Category: We Heart Health Literacy

This week, we share our top design tips for health information. Enjoy!

1. Plan where your content will live. Will it live on a printed flyer, on a website, on a mobile app, on a houseboat in the Florida Keys? Each platform requires a different design approach. Wherever your content will live, plan for design accordingly — before you develop the content.

Source: usability.gov

1. Chunk content. Organize your content into easy-to-look-at chunks. This will make your material look appealing and keep your reader from getting overwhelmed. Keep your paragraphs and line lengths short.

Source: healthfinder.gov

1. Make room for white space. We never tire of preaching the benefits of white space. Keep in mind that white space is not always “white.” It’s just space on the page that gives your content (and reader) room to breathe.

Source: NYC.gov

1. Achieve balance. It turns out in both life and design, we need balance. The composition of a page, from its layout to its colors, needs to appear balanced.

Source: Burton.com

The bottom line: When developing health information materials, don’t forget that good content needs good design.

So what exactly is the difference between plain language and readability? And what about health literacy? How do they fit together? Or are they the same?

Never fear, dear readers! We’re here to take a quick look at what it really means to talk about readability, plain language, and health literacy. They’re all important — and they’re definitely related — but each term means something different.

Readability is how easy (or not) something is to read. Readability formulas measure this by looking at the length of the words and sentences in a document. They can tell you what grade level your document is written for, and they’re everywhere — Microsoft Word even has one built in. But we’re not fans of these formulas because they don’t take into account plain language principles or the user’s context.

Plain language is writing that people can understand. It ensures that people can easily grasp your message the first time they read it. We’ve written about many plain language principles before, like:

• Using familiar terms
• Chunking information
• Writing in a conversational tone

When you get plain language right, readability naturally comes with it. But something written in plain language won’t improve health literacy if people don’t know what to do with the information.

Health literacy is a person’s ability to access, understand, and use health information so they can make informed choices about their health. It’s a complex concept that depends on the quality and clarity of the communication as well as the skills and experience of the user. On the communication side, plain language is important — but writing for health literacy also means making the content relatable and actionable for your audience.

Whew. Now you have the facts you need to settle all those heated cocktail party disputes. (No really. We talk about this stuff at cocktail parties.)

The bottom line: Readability, plain language, and health literacy are all important — so it pays to understand what makes each unique.

Tweet about it: What’s the difference between readability, plain language, and #HealthLit? @CommunicateHlth explains: https://bit.ly/2uLSRsU

Let’s kick off this post with a fill-in-the-blank exercise:

• “I’m feeling sick. I think I’ll go see my ______.”
• “An apple a day keeps the ______ away.”
• “Just what the ______ ordered.”

For now, keep your answers to yourself. And no cheating! We’ll come back to them later.

This week we’re addressing a question we get a lot at We ❤ Health Literacy Headquarters. When writing about health care professionals for a general audience, is it best to say “doctor,” “provider,” or something else altogether?

Technically speaking, titles depend on degrees (obvs). But unless you’re staring at a framed diploma, knowing the best way to refer to a health care professional can be tough. Our advice is to keep it simple and go with what most people use in everyday conversation: “doctor.”

Yes, there’s technically a difference between a doctor, physician, clinician, nurse practitioner, psychologist, physician assistant, and so on. But when people are feeling sick, they just go to “see a doctor.” This is not the time to pull rank.

Of course, we do make exceptions sometimes. For example:

• It might make sense to use “doctor or nurse” when talking about primary care (although repeating that phrase can make your content clunky, so use it sparingly)
• If you’re writing about something super specific, like childbirth, it’s fine to say “doctor or midwife” — especially if you define for your audience what exactly a midwife does

Now, think about your answers to the fill-in-the-blank questions above. You answered “doctor” for all of them, right? In other words, using plain language just means that you write how you speak.

The bottom line: Don’t be afraid to refer to different kinds of health care professionals as “doctor.” Plain language is on your side.

Tweet about it: Don’t be afraid to refer to different kinds of health care professionals as “doctor,” says @CommunicateHlth. #PlainLanguage is on your side! https://bit.ly/2TESQpy #HealthLit

While we try not to get too bogged down in grammar, dear readers, sometimes it can’t be avoided. Erm… that is… sometimes we can’t avoid it.

Why? Because as health communicators, we always try to write in active voice. “It can’t be avoided” is in passive voice. Passive voice makes sentences less personal, less clear, and less direct. Yuck!

