Category: We Heart Health Literacy

We’ve all seen the devastating news from Flint, MI. Many of us have already taken action — either personally or professionally. As health communicators, we have an important role to play in educating the public (or sometimes just our friends and family) when a health crisis makes headlines. Especially when it’s a complicated environmental health topic like lead poisoning.

You see, dear readers, lead poisoning prevention is near and dear to our ❤s at We ❤ Health Literacy Headquarters. We see it as a social justice issue, as lead poisoning disproportionally affects already vulnerable populations — like people of color, refugees, and people who can’t afford lead-safe housing.

As we communicate about the health impact of the crisis in Flint — and about the ongoing prevention efforts throughout the country — here are a few tips to keep in mind:

• Use plain language to explain the causes and dangers. Watch out for jargon like exposure or monitor.
• Make sure your message is appropriate for your audience. For example, telling the residents of Flint that lead poisoning is 100% preventable certainly isn’t the best approach at the moment. Instead, focus on clear action steps that concerned parents can take — like drinking bottled water and getting kids tested for lead poisoning.
• Never rely on numbers alone to communicate risk. If you’re following the Flint lead crisis news coverage, chances are you’ve been hearing about parts per billion (how lead is measured in water) and micrograms per deciliter (how lead is measured in a child’s bloodstream). With complex measurements like these, it’s even more important to give context for what certain measurements actually mean for individuals and their families.

It’s also important to remember that lead poisoning doesn’t only come from catastrophic events like Flint. CDC has some great plain language resources on lead poisoning prevention (disclaimer, we may have had something to do with these, back in the day):

• Lead Poisoning: Know the Facts
• Lead Poisoning: 5 things you can do to help lower your child’s lead level

The bottom line: Public health disasters like the lead poisoning crisis in Flint can offer valuable reminders about the critical need for effective health communication.

Online surveys can be great tools for learning about your audience, but it’s important to create them carefully to get the information you want — especially if your audience has limited literacy skills.

Whether you’re using existing survey questions or creating new ones, plain language and clear design principles apply (surely this is not surprising, dear readers).

If your survey is full of jargon, you might be testing how well your participants understand the survey itself, rather than getting accurate answers to your questions. (In fact, if your audience has extremely limited literacy skills, a written survey may not be a good way to gather information at all.)

Keep these tips in mind to make sure you’ve applied plain language and clear design principles to every last nook and cranny of your survey:

• Write clear and simple instructions. If participants can select more than one answer, ask them to “Check all that apply.”
• If you’re using a scale, make sure it’s consistent and easy to understand. For example, if 1=bad and 10=good in the first question, stick with that format for the following questions, too. Switching up the response order can confuse participants and leave you with bad data.
• Left-justify questions, charts, images, and the Next/Previous buttons. When you center or right-justify important information, it’s easy for participants to skip over it.
• Add visual cues to help participants follow along. Number questions, be sure to use plenty of white space, and let folks know how many questions are left.
• Split questions into multiple pages. Long, scrolling surveys take longer to complete (it’s so easy to lose your place!) and participants are more likely to miss questions. Instead, separate information into meaningful chunks, and arrange the chunks in a logical order.
• Pilot test your survey. Test your survey with a small number of participants (10% of your total sample is a good rule of thumb) to work out any kinks.

The bottom line: Apply plain language and clear design principles to your surveys to get data you can use.

We’ve warned you, dear readers, about the use of subpar illustrations and photos. Today, we focus on the exciting potential of using (well done) GIFs to support your health messages.

GIFs (graphics interchange format files, if you were curious) are a great way to help deliver a complex message — like when you need to text a friend about how excited you really are. They can also come in handy when you’re trying to convey health behaviors that are hard to describe in words.

For example, you can create custom GIFs from illustrated images to easily show a specific movement — like these exercise GIFs.

One advantage of using GIFs is that, unlike video clips, they don’t need to show real people or places. With animated images, you have more control over the message. For example, this resource from the American Academy of Pediatrics helps concerned parents identify and communicate about physical developmental delays. It includes several GIFs comparing movements of a child with typical development to movements of a child with a physical developmental delay.

These animated illustrations let parents focus on the movements that you’re trying to draw their attention to — and not the child’s adorable outfit, the toys scattered across the floor, or other details that aren’t part of the main message.

The bottom line: Consider GIFs when creating health content. And give yourself a high five for your health literacy prowess!

A common question we get from clients and readers alike is, “Should I use ‘sex’ or ‘gender’ in my health information?” Never fear, dear readers, we’re here to set the record straight!

Sex is biological. It’s about your chromosomes, your anatomy, and your hormones. In terms of sex, most people are male or female.

Gender is social. It’s how your identity relates to society’s ideas of what it means to be a man or a woman.

While it may be tempting to use these terms interchangeably, it’s not accurate. It’s not always as simple as male = man and female = woman. Some people are intersex, meaning their physical sex characteristics aren’t typically male or female. And for transgender, non-binary, and agender people, their gender doesn’t “match” the sex they were assigned at birth.

For health communicators, it’s important to be clear about what we mean. When you find yourself about to write “sex” or “gender,” take a moment to think about what you’re really trying to say. (And if you’re working on a form or survey, think about whether you need to ask about gender at all.)

For example, if you’re talking about prenatal testing, you’re definitely looking at the baby’s sex. That 20-week bundle of joy has only just started to develop a nose — it has no idea what its gender is.

