Category: We Heart Health Literacy

For today’s We ❤ Health Literacy Book Club, we dive into a book that’s required reading at CommunicateHealth. Now in its third edition, Don’t Make Me Think: A Common Sense Approach to Web Usability by Steve Krug is a quick read, but the lessons it contains have true sticking power.

If you’re creating or managing a website and you only have time to read 1 book, dear reader, make sure this is it.

The title tells you a lot about Krug’s recommendations for creating easy-to-use websites. The book does a great job illustrating the differences between what you probably want to build (a website with great, detailed content and logical information architecture) and what your users will be looking for (obvious clues that quickly and easily lead them to the information they want).

Krug gives us health communicators the harsh truth: People usually scan pages quickly and just muddle through a site until they stumble on what they’re looking for. So if we want all of our great content to be findable, we have to pay attention to things like visual hierarchy, simple design, and following web conventions.

The book tells you how to do all this and more — in fewer than 200 easy-to-scan illustrated pages with plenty of white space.

And if you have time to read a second book, a great companion to Don’t Make Me Think is Ginny Redish’s Letting Go of the Words. Keep these books nearby and refer to them often. Your website users will thank you!

The bottom line: Set your website users up for success and happiness by following the tips in Don’t Make Me Think.

National events and conferences are great places to pick up new ideas, get perspective and inspiration, and strengthen your health communication muscles. They’re also excellent opportunities to meet other health literacy advocates, swap resources, and share strategies.

Here are just a few of our favorite health literacy events coming up this year:

Institute for Healthcare Advancement (IHA) Health Literacy Conference
May 6–8 • Irvine, CA

Tufts University Health Literacy Leadership Institute
June 8–12 • Boston, MA

National Conference on Health Communication, Marketing, and Media
August 11–13 • Atlanta, GA

Health Literacy Research Conference
November 2–3 • Bethesda, MD

There are also plenty of regional events worth checking out, like the Oregon and SW Washington Health Literacy Conference or the Wisconsin Health Literacy Summit. To find events in your area, check your local Society for Public Health Education (SOPHE) chapter.

Mark your calendars!

The bottom line: There are lots of great events in 2015 where you can connect with other health literacy advocates.

Update: Silly us — we forgot to mention Plain Talk next week on March 12–13 in Arlington, VA where you can check out our very own Stacy Robison, Sandy Hilfiker, and Adam Moorman presenting!

Because of the Affordable Care Act, more people are getting health insurance than ever before. Yay!

On the less fun side of things, these new customers are wading through a pile of complex terms. Words like premium, deductible, co-insurance, and co-pay are just the beginning (don’t get us started on actuarial value). It’s enough to make anyone’s head spin.

As a health writer, you can help keep the chaos at bay by using plain language words and phrases as much as possible. When readers do need to know a term, don’t just use it — teach it.

The teaching approach is what we suggest for “co-pay.” Since this is a term that people are going to see again and again in the health insurance world, explain what it means and give an example:

What is a co-pay?
A co-pay is the amount of money you pay when you get a health care service. For example, if you have a $20 co-pay for doctor visits, you’ll pay $20 each time you go to the doctor.

The question we tend to get from our health insurance friends is, “What if they haven’t met their deductible yet, and what about the out-of-pocket maximum?” Our answer: “co-pay” is a relatively simple term on its own, and it’s best to keep it that way. If you have to, explain the deductible and out-of-pocket max separately. But don’t bog down the explanation of “co-pay” with more detail than your readers need.

Oh, and were you wondering where that mysterious “ment” went? “Co-pay,” not “co-payment,” is the term you’ll hear in everyday conversation. So keep it simple and stick with “co-pay.”

The bottom line: “Co-pay” is a health insurance term people need to know. So teach it — simply.

We self-professed health nerds love logic. We love researching, exploring, experimenting, and drawing conclusions. But even we don’t always rely on logic to make decisions in our day-to-day lives. Every day, people make decisions based on gut reactions — a phenomenon also known as the affect heuristic. These gut reactions cause us to automatically and unconsciously label things as good or bad in a split second.

Gut reactions aren’t always bad. They tell us to stay away from rattlesnakes. They remind us to give a trustworthy person another chance. But there are occasions where gut reactions and actual facts are at odds. For example, many people who are afraid to fly still get into a car multiple times a day — even though, statistically, a car trip is much riskier.

When we’re communicating about health, we need to be particularly aware of our audience’s gut reactions. This dynamic is clearly playing out in the current discussion over a parent’s choice to not vaccinate their child.

