Category: We Heart Health Literacy

Now that beach season is finally upon us, it’s time for another installment of the We ❤ Health Literacy Book Club. For this one we’re branching out a bit — the book isn’t so much about health literacy as it is about public health in general, but we ❤ it and we bet you will, too.

Randy Shilts’ award-winning And the Band Played On achieves something that not many public health books do — it’s a total page-turner! Originally published in 1987, it tells the story of the first 5 years of the AIDS epidemic in the United States. And it really is a story — the book is an almost-daily account of the key players living through the early days of the epidemic.

Stilts’ work is deeply rooted in his criticism of the initial reaction to the AIDS crisis — he condemns the medical world, the scientific community, and most particularly the Reagan administration for a flawed response that cost an unspeakable number of lives.

It’s a moving story that also serves as a reminder to do our homework. The issues we communicate to consumer audiences may have complex, emotional, and nuanced stories behind them — and we’ll be better at our jobs if we’re familiar with their implications.

The bottom line: Get the whole story of the early days of AIDS from Randy Shilts’ And the Band Played On.

With summer around the corner, it’ll soon be time for things like picnics, long strolls in the park, and… helping people prevent dehydration. So here’s another installment of “Complicated health terms: When to skip them, when to teach them.”

As health educators, we often have to decide if a complex medical term is essential to our message or not. “Dehydration” is one of those words.

Say you’re writing a blog post about how to stay safe and healthy this summer. Since dehydration isn’t the only topic you’ll touch on, you don’t need to complicate things with that particular term. It’s probably enough to say: “Be sure to drink plenty of water because your body loses water when you sweat.”

On the other hand, if you’re writing something more in-depth that’s targeted to a particular audience — amateur athletes or older adults, perhaps — it makes sense to use “dehydration” and explain it. You might say something like:

Be sure to drink plenty of water when you’re out in hot weather. If you don’t drink enough, your body will lose too much water when you sweat — which can cause problems like headaches, dizziness, feeling tired, and muscle cramps. This is called dehydration, and it can be a very serious health problem.

The bottom line: Whether you need to use “dehydration” depends on your audience and the purpose of your material. Keep things simple and only use it when you need to.

Dear readers,

We’re taking a break from our usual tip to give a very big thank you to each and every one of you. This little idea we had nearly 2 years ago now has well over 1,000 subscribers — not to mention our fans on Twitter and our blog.

We love interacting with our readers, so don’t be shy — send us an email, leave a comment on our blog, or tweet to let us know what YOU want to hear about. Are there certain jargon terms you wrestle with and just haven’t found a great alternative for? What battles are you fighting with subject matter experts who still aren’t buying this plain language thing? What health literacy resources make your heart go pitter-patter?

And please spread the word. Let your colleagues know they can sign up today.

Thanks again — we really can’t do it without you. (Well, we could, but it’d be pretty silly.)

Cheers,
The We ❤ Health Literacy Team at CommunicateHealth

Have you ever clammed up while expressing concern about a loved one’s health? Or felt embarrassed when talking with the doctor about bodily functions? Or dreaded having to explain to the receptionist why you need to see the doctor ASAP?

It’s not just you. We think it’s safe to say most of us have. And that’s because talking about personal health issues can be anxiety inducing (not to mention off-limits in polite conversation!) — so we tend to avoid it. And that can get in the way of health.

That’s why we want to draw your attention to a format we ❤ for talking about tough issues: conversation tools. Creating a conversation tool gives people the language they need to communicate effectively about a challenging health topic. And that can make a really big difference.

Conversation tools are different depending on what you’re trying to accomplish, but they all offer questions or statements to use when talking about a health issue.

For example, conversation starters can help someone find the right words to talk with a loved one. Offering questions for the doctor can help a person communicate better with a provider. And more comprehensive step-by-step conversation guides are great for a person preparing for an in-depth, challenging discussion.

The next time you’re developing health information, try incorporating a conversation tool. We think your audiences will ❤ it.

The bottom line: Talking about health isn’t easy — help people communicate better by giving them the language they need.

In our last installment on testing techniques, we talked about card sorting — a simple exercise that helps you develop an intuitive, logical sitemap for your website.

Card sorting is great when you’re building a website from the ground up. But what if you’re trying to find out how well an existing website is organized? That’s where tree testing comes in.

Think of a website as a tree with branches that keep dividing. The more branches you follow, the further you go into the site. Tree testing helps you learn how intuitively those branches are organized. Do the branches — or paths — lead people where they expect? Is information located where they think it will be?

The process is simple. Participants sit down with the testing software, which is loaded with a basic version of the sitemap. You pre-load instructions with a few tasks — things like, “How would you get driving directions?” or “Where would you find out about treatment options?”

Then you let participants do their thing. They don’t see the whole sitemap at once. Instead, it’s revealed as they go — like a real website. Once a participant clicks on an initial topic, the software shows the available subtopics.

The tree testing software records where participants clicked and if they completed the task. The results will tell you a lot. Did they find the right spot directly? Did they hit a dead end and backtrack? Did they give up altogether?

We ❤ tree testing because it gives potential users a powerful voice. Their choices tell you what’s working on your site and what’s not — and then you can fix it.