Here’s a quick and dirty explanation of active versus passive voice. Essentially, it’s all about the subject of the sentence. Using active voice means constructing a sentence so that the subject is doing the action. In passive voice, the subject receives the action instead — it doesn’t do the action itself.

For example:

• Active voice: He saw his doctor.
• Passive voice: He was seen by his doctor.

Another problem with passive voice is that it can leave out the subject altogether. That really makes content feel impersonal and indirect.

Which of these more effectively communicates that your reader needs a flu shot?

• Active voice: Doctors recommend that you get a flu shot.
• Passive voice: Getting a flu shot is recommended.

“Getting a flu shot is recommended” is super vague — who’s doing the recommending? You’re much better off specifying the subject (doctors, in this case).

How can you recognize passive voice so you’ll know to revise it in your materials? Here’s a helpful hint: look for some form of the verb “to be” in the phrasing of the action — it could be “is,” “are,” “was,” “were,” or “been.” You can also use zombies to help figure it out.

Your readers count on you for clear, actionable, personalized health information that they can really understand and use. Using active voice is good writing, period.

The bottom line: Using active voice can help personalize your message and keep your content clear and direct.

Tweet about it: For the sake of #HealthLit, make your voice active! http://bit.ly/PUClzI via @CommunicateHlth

People like pictures. So health communicators often rely on stock photos to grab a reader’s attention. Finding one is a cinch. Just enter a health topic in a stock photo agency’s search, and you’ll get pages and pages of results.
But there’s a problem: A lot of those results are just not that helpful.

Some are freaky.

(A few keywords you may have searched to get this result: Doctor, injection, nurse, patient, mummy.)

Some are inexplicable.

(A few keywords you may have searched to get this result: Kitchen, peanut butter, pollution, toxic, post nuclear winter.)

Some feature fruit bowls fashioned from human heads.

(A few keywords you may have searched to get this result: Banana, fruit, healthy, nutrition, fashion.)

Some illustrate hazards faced by women eating salad in zero gravity.

(A few keywords you may have searched to get this result: Food, organic, salad, vegetarian, cheerful.)

But more common — and actually worse — are pictures that mean absolutely nothing. You’ve seen ones like this a million times:

Oh, hooray! She’s so, so happy! But why? She’s gone gluten-free? She refinanced at a low rate? She makes $6,000 a month from home? This picture doesn’t tell a story.

Using photos as mere decoration is a missed opportunity. Instead, use images that help communicate your message. You know, photos of real people doing realistic things that are actually related to your content in an obvious way.

If you’re writing about bike safety, show someone wearing a helmet and riding safely on a bike path. If you’re writing about quitting smoking, show someone circling a quit date on a calendar. Choose images that really show what you’re writing about.

Otherwise, what’s the point? We doubt the thumbs-up lady knows.

The bottom line: Too many sites rely on staged, generic stock photos. Be choosy — only use images that directly support your message.

Everyone has a vague sense of what the phrase “lifestyle changes” means. You know: eating better, exercising, and… uh… other healthy stuff.

But when you’re trying to communicate health recommendations, giving readers a vague sense of your message isn’t good enough. People need actionable information to help them improve their lives, not fuzzy advice to “do healthy things.”

Here’s a telltale sign that a term isn’t clear enough to be useful: it could mean the opposite of what you’re trying to convey. After all, wouldn’t “sit on the couch more” and “drink trans fat smoothies” count as lifestyle changes?

Something else to consider: “lifestyle changes” isn’t something people actually say. No human has ever written, “Make lifestyle changes” on a New Year’s resolution list. What they actually write is something specific. Eat less sugar. Start yoga classes. Quit smoking.

That’s why, dear readers, instead of talking about “lifestyle changes,” it’s important to be specific. According to the research, which particular behavior changes will help? Who will they help? How much? If you say exactly what you mean, you’ll do your audience a big favor.

The bottom line: People tune out vague phrases like “make lifestyle changes.” Change your tune and get specific instead.

Tweet about it: Why “lifestyle changes” can be the wrong choice — at least in health writing: https://bit.ly/2VsYb0w via @CommunicateHlth #HealthLit

As health literacy becomes a national priority, more organizations are bringing health literacy advocates together under one roof. Health literacy events and conferences are great opportunities to meet in person, swap resources, and share strategies.

