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.
“Health Lit Live” is our series of interviews with the movers and shakers on the health literacy scene. In this edition, our imaginary illustrated host Doug Doodleman sits down with renowned health literacy expert — or as he describes himself, “notorious health literacy recidivist” — Dr. Michael Paasche-Orlow, Professor at Boston University School of Medicine. Dr. Paasche-Orlow collaborated with the National Library of Medicine (NLM), RTI International, and CommunicateHealth to create the Health Literacy Tool Shed.
Doug: Welcome, readers! Today we have — who is this? Oh yes, Dr. Paasche-Merlot, who’s going to chat with us about this Health Literacy Tool Shed he helped develop in his backyard.
Paasche-Orlow: Thrilled to be here!
Doug: Listen, I’m going to cut right to the chase. I already have a tool shed in my yard. It’s kind of ramshackle and I’m a little scared to go in it because tools can be so pointy. And, you know, spiders. I ask you this: Why should I go in your tool shed?
Paasche-Orlow: Doug, I’m going to be blunt here. It’s not that kind of tool shed. It’s a growing, curated online database of over 200 validated health literacy tools and assessments. It’s on the web, but there are no spiders.
Doug: Oh, they’re tools you get on the interwebs, eh? So tell me what these e-dealies do.
Paasche-Orlow: Well, health literacy is often a key variable in research. We want to know things like: How might a person’s health literacy affect her overall health? Or, did a new health campaign have an impact on a population’s health literacy? We need reliable tools to measure health literacy to find that out.
Doug: That makes sense.
Paasche-Orlow: There are a lot of health literacy assessments out there — many have been developed in just the last 10 years. Our idea was to create an interactive, one-stop shop where researchers could check out a variety of these tools and choose the one that best meets the needs of their project.
Doug: How would a researcher actually use the Health Literacy Tool Shed?
Paasche-Orlow: You can browse the tools or sort them by different criteria — like the type of health literacy you’re measuring, the specific focus, language, or how long it takes to do the assessment. Once you find what you need, you download it.
Doug: Cool! So can anybody hang a tool up in the shed? Just so happens I whipped up this pretty sweet tool backstage on construction paper with crayons and glitter and macaroni and —
Paasche-Orlow: Afraid not, Doug. We have clear criteria for what gets included. For example, every tool has to have been published in a peer-reviewed journal — we need a clear description of how the tool works and how it was developed.
Doug: Bummer. So how extensive is this collection? Do you have a measure of health literacy related to, say, dentistry and oral health?
Paasche-Orlow: We have several, actually.
Doug: Color me impressed. How about a tool to assess health literacy in Cantonese-speaking patients with diabetes?
Paasche-Orlow: Yep.
Doug: Amazing! What about a tool to assess “transcripts” of fictional health literacy focused talk shows hosted by fabulously telegenic doodles — in Elvish?
Paasche-Orlow: You got me on that one.
Doug: Kind of an oversight, don’t you think?
Paasche-Orlow: Sure, Doug. But you can suggest it using the online form on the website. We encourage users to recommend tools they think we should add, so the site is as useful as possible.
Alt: A doodle in a chef’s hat and an apron that reads “I love PL” enthusiastically prepares a Thanksgiving turkey. There are many ingredients on the table, with labels like “Active Voice,” “Bulleted Lists,” “Chunks,” and “White Space.”
It’s that time of year again! A time to give thanks, share gratitude, and (of course) eat a nice slice of pumpkin pie.
We’re incredibly thankful here at We ❤ Health Literacy Headquarters for you, our dear readers. So we thought we’d share some ideas to help you showcase your stellar health communication skills at the Thanksgiving table.
You know that time-honored tradition where everyone shares what they’re thankful for? And when it’s finally your turn you sit there, tongue-tied, hiding behind your fancy napkin even though there’s so much you could say?
Fear not — here’s the perfect recipe to give thanks the plain language way.
Just a pinch.Keep it short and sweet. Grandma’s already starting to fall asleep in her mashed potatoes.
A dash of this (not that!).Skip impressing your friends and relatives with jargon — no need to talk about your fantasy football “proficiencies” when you can say “mad skills” instead.
A scoop of specifics.Why exactly are you thankful for [insert name or thing here]? Don’t be vague — give an example. It’ll show how thoughtful you are!