Historically, the public health community has focused vaccine messaging around the importance of herd immunity, fighting back with statistics, and dispelling myths (which often involves repeating the myth — one of our health literacy no-nos). None of these methods have been particularly effective.

In contrast, the anti-vaccine community has relied almost entirely on eliciting emotional responses from parents. Support for the anti-vaccine movement is born from emotion: a parent’s fear that vaccines will harm their child, a parent’s instinct that they know best how to protect their child, or a parent’s mistrust of modern medicine.

Here’s the good news: with this latest measles outbreak, the public health community is countering the anti-vaccine base with an emotional appeal for vaccination. We’re telling parents why vaccines matter. We’re telling them that vaccines keep children and people with compromised immune systems safe. We’re putting a face to the outbreaks of vaccine-preventable disease.

And that evokes the emotional response that can help us change minds and get kids vaccinated.

The bottom line: Always address your audience’s gut reaction to a topic — it’ll help your facts go further.

Given that we’re all glued to our phones these days, it’s no surprise that communicating about health (along with any other topic you can think of) is now happening via text message. Services like text4baby and smokefreeTXT are just a few of the campaigns paving the way for what will certainly become a more widely used health communication channel in the years to come.

It also probably comes as no surprise that we have a lot of good things to say about texting for health.

First, how often do we advocate for making health information accessible? Exactly. You can’t get much more accessible than someone’s pocket — which makes texting a great way to communicate about anything, health included.

Second, text messages are inherently short, so you have to get right to the point. As with Twitter, there’s no room for all that nice-to-know information. It’s need-to-know only. And you know how much we love that.

Third, texts are private — no actual human interaction required! This may be part of the reason why text messaging has proven effective in communicating about personal topics like sexual health.

The bottom line: Text messaging services can be an effective way to reach your audience with the health information they need.

In this installment of the We ❤️ Health Literacy Book Club, we’re presenting a book that’s not really about how to improve health literacy. It’s about the many reasons why health literacy is so important.

Rebecca Skloot’s The Immortal Life of Henrietta Lacks tells the story of the woman behind what are known as HeLa cells, the first human cells to grow successfully in a lab. Medical researchers still use HeLa cells today.

A book about science that also appeals to non-scientists, The Immortal Life of Henrietta Lacks is an accessible and fascinating combination of social history, science writing, and biography. The book raises some hard questions related to medical ethics, informed consent, mistrust of health care systems, and the many ways that racism impacts people’s health.

The intertwined stories of the Lacks family and the researchers who developed the HeLa cells give the author plenty of opportunities to explore these issues. As Lawrence Lacks, Henrietta’s oldest son, asks, “If our mother is so important to science, why can’t we get health insurance?”

In this video about the book, teachers describe reading Skloot’s book with their middle and high school students. One reader says, “If they had taught science like this in school, I would have taken so many more science classes, and who knows what would have happened?”

Now there’s an idea for improving health literacy. 

The bottom line: Pick up The Immortal Life of Henrietta Lacks to learn about one woman’s extraordinary impact on science — and for a reminder of why health literacy is so important.

Tweet about it: This #BlackHistoryMonth, @CommunicateHlth’s We ❤️ Health Literacy Book Club is revisiting The Immortal Life of Henrietta Lacks, a #PublicHealth must-read: https://bit.ly/3M27X4a #HealthLit

You know when you’re on a website and you just can’t find what you’re looking for? Like, “Where is this place located?” or “What’s the phone number so I can order take out because I’m hangry?”

We don’t have to tell you that’s enough to drive you crazy. A sitemap that isn’t intuitive can ruin a website, no matter how worthy the content. That’s why we’re big fans of card sorting — a testing approach that can help you create an intuitive site map.

Here’s how it works. You give participants a stack of cards, each with the name of a topic that’s on your website (for example, “types of flu vaccines,” “flu basics,” and “flu shot locations.”) Then, you ask the participants to group those cards into smaller stacks of topics that belong together.

You can either give the participants categories to sort the cards into (that’s called a closed sort) or let the participants create the categories themselves (an open sort).

Then you sit back and watch. As they sort the cards, your participants will show you what topics naturally go together in categories — and which topics don’t seem to fit anywhere.

Card sorting is crucial when you’re building a new website from scratch or dramatically overhauling an existing one. But what if you just want to see if your existing site map could use a few tweaks? In that case, you might want to use a related technique called tree testing — so stay tuned for Testing Techniques Part 2!

The bottom line: Every website needs an intuitive site map. Card sorting can help you decide how to organize and label your web content.

We ❤ how easy it’s become to access health information online. Just enter a symptom or disease into your favorite search engine and you’ll have the answers you want in no time.

