and design. Of course, designs don’t actually have genders, but gender is a powerful concept in our culture — and we tend to interpret various design elements as masculine or feminine.

Marketers are especially fond of gender-specific product designs (remember Bic for Her pens?) because targeting a specific group of people can make them more likely to relate to a product. But gendered design has a dark side: it can reinforce stereotypes and even make women pay extra for their “womanly” products.

How does this apply to health communication? As you know, dear readers, it’s important to consider your audience and test your material if you can. But in general, it’s best to steer clear of very gendered design elements — even if you’re designing for a mostly single-gender audience.

Let’s say you’re designing a website for an OB/GYN practice. Before you decide to go with pink and flowers, think: do all women really like those things? Might they feel like you’re pandering to them? How would a transgender patient react to that design?

This isn’t to say that all design needs to be entirely gender neutral. For example, designers trying to evoke a feminine feel might consider using more curvy lines than straight ones — and someone looking for a very masculine feel might choose a bold color palette over a light one. The key is to focus on subtle cues that don’t rely on clichés or stereotypes.

The bottom line: When it comes to gendered design elements in health communication, less is usually more.

As you know, dear readers, communicating about treatment options to patients who are sick and scared is a big health literacy challenge. And what’s even harder? Communicating about medical care when every treatment is likely to cause more harm than good.

That is the tough — and important — subject of Being Mortal: Medicine and What Matters in the End by Atul Gawande.

The book is partly a history of care and treatment of older adults in the United States, and partly a rallying cry for doctors, patients, and family members to have honest conversations about what’s most important to someone with a terminal illness.

Gawande, a surgeon himself, asks: “When should we try to fix and when should we not?” To help people make the best decision, he lists a series of questions that get at both the patient’s understanding of the situation and what makes their unique life worth living.

We won’t spoil the ending by listing the questions here. For the full context, we definitely recommend reading the book, in which Gawande combines facts and data with compelling personal stories — including his own father’s death from cancer.

Of course, the conversations Gawande advocates for are hard. Few people want to talk about the inevitable, but Being Mortal offers both a reason and a way to do it. Because, as Gawande says: “Death, of course, is not a failure. Death is normal.”

The bottom line: Being Mortal explores options for making illness and death less harrowing — and more meaningful.

We know you’ve been there: you’re trying to find a specific piece of information on a website. You navigate to where you expect it to be — it’s not there. You find somewhere else it might fit, even if it’s a stretch — nothing. You can’t find it with the search function. You have failed, and you think, “I’m an intelligent, fairly tech-savvy human. Why can’t I find what I need?!”

It’s scenarios like this, dear readers, that keep us up at night. (No, really. It’s true.) And that’s why, in our latest installment on testing techniques, we’re focusing on usability testing.

When you’re creating a communication product, it’s important not to make any assumptions. Usability testing helps you get past assumptions and find out how easy (or hard) it is to use your website, tool, or print material.

By having real-life users give it a whirl, usability testing gives you invaluable feedback on your product’s navigation, labels, content, and design — feedback you can use to improve your product. And that, dear readers, means your target audience gets a product they can really understand and use.

Now, really. Who doesn’t ❤︎ that?

Keep these tried-and-true tips in mind when you do usability testing:

• Pick a few key tasks for participants to try. For example, can they find the schedule of first aid classes and sign up for a class?
• See what people do on their own. Include time for some unguided, free exploration where participants just click on what interests them. Ask them to “think out loud” as they go.
• Test in person when you can. It’s helpful to see participants’ reactions and non-verbal behavior as they’re interacting with your product. And it’s easier from a logistical standpoint, too! (You can also test remotely with an online screen-sharing platform when necessary.)
• Always test with people from your target audience. After all, who needs to know how to use your product?
• Consider recruiting folks who may have low literacy levels. Working with populations who may have limited literacy skills can help you make sure that your product is easy to use for everyone.
• Test digital products on various devices — desktop, laptop, tablet, mobile, and beyond! You can even test on multiple devices with each participant, so they can interact with your product across platforms (and so you get more feedback).

And don’t worry — usability testing doesn’t have to break the bank. Also, be sure to check out Steve Krug’s book Rocket Surgery Made Easy for more usability testing ideas.

The bottom line: Usability testing gives you super valuable feedback on how your product works (or doesn’t work) for your target audience.

In online health content, images aren’t just pretty pictures — they’re used to support and reinforce your message. (If that’s not the case, Houston, we have a problem!) So it’s important that your image content is accessible to all users. Alt text to the rescue!

Alt text (alternative text) is exactly what it sounds like: a written description of an image’s content for users who can’t access the image itself. Like many best practices in web design, alt text is important for users with disabilities, but it also benefits many others.

For users who are blind or visually impaired, a screen reader can read the alt text aloud. And for those with out-of-date web browsers or slow connections, alt text will display in place of an image that doesn’t load properly. Well-written, descriptive alt text will also improve your search engine optimization (SEO). Bonus!

To make sure you’re writing alt text that’s as helpful as possible, keep the 3 Cs in mind:

• Clear: Alt text needs to include all the relevant information that’s in the image. What would someone miss by not seeing the image?
• Concise: Explain what’s in the image but don’t repeat information that’s already included in your content.
• Consistent: Try to keep things like tone, verb tense, and level of detail consistent in alt tags — just like any other written content.

The bottom line: When you write concise, accurate alt text for your images, everybody wins.

The decisions we make as part of health care — like which treatment to try, or whether to have a certain test — are very personal. Yet recent studies show that doctors make most decisions about patients’ health care, not patients themselves. Hmm.

That’s why we’re talking about shared decision making this week — and (you guessed it) how health literacy fits into the mix.

The idea behind shared decision making is that the patient’s opinion is just as important as the doctor’s. Specifically, shared decision making holds that:

• Patients are the experts about their bodies
• Doctors and patients should discuss options together, including the risks and benefits
• Patients’ preferences, beliefs, and values must be part of the equation

Shared decision making only works when patients understand the choices available to them. That’s why we ❤︎ decision aids — tools that explain the options as well as the benefits, risks, and costs. Some decision aids are web-based tools, while others are printable handouts.

This will come as no surprise, dear readers, but creating decision aids that are written and designed with your audience in mind can go a long way toward supporting shared decision making.

Here are a few particulars to keep in mind when you’re creating a decision aid:

• Write in a conversational tone
• Support your content with graphics (consider mainly visual tools for people with very limited literacy skills)
• Translate content into patients’ languages
• Test, test, test — even if informally — with your audience

The bottom line: It’s best when patients and doctors are partners in health care — and plain language decision aids can help make that happen.