Category: We Heart Health Literacy

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

This post tackles a common word in health writing: vaccines. Everybody needs them, so we often write about them — but what’s the simplest, clearest way to do it?

Usually, our advice to fellow plain language writers is to define a medical or technical term in plain language the first time you use it. In this case, you might say: “Get the flu vaccine (shot) every year.”

But is “vaccine” really an essential health term for general audiences? We don’t think so. Most of time, we’d just say: “Get the flu shot every year.”

Yes, we know that the flu vaccine also comes in a nasal spray. But let’s not get lost in the details. Cover the basics of what the flu shot is and how it works — then you can go into the nuances of nasal spray versus shot, if you need to.

For most consumers, shot is a familiar word. Getting shots is a common experience. If you connect your writing to things people are used to, you’re more likely to get your point across.

The bottom line: Say “vaccine (shot)” if you absolutely have to. But we prefer “shot” for most audiences.

When budgets get tight, user testing often ends up on the chopping block. But there’s a way to do it on the cheap when more formal testing isn’t an option. Take it to the people — do a pilot test!

Pilot testing allows you to develop or improve your health materials together with your priority audience. Let’s face it: All materials have problems (some more than others). These problems may not be obvious to you, but your users will always spot them. Use this to your advantage.

You can do pilot testing with just about anyone. Ideally, you have 3 to 8 people from your priority audience test your materials. If that’s not possible, settle for the “1 is better than none” approach. The feedback of a single coworker not involved with your project is better than nothing. Parents and grandparents are often good to test with, too — plus it counts as a phone call!

Although your results may not be generalizable in the academic sense, even a test or 2 will catch usability issues that you likely wouldn’t have caught on your own.

We like to pilot test anywhere people wait: clinic waiting rooms, community centers, libraries, adult education centers, campus student centers. And recruiting is pretty easy as long as you’re prepared to hear about 10 “no thanks, I’m in a rush” responses for every 1 person who stops to talk with you.

The questions you ask will depend on what you’re testing, but here’s our greatest hits collection:

• What catches your eye?
• Who do you think this material is designed for?
• Tell me in your own words what this is trying to say.
• What is it telling you to do?
• What do you think of the pictures? Do these people look like anyone you know?
• Do you think you could do what this material is suggesting?
• Do you think people will take any of these steps after reading the material?

And, we’d like to give a friendly reminder to always get the needed organizational approval for testing (e.g., Institutional Review Board (IRB) clearance). Small pilot tests are often exempt, but it’s best to check before you start.

The bottom line: Pilot testing can be an easy and inexpensive way to get feedback from your audience. Try it with your next project.

In 2014, the Centers for Disease Control and Prevention (CDC) made a front page-worthy decision that’s still worth noting today. In response to efforts by HIV activists, CDC decided to officially update its term for sex without a condom from “unprotected sex” to “condomless sex.” (We love this so much that we almost want to use all caps to tell you how much. But we won’t.)

Why did this decision thrill us here at We ❤ Health Literacy Headquarters? Because, dear readers, when people say “unprotected sex” in health information, what they’re actually talking about is sex without a condom.

“Unprotected” is a vague — and potentially misleading — term where sex is concerned. Consider these scenarios:

• A woman who’s on the pill has sex with a man, and they don’t use a condom. She may be protected from pregnancy, but she could still get an STD. Did she have protected sex or unprotected sex?
• A man has sex with his monogamous partner who’s HIV-positive. They don’t use a condom, but his partner has an undetectable level of HIV in his blood — and they’re both taking preventive medicines. Would it really be accurate to say that’s unprotected sex?

Interesting questions, right? And maybe even a little loaded since the word “unprotected” can convey a bit of judgment or blame — if you’re doing something “unprotected,” the implication is you’re being careless.

So CDC has sent the vague “unprotected sex” packing, replacing it with exactly what they mean: “condomless sex.” Although we prefer the phrase “sex without a condom,” this change is a huge improvement — and will hopefully be adopted by every sex ed teacher in the land.

This is a prime example of health literacy in action — and why it matters.

The bottom line: “Condomless sex” is more specific than “unprotected sex,” and it takes away the blame.

Tweet about it: This week from @CommunicateHlth: When you’re talking about sex without a condom, follow @CDCgov’s lead and ditch the word “unprotected”! Details: https://bit.ly/2G3wzLQ

It’s a fact: more and more people are seeking health information online. This means that websites need to be — and look — easy to use. And nowhere on your site is this more important than the homepage.

You can’t judge a book by its cover, but you can judge a website by its homepage.