The bottom line: This Thanksgiving, don’t just give thanks for plain language — give thanks in plain language, too!
You’re sitting down to write your latest, greatest health content. You’ve got a topic and a message, and “plain language” is practically your middle name. So, are you good to go? Not quite yet — you need to know your audience, too.
You wouldn’t talk to your best friend the way you’d speak to your insurance broker or your grandmother. And of course, dear readers, the same logic applies to health content.
Take some time at the start of your project to sort out your audience. Ask yourself about their age, race and ethnicity, cultural background, and reading level (and write down your answers so you can refer to them as you write). Also think about other factors that might influence how they approach your content, like gender or health status.
Then tailor your content so it specifically speaks to your audience:
Choose examples that are familiar to your audience. If you’re including a sample recipe in your content, be sure it has ingredients your audience already knows about.
Make suggestions that are realistic for your audience. If you know that cost is a barrier to healthy eating, include tips for food shopping on a budget.
Choose stock photos your audience can identify with. You may have a great picture on hand of an African American family sitting down to a turkey dinner, but if you’re trying to reach East Asian teenagers, save it for another time.
Finally, don’t forget to test a draft with members of your target audience.
The bottom line: Readers are more likely to act on your health content when it’s relatable.
It’s a very exciting week in health literacy land, dear readers! One of our all-time favorite resources has been updated to include the very latest in best practices of user-centered design, usability, and health literacy.
That’s right, the second edition of Health Literacy Online is here! This research-based guide has practical tips for creating easy-to-use health websites and digital health information tools.
Wondering how to improve user engagement? Not exactly sure what makes a helpful search function, um, helpful? No problem — Health Literacy Online has your back.
The guidance in the latest edition reflects the fact that many more people are now accessing the internet on mobile devices (you’re totally reading this on your smartphone, aren’t you?). In today’s mobile-heavy digital world, this is important stuff.
There’s also a really cool section about conducting user testing with participants with limited literacy or health literacy skills, plus valuable information about the cognitive processing and online behaviors of people with limited literacy skills.
A disclaimer here: We were involved in the development of this guide, so we’re a teensy bit biased. Regardless, we’re pretty confident that you’ll ❤ the second edition of Health Literacy Online, too.
The bottom line: Check out the latest edition of Health Literacy Online — you won’t be disappointed.
Write in the active voice, not the passive! You’ve probably heard this advice from some wise communicator types before — you know, like us. But how can you tell whether a sentence is active or passive?
“If only there were a simple test,” you think to yourself. “Ideally, one with a seasonally appropriate spooky theme.”
Well, dear readers, have we got the passive voice test for you! Just in time for Halloween, we present the Zombie Test, devised by Rebecca Johnson, PhD, from the Marine Corps University.
How does it work? Just insert “by zombies” right after the verb in your sentence. If the sentence makes sense with this undead addition, it’s passive — and you probably want to revise it. If it doesn’t make sense when you add “by zombies,” you’ve got an active sentence on your hands.
Behold the test in action.
The epidemiologists reassured by zombies the fidgeting trick-or-treaters.
That sentence doesn’t make sense with the added zombies, so it’s active. It’s already got a clear subject (the epidemiologist) who’s doing the action (reassuring), so you’re all set. But what about this?
The form needs to be processed by zombies before the prescription can be dispensed by zombies.
Who’s doing the processing and dispensing? There’s no subject! It’s passive! Run for your life!
But there are tools that can get you a lot closer to creating health education products that will work for your target audience. Earlier this month, we discussed the CDC Clear Communication Index. Today, we discuss another favorite: The Suitability Assessment of Materials, or the SAM. (Go to chapter 4, page 41 to get started with the SAM.)
The thing we ❤ about the SAM is that it includes factors that affect readability and factors that affect comprehension. The tool groups these factors into 6 areas:
Content
Literacy demand
Graphics
Layout and type
Learning stimulation and motivation
Cultural appropriateness
Swoon.
Distinct as these factors may be, they all play a role in how useful a material is, so it’s helpful to have them represented together in a single tool. Consider each of the 6 areas as the ingredients you need to combine to create a clear, useful product.
Using the SAM is pretty straightforward. Each of the 22 factors gets a score of 0, 1, or 2. At the end, you get a score that deems your material superior, adequate, or not suitable.
No surprise here, but we recommend revising your materials until they’re superior!
The bottom line: Use the SAM to help you develop better health communication products.