And a pro tip: This isn’t a great testing technique for users with very limited literacy skills. However, the results you get from other participants will improve the website for all users. What’s not to ❤ about that?

The bottom line: Tree testing helps you create a website where users can easily find what they want — because it’s exactly where they expect it to be.

Change is never easy — and convincing your target audience to take action and change their behavior is harder still. Using plain language and good design are key, but health communicators also need to know how to motivate their audiences to make a change.

Fortunately, smarty-pants academics are hard at work developing models and theories that help us understand how and why people change their behavior. Our Useful Theory series takes a look at some of these models. Last time, we checked out the Stages of Change. Today, we’re exploring Icek Ajzen’s Theory of Planned Behavior.

The gist of the theory is that a person’s behavior depends on the answer to 3 main questions:

• What do I think will happen if I do this behavior? How likely is a good outcome versus a bad one? (Behavioral beliefs)
• What do others think about this behavior? Do other people expect me to do it? How much do I care about their opinions? (Normative beliefs)
• Do I think I can realistically do it? What’s going to make it easier or harder for me? (Control beliefs)

Let’s say you’re trying to convince your audience to quit smoking (which is a great idea!). Talking about the harmful health effects of smoking might work — but what if your audience’s main concern is that all their friends do it and think it’s cool? Or maybe they already know it would be healthier to quit, but think it’ll be too hard.

As you develop your health content, think about how your audience might answer the 3 questions. (Or, better yet, do some user testing and find out for yourself!) By addressing likely barriers and concerns, you can empower your target audience to make positive, healthy changes.

The bottom line: If you want your target audience to change their behavior, identify and address the factors that might be holding them back.

As we may have mentioned once or twice, we ❤ testing with your target audience — especially when the audience is people with limited health literacy skills. Your product will be more useful, relatable, and relevant because of it. But recruiting participants with limited health literacy skills isn’t easy.

After all, you can’t just walk up to someone and ask, “What’s your level of health literacy?” But you can find the right participants by partnering with local, community-based organizations — like adult learning centers, community health centers, social service organizations, and senior centers.

Check out some of these tried-and-true tips to recruit participants with limited health literacy skills:

• Screen for participants by demographic measures associated with limited health literacy. For example, look for people who have a high school education or below, a low household income (this differs by state, but it’s usually around $40,000 or less), and who haven’t searched for health information online in the last year.
• Create outreach materials in plain language. Skip terms like “usability” and “participant.” And whatever you do, don’t call it “testing!” Try a phrase like “feedback session” instead. Use a conversational tone to help folks feel more comfortable.
• Conduct research in a place that’s easy to get to and comfortable for the target audience. We ❤ trusted community centers on public transportation routes.
• Set a relaxed tone by dressing casually, interacting in a friendly manner, and offering healthy snacks. You don’t want your participants to feel like they’re being tested or studied. Remember, you’re testing the product, not the people.
• Offer cash incentives when you can. Gift cards and pre-paid credit cards have limitations — they can’t be used to pay bills and other living expenses.

The bottom line: To recruit people with limited health literacy skills, connect with community-based organizations and screen for participants from demographics associated with limited health literacy.

Design thinking is a step-by-step way to approach the creative process. Much in the way that you would follow steps to conduct an experiment or program an app, you can use design thinking to guide your creative process. And it puts the end-user at the center of your thinking, which is something we really, really ❤.

The best part is that you don’t have to be a designer to use design thinking! It’s intended for anyone trying to come up with a creative solution to a problem. Try it the next time you’re faced with a health communication challenge.

Here’s how it works:

1. Empathize with the target audience by becoming an audience member or involving yourself with the group (for example, try to do the activity yourself or observe and talk with members of the target audience)
2. Define the specific problem based on your observations during the first step
3. Ideate as many possible solutions to the defined problem — push yourself to think outside of the box
4. Prototype by building working examples of the possible solutions
5. Test your prototype with users to see if it successfully addresses the defined problem

You can repeat any step as often as needed until you find a solution or product that works.

Want to learn more about design thinking? Try the 90-minute design thinking crash course from the Institute of Design (d.school) at Stanford. The school has popularized the method by introducing it to a variety of fields, including business, medicine, and science.

The bottom line: The next time you have a problem to solve, try using design thinking to come up with an effective user-centered solution.

Because it’s our — err, we meant your — favorite kind of post, we’ve got another installment of our unofficial “use simpler words” series. On the chopping block this week: “monitor.”

Consider these somewhat vague statements:

• We’ll be monitoring your blood pressure from now on.
• Monitor your child’s fever to make sure it’s not getting higher.
• Use this home kit to monitor your blood sugar.

Now take a look at these simpler, clearer, and more specific alternatives:

• We’ll be checking your blood pressure regularly from now on.
• Take your child’s temperature every hour to make sure her fever isn’t getting higher.
• Use this home kit to test your blood sugar each day.

And there you have it, dear readers. The word “monitor” implies an ongoing action, but it doesn’t say anything about frequency. Your health information will be more useful and specific without it.

Plus you won’t run the risk of anyone thinking you’re talking about a computer screen. That’s what we call a win-win.

Bottom line: Be more specific and less confusing by retiring the word “monitor.”