Category: We Heart Health Literacy

This week we’re addressing the difference between a couple terms that are easy to confuse when writing health information. “Symptom” and “sign” are often used interchangeably when talking about the health effects of conditions or diseases — but guess what? They aren’t actually the same at all.

Ever heard the saying, “Beauty is in the eye of the beholder”? Well, our favorite way to remember the difference between these similar words is that it’s in (you guessed it!) the eye of the beholder. In other words, whether something is a sign or a symptom depends on who’s able to notice it.

Technically speaking, a symptom is something that only the person experiencing it can observe. A sign is something that other people can observe, too. So instead of thinking about the health effect itself, think about the person who notices it. Symptoms are what a patient feels (like a headache) and signs are what a doctor can see or measure (like high blood pressure).

Now that you know the difference, dear readers, here’s a curve ball. For some audiences, “symptom” is an unfamiliar word. And since both signs and symptoms fall into the category of “things that happen when you’re sick,” it may be appropriate to use “sign” regardless of who notices it.

The bottom line: A symptom is something only you know is there. A sign is something other people can notice.

Tweet about it: Ever wonder about the difference between signs and symptoms? http://bit.ly/JKUcGN #HealthLit via @CommunicateHlth

In Episode 1 of our space series, we discussed the importance of using space to improve readability by “chunking” text. Now, in Episode 2, we’re discussing the wonders of including white space in the visual design of your content.

Let’s start with a non-writing example. Think of your closet before and after you clean it. Before, it’s a jumbled, anxiety-provoking mess. After, you can easily find what you need, without getting distracted by things like jeans you haven’t worn since high school.

Content works the same way. If it’s crowded and cluttered, your readers may be turned off. If it’s clean and orderly, your readers are more likely to see it as clear and understandable.

Of course, white space doesn’t always need to be white. The phrase “white space” refers to the background and in-between areas — the space without text or images. To increase white space, add extra space (or padding) around images, call-out boxes, and sections of text.

Adding white space can go a long way toward making your health communication materials more appealing. But don’t just take our word for it, dear readers! Ask yourself: Which of these examples* would you be more likely to pick up and read?

*Courtesy of the Massachusetts Department of Public Health

The bottom line: Make your content more appealing and easier to read by adding white space.

Tweet about it: Why add white space to your next #HealthLit material? It’ll be more attractive and easier to read. http://bit.ly/2GVq2hP via @CommunicateHlth

It’s that merry time of year when celebrations often involve eating. A lot. And how about that gravy — was it sodium-rich enough for you? Or did you practice your healthy principles and have a low-salt holiday meal?

Sodium is the actual mineral that causes high blood pressure if we eat too much of it. Salt is the most common source of sodium and the word most people use when talking about eating healthy. As veteran health literacy advocate Dr. Rima Rudd of the Harvard School of Public Health is famous for saying, “You don’t sit at the family table and say, ‘Pass the sodium, please.’ ”

When writing for health behavior change, it’s important to write clearly and use familiar words — while also educating readers about key terms they need to know. Whether it’s reading a Nutrition Facts label or talking to a nurse about blood pressure, sodium is a word people are likely to come across.

So how do you sprinkle some salt into your sodium? Follow one of our favorite (and simplest!) principles of writing for health literacy: Use the medical/scientific/technical term and then provide the plain language equivalent. Here’s an example:

9 out of 10 Americans eat more sodium (salt) than they need. Too much sodium increases your risk for health problems like high blood pressure.

The bottom line: Don’t shy away from the word “sodium.” Just be sure people know you’re talking about salt.

Imagine you have come up with an awesome new health literacy initiative. You’ve put in the time planning, developing, and testing it. You’re about to educate hundreds — scratch that — thousands. You can see it catching on: health literacy is taking the world by storm.

Now, how do you make that vision a reality? The truth is that most big ideas don’t make it because more attention is given to creating the ideas than spreading them.

Fear not, health literacy warrior! Look to the Diffusion of Innovations Theory. The theory describes many things, but where we see its value is in explaining how new innovations catch on. Understanding this can help you better promote and market your program.

Use the concepts below when you explain the benefits of your program to the masses. (Don’t be intimidated by the fancy buzzwords!)

• Relative Advantage: How much better your innovation is than the one it’s replacing
• Compatibility: How your innovation falls in line with potential users’ experiences and values
• Complexity (or Simplicity, as we like to say): How easy the innovation is to understand and use
• Trialability: How easy it is to try out the innovation before committing to it
• Observability: How easy it is for users (and the people they know) to see results from using the innovation

By using these concepts when you promote your program, you’ll greatly increase the chance that people will give it a try.

The bottom line: When promoting a new idea (like a health literacy program), use the Diffusion of Innovations Theory to increase the chance of it catching on.

As advocates for health literacy and plain language, we need to be ready to respond to a skeptic at a moment’s notice. Are you ready, Team Plain Language? Team Jargon can be intimidating, but with the right tools, we can win!

Every effective advocate has go-to arguments on hand, so we’re sharing a few of our favorites to help you build your arsenal.

1. Plain language is the law. Since President Obama signed the Plain Writing Act of 2010, many federal agencies began writing more clearly. Similar regulations also apply to credit cards and health insurance.
2. Simple sells. Many private companies are moving toward using plain language because it increases customer satisfaction. Just think about Apple. Customers (aka most people) are busy — they want to understand things quickly and easily.