The homepage is often your audience’s introduction to both your brand and your content. So it needs to make a good first impression, and fast. Research shows that users decide within just 10 seconds of landing on a webpage whether to stay there or go elsewhere.

How can you make your homepage compelling and user friendly? Here are some tips:

• Keep it clean. Brief text and a simple color palette help you create a clutter-free page. In other words, white space is your friend.
• Make your purpose clear. Use text and graphics to clearly state the purpose of your website right there on the homepage.
• Provide a simple navigation. This will enable users to quickly scan and understand the different sections of your website.
• Implement responsive design. Chances are users will access your website from all kinds of devices. Make sure people can easily view it on a computer, phone, tablet, plane, train, or automobile.

But don’t just take our word for it. Test your homepage with your audience and see what they think.

The bottom line: When designing your website’s homepage, keep it simple. This will set the tone for your brand and content.

Tweet about it: Less is more! Find out why @CommunicateHlth recommends keeping #HealthLit homepages clean and simple: https://bit.ly/2MQ3MgV

In Episode 3 of our space series, we want you to think about empty space. And no, this isn’t philosophy class or your latest meditation — it’s an important part of communicating health information. When you’re developing health content, think about the space it will occupy ahead of time.

It’s like furniture shopping — you need to know the size of your apartment before you purchase that oversized La-Z-Boy sofa set.

For example, if you’re creating a website, make the navigation labels descriptive but short. Your users want to know what’s in each section of the site — but if they’re viewing it on mobile (as many people do), you don’t want lengthy menu items taking up a lot of space.

On the other hand, if you’re writing a tri-fold brochure, we’re very sorry. Kidding! Make sure your content will fit in each panel with comfortable margins and a readable font — and room to fold the paper.

If you have too much content for your chosen medium, you have 2 choices: cut back your content or pick a new way to present it. Maybe that content you want in an app really belongs on a full website.

As we’ve discussed before, dear readers, white space is incredibly important for health content. So make sure that you’re thinking about space from the beginning.

The bottom line: Design starts with content. Think about how your text will work in its space.

Tweet about it: Think about white space as you write your content. https://bit.ly/2Marlwl via @CommunicateHlth #HealthLit

With so much health information available online these days, you might be wondering: Does anyone still need health brochures?

We say… maybe. How you deliver content depends on your audience. If you’re rocking a Twitter feed but your audience is watching Golden Girls episodes on Betamax, you’ve got a problem.

Don’t get us wrong, dear readers — we ❤ digital content. It lets you reach more people in fun and innovative ways. In particular, mobile is becoming a great equalizer across income levels.

That said, you need to meet your audiences where they’re at. Like it or not, they may be at the doctor’s office staring at a rack of brochures — or they may be at home, without access to the computer they use at their local library.

And sometimes, people want both. For example, when we’re doing usability testing, we often hear testers say things like, “This webpage is great. I would print it out and show it to my mom.”

So keep on with digital and mobile. Find new and creative ways to get your messages out there. But always research your audience, including how they want to access and share your content.

The bottom line: Go bold with digital and mobile — but do your homework to be sure you know how and where your audiences get their health information.

Tweet about it: Is the health brochure dead in the digital age? Not yet. bit.ly/2MRCLFj via @CommunicateHlth #HealthLit

Update (May 2018): Since we wrote this post more than 4 years ago, HealthCare.gov has updated its definition of “premium” from “the amount that must be paid for your health insurance or plan” to the way more conversational “amount you pay for your health insurance every month” (pause for applause).

Today, we tackle the ever-present health insurance “premium” — or, as it’s sometimes defined: “The amount that must be paid for your health insurance or plan.”

Hang on. Wouldn’t the “amount that must be paid” be … a payment? Why not just say “monthly payment” instead? To most folks, that’s what “premium” usually means in the context of health care.

One of the health literacy principles we live (and write) by is to always use the simplest words available to communicate information. If a complicated word is essential, by all means, use it — being sure, of course, to define or explain it. But if a term isn’t essential, just don’t use it.

Let’s put “premium” to the test. Is there any difference in meaning between the following sentences?

• Your premium is due on the first of the month.
• Your monthly payment is due on the first of the month.

Right. Our vote here: “premium” isn’t essential.

If you really think your readers needs to learn the term “premium,” we recommend saying “monthly payment (also called a premium).”

The bottom line: Terms like “deductible” and “co-payment” are essential when talking about health insurance — but “premium” isn’t. Try “monthly payment” instead.

Tweet about it: If you mean payment, say payment (not premium): http://bit.ly/1aaPyOI #HealthLit via @CommunicateHlth