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

Institute for Healthcare Advancement Health Literacy Conference
May 7–9 • Irvine, CA

Tufts University Health Literacy Leadership Institute
June 9–13 • Boston, MA

National Conference on Health Communication, Marketing, and Media
August 19–21 • Atlanta, GA

Health Literacy Research Conference
November 3–4 • Bethesda, MD

Many states offer more localized events, like the Florida Literacy Conference or Texas Health Literacy Conference. To find events in your area, check your local Society for Public Health Education (SOPHE) chapter.

The bottom line: There are lots of great events in 2014 if you’re looking to connect with other health literacy advocates!

For most health educators, the value and importance of vaccines goes without saying. But, educating people — whether in person or via a website or fact sheet — about the benefits of vaccines can be challenging. Here are some ideas.

Talk about herd immunity, but without the “herd.”
True, there were cows involved when the smallpox vaccine was developed. But we’re pretty sure that most people don’t like thinking of themselves as part of a herd. Instead, try making a connection to people they care about.

When people say:
“I won’t get too sick from the flu, so I don’t need to get the shot.”

You can reply:
“When you’re up to date on your shots, you’re not the only one who’s protected. You also help to protect everyone around you — like your children, your parents, and people in your community who get sick a lot.”

Ax the stats.
Public health folks love to cite statistics. And there’s nothing wrong with telling a professional audience that 604 (87%) of the measles cases reported from 2001 to 2010 were import-associated.

But when you’re communicating with most people, it’s better to say something like this: “Getting all your shots is important because diseases can travel quickly around the world. For example, most Americans who get measles catch it while traveling overseas.”

Meet people where they are.
Recognize that your readers may have fears or misconceptions about vaccinations. If they do, it just means your work isn’t over yet.

Your impressive statistics won’t convince people to get a shot if they believe it’s unsafe, so take the time to dispel myths along with presenting facts.

The bottom line: Take the time to explain the benefits of vaccines — and think about your audience’s needs while you do it.

We ❤ giving you simple, clear answers to your health communication challenges. But when it comes to describing people as Latino or Hispanic? The short answer: both terms work, and neither is best.

First, let’s clarify what each term means. (Special thanks to @terryblas and his comic You Say Latino for breaking this down for us.)

• Hispanic refers to language. It describes people from primarily Spanish-speaking places, such as Puerto Rico, Mexico, and Venezuela.
• Latino refers to geography. It describes people from Latin America, which includes Mexico, Central America, South America, and some of the Caribbean Islands.

Now, as with any question of naming and identity, we believe the “right” answer comes down to how individuals want to identify themselves. It’s a personal preference, not a general rule. Polling in recent years shows a pretty even split between people preferring (for themselves) Hispanic or Latino.

So about that simple answer…

We recommend avoiding both terms whenever possible and getting specific instead. Many people are likely to identify as Mexican American or Salvadoran or Peruvian (or maybe just American) before they identify as either Latino or Hispanic.

If you’re writing about an individual or smaller group, ask them which term they prefer. But if you can’t be that specific, rest easy — Hispanic and Latino are both okay terms to use.

And finally, if you choose Latino over Hispanic, use Latino if you’re referring to only men or to men and women. Use Latina if you’re referring exclusively to women. Or you might want to look into whether your audience prefers the newer term Latinx.

The bottom line: If you can, get specific — like Mexican or Costa Rican. If you can’t, Hispanic or Latino both work.

Tweet about it: What’s the difference between Hispanic and Latino? @CommunicateHlth shares tips for deciding which term to use! https://bit.ly/2P0jAP7 #HealthLit

Telling people they have the power to lower their risk for a certain disease is a great motivational tool. So, when you’re writing health content that encourages readers to make healthy changes, the concept of disease risk is useful.

Unfortunately, “risk” is often paired with “factor” to form a term that’s the opposite of helpful. For readers with limited health literacy skills, the concept of risk is already a tricky one — so why complicate matters further by talking about abstract “risk factors” when you can directly explain the risk? We suggest you don’t.

• Instead of: Smoking is a risk factor for lung cancer.
• Try: If you smoke, you have a higher risk of getting lung cancer.
• Instead of: Physical inactivity is a risk factor for heart disease.
• Try: Getting active can help you lower your risk for heart disease.

Bonus: Ditching the “factor” also makes it easier to address your readers directly by writing in second person, which is another great strategy for writing actionable content.

The bottom line: “Factor” increases the risk for confusion — so when you talk about risk, factor it out.

Tweet about it: Writing #HealthLit content about risk? Ditch the “factor,” says @CommunicateHlth: https://bit.ly/2RmHUrQ