Infographics are all the rage lately — and it’s easy to see why. Their visual appeal makes them 30 times more likely to be read compared to text articles. Plus, information that’s presented visually is easier to understand and remember. What’s not to ❤?
Keep it accurate. Start with reliable raw numbers and choose a type of visualization that makes sense for your data (none of these, please!).
Choose ahero statistic. Make the most impressive fact you’ve got the focal point of your infographic.
Tell a story. Use your hero statistic and other supporting data to construct a narrative that drives home your main message (you do have a main message, right?).
Design thoughtfully. Use elements like contrast, visual weight, placement, and shape to make your hero statistic “pop.”
Keep it simple! Keep text to a minimum, include plenty of white space, and stick to a limited color palette so you don’t overwhelm your reader.
Design with sharing in mind. Horizontal infographics — or those that can be broken into horizontal sections — are easier to share on social media.
The bottom line: Good infographics aren’t just pretty pictures — they use visual data to tell a story. Use a hero statistic and simple, intentional design to make yours a winner.
In honor of Health Literacy Month, We ❤ Health Literacy is kicking off a new series of interviews with the movers and shakers on the health literacy scene — “Health Lit Live.”
In our very first installment, our imaginary host Doug Doodleman raps with Dr. Cynthia Baur about the CDC Clear Communication Index, which she helped develop. Dr. Baur is a health literacy and plain language specialist and Senior Advisor in the Office of the Associate Director for Communication at the Centers for Disease Control and Prevention (CDC).
Doug: Thanks so much for joining us today here on the World Wide Web, Dr. Baur.
Dr. Baur: Thanks. It’s a pleasure to be here, so to speak.
Doug: So, CDC, eh? That makes me think: Hazmat suits! Outbreaks! Disease detectives! Do CDC communicators go out into the field to do cool stuff, too?
Dr. Baur: Depending on the situation,
communicators may go into the field as part of investigations and work alongside the epidemiologists, or disease detectives. For example, many communicators have deployed and are still going to West Africa for the Ebola response.
Doug: Wow! Communicators to the rescue! Okay, so tell me about this new-fangled CDC Index — it’s a tool to help people assess the clarity of their materials, right?
Dr. Baur: You’re right. A lot of readability formulas are pretty weak — just counting syllables or sentence length, which won’t tell you much. Communication checklists are often long and hard to use, with scores that can vary widely depending on who’s doing the scoring.
Doug: So what makes the Index better?
Dr. Baur: We took a different approach. Because
we’re a science-based agency, we created a science-based tool — one that takes some of the subjectivity out of scoring. We developed 4 questions and 20 items to score. We don’t ask people who are scoring to assess the quality of a document — instead, they’re looking for specific items, like “Is the main message at the top, beginning, or front of the material?” and “Does the material use numbered or bulleted lists?”
It’s more objective than other tools and it includes some aspects of communication that other tools don’t consider, such as how numbers are presented.
Doug: Okay, but let me be blunt: I’m an extremely busy doodle, what with being an in-demand illustrated individual and whatnot — and my dear readers are busy too. Even if the science supports it, who’s got time for another tool?
Dr. Baur: We get it. So we designed the Index with ease of use in mind. Once you become comfortable with it, you should be able to score a material in about 15 minutes.
Doug: Gosh! And what would I need to access this Index? A mainframe computer running UNIX? CDC clearance with a retinal scan and biometric —
Dr. Baur: Nope. Anyone can go to the website and begin using the scoring widget right away. That’s it.
Doug: Well that sounds easy! So Dr. Baur, my last question is this: Could you set me up with one of those cool windbreakers with the CDC logo on the back? So I could yell “Stay calm! There’s been a dangerous outbreak of jargon! Evacuate the — ”
Dr. Baur: No.
Doug: A hat?
Dr. Baur: No.
Doug: Okay! Thanks, Dr. Baur! And dear readers, be sure to stay tuned to your internet-based reading machine for the next installment of Health Lit Live!
It’s October, dear readers: Time to enjoy the fall colors, go apple picking, add pumpkin spice to everything you eat — and celebrate Health Literacy Month!
Of course, every month is Health Literacy Month here at We ❤ Health Literacy Headquarters. But we’ll jump at any excuse to spread the word, so this week we’re sharing a roundup of WHHL health literacy basics. Enjoy!
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