But how do people without internet access get the information they need to take care of their health? The answer may warm your ❤.

In 2013, a study by Pew Research found that half of online health research is done on behalf of someone else. That means 1 in 2 online health searches are meant to help a family member or friend stay healthy and informed. And how do people searching on behalf of their loved ones get the information they’ve located to the person who needs it? Enter the printer.

That’s right — even if it feels a bit old school, don’t forget about people who may be printing out your online health content.

Here are a few options for ensuring printer-friendliness:

• Follow all the basics of good web design. Use lots of white space, good color contrast, a clear content hierarchy, and images that enhance content.
• Specify a print stylesheet — a unique stylesheet that will only be used when the browser requests to print the page.
• Design your site with fluid, percentage-based widths. Since you don’t know if the user will be printing from a phone, tablet, or computer, you can’t count on a certain width for printing.
• Make the print option obvious. Include a print button on every page to make printing quick and simple for the user.
• If your site uses pagination, make sure that printing will override that — or give users a “view all pages” option.

The bottom line: Make your online health information printer-friendly. It’ll reach a lot more people that way.

Most of us can name a few things we could do to live healthier lives: eat more fruits and vegetables, exercise for 30 minutes a day, get at least 8 hours of sleep every night.

So, because we know these behaviors will improve our well-being, we all do them, right? Um. Well, no.

The truth is that we’re not always ready to change our behaviors. In fact, research shows that at any given time, only about 1 in 5 people are prepared to give up an unhealthy behavior or adopt a healthy one.

According to the Stages of Change theory (also known as the Transtheoretical model), most of us go through 5 stages before and during behavior change:

1. Not ready (Precontemplation)
   You don’t intend to change your behavior in the next 6 months. You may see more cons than pros to changing, or you may have given up hope that you can make the change at all. You may not even know your current behavior is unhealthy. You may need information or encouragement.
2. Getting ready (Contemplation)
   You intend to change your behavior in the next 6 months, but you’re still reluctant. You probably think the pros and cons of changing are about equal, so you may need someone you trust to remind you of the pros.
3. Ready (Preparation)
   You plan to take action in the next 30 days. You believe the pros of changing outweigh the cons. You may begin taking small steps toward making the change, like telling your friends and family.
4. Action
   You have changed your behavior in the last 6 months. You may need to use techniques to keep you moving forward, like giving yourself rewards for making healthy changes.
5. Continuing (Maintenance)
   You changed your behavior more than 6 months ago. You need consistent support to avoid slipping back into the unhealthy behavior.

As health communicators, we can be more effective if we tailor messages to our audience’s stage of change.

Say you want to convince your friend to stop smoking. You may instinctively say, “Smoking’s bad for you! Stop smoking right away!”

But what if your friend hasn’t even begun to think about quitting? He’s probably not ready to throw his cigarettes in the trash and call it a day. He may need more information about the benefits of quitting or encouragement that quitting is possible.

So instead, you could say, “I want you to quit smoking because you’ll feel healthier and live longer. I know you may not be ready to quit now, but I believe you can do it eventually.”

It’s also important to remember that these 5 stages can fluctuate — for example, at the start of the year many people are at the gym trying to lose weight, but by Valentine’s Day they’re back on the couch contemplating.

The bottom line: When writing health information, consider where your readers are in the Stages of Change model. Then write action steps to match that stage.

High-fructose corn syrup. Lactose intolerance. Is it us or does it seem like there are lots of “-ose” words cropping up in health talk lately? So today we thought we’d talk about another “-ose” word that can be important in health writing — especially for the 1 in 11 people in the United States who have diabetes. That’s right, dear readers, let’s talk about “glucose.”

So, do we embrace the scientific word or opt for a simpler alternative? Our answer: it depends on your audience.

When writing for people who don’t have diabetes, skip the word “glucose.” After all, like most other “-ose” words, glucose is a type of sugar. It’s enough to just say “sugar.”

After we eat, our bodies break the food down into sugars. In most people, these sugars turn into energy. But in people with diabetes, many of these sugars don’t turn into energy — instead, they build up in the blood. That’s why people with diabetes have high blood sugar levels.

For people who will likely see the word again (like those who are newly diagnosed with diabetes), use and define “glucose” before giving an explanation.

Glucose is a type of sugar that your body makes when it breaks down food. In most people, glucose gets turned into energy. But in people with diabetes, glucose builds up in the blood. And too much glucose in your blood leads to health problems.

The bottom line: For most audiences, skip “glucose” and use “sugar.” For people who need to know “glucose,” use it — but keep the definition short and sweet.