On the other hand, if you’re talking about which groups face the highest rates of intimate partner violence, that’s gender. It’s about how people are perceived and treated as men or women, not about their physical characteristics.

The bottom line: Resist the temptation to use “sex” and “gender” interchangeably — think through what you mean first.

We’ve talked about knowing your audience and tailoring your content, but how do you write relevant content when your target audience is very broad? Say, all Americans ages 18 through 45?

That’s a big group of people with really varied demographics. In these instances, your main objective is to not exclude any of your readers. You do this by focusing on things that are accessible to — and inclusive of — nearly everyone in your target audience.

Use these tried-and-true tips to create content that will work for (almost) everyone you’re trying to reach:

• Use common, realistic examples. Cross-country skiing is a great way to stay active, but it’s not an option for people in warmer climates or those who can’t afford the equipment. Instead, give low-cost exercise examples that could work in warm and cold weather — like walking or playing catch.
• Avoid assumptions. Let’s say you’re writing content for pregnant women. Instead of saying “your husband,” “the father,” or even “your partner,” try using more inclusive language, like “partner, family member, or friend.”
• Test your materials. Ask research participants: Who do you think this material is written for? Would you be able to do these action steps? Then adjust as needed.

As always, keep your message concise and in plain language.

The bottom line: When you’re writing for a broad audience, consider their diverse needs to make sure your content hits the mark.

As the calendar pages of 2015 dwindle, let’s commit to making 2016 bigger, better, and more health literate than ever! We can do it, dear readers.

Still looking for a resolution? Here are a few to ponder (even though you’re probably already doing them because, well, our readers are the best!):

• Lose the jargon and use plain language terms
• Use the CDC Index to see if you can make your content even better
• Make sure your online content is accessible to people with disabilities
• Test your materials with users — especially with people who have limited health literacy skills
• Remember that health literacy isn’t only about written communication — the same principles apply to how you communicate health information in person

The bottom line: In 2016, recommit to making health literacy a priority in the work you do.

We hope your 2015 has been filled with plain language, clear design, and calls to action!

And we wish you, our dear readers, a very happy and healthy holiday season!

Cheers,
Your friends at CommunicateHealth

[Editor’s note: We have a few hardcore Star Wars nerds here at We ❤ Health Literacy headquarters and their enthusiasm in these final days before the release of The Force Awakens has gotten unbearable. In an effort to distract them, we’ve given them this week’s post — sincere apologies to all you non-Star Wars lovers out there.]

The wisdom of Star Wars has been applied to just about everything — from religion to psychology to philosophy. So why not health literacy? Drop your blasters and get some health literacy tips from a galaxy far, far away.

Have a clear main message. Remember the good Star Wars movies? About those kids who fight evil and save the galaxy? That clarity worked. The ones about the trade embargo that is actually just a ruse disguising a power play by the senator from Naboo, who secretly is — well, those didn’t work quite as well.

Test (and retest) your materials. Clearly, the Empire needed to do more prototype testing. How else can we explain the obvious flaws in the construction of the Death Star’s thermal exhaust port and reactor? You know, the ones that got it blown up — twice?

Use plain language. Think about all the famous Star Wars quotes: “May the Force be with you,” “I am your father,” and “Help me, Obi Wan Kenobi — you’re my only hope.” Simple and direct. And sure, technically they’re called All Terrain Armored Transports, but everyone calls them walkers. Always use language that regular people use.

Cut everything that’s not essential. As it turned out, Luke did just fine without that hand.

Keep it simple. Did you see Yoda living in a splendid palace befitting his status as the greatest Jedi in the galaxy, pampered by Rodian and Twi’lek servants? Nope — dude is living solo in a boggy tree trunk. If ever a Muppet embodied the principles of simplicity, it’s him. (Just don’t write like Yoda — know what we mean, you do, hmm?)

The bottom line: May the Force be with you, health literacy fans. And let’s hope Episode VII is one of the good ones.

Cancer is a confusing, scary subject — so it’s no surprise that it’s also a tricky one to write about.

As you know, dear readers, communicating about cancer involves a lot of complex terminology. And when people are under a lot of stress (like when they’re worried about cancer), their reading comprehension drops regardless of their usual level of health literacy.

So before you use a complex cancer term, always ask yourself if there’s a simpler, more direct replacement that’s still medically accurate. For example:

“If the cancer is metastatic, you may need different treatment.” Instead of using “metastatic,” can you say, “If the cancer has spread”?

“We will run tests to find out if the tumor is benign or malignant.” Try to avoid words like “benign” and “malignant” — and even the confusing word “tumor” when possible. Instead, you could just say, “We will run tests to find out if you have cancer.”

“You may need a biopsy of the prostate tissue.” Leave out the jargon word “tissue” and say where it’s coming from (in this case, the prostate).

“Biopsy” is trickier. With some audiences, you could simply call it a test. But if you’re talking to people who may need repeated biopsies, teach the term instead. Add a sentence like, “During the biopsy, a doctor will take a small sample of your liver to test it for cancer.”

Keep in mind that you can’t always use these simpler substitutions. Depending on your audience and goals, you may need to use more complex terms. That’s okay, as long as you explain them in plain language.

The bottom line: When you’re writing about cancer, avoid jargon when you can — and explain important terms in plain language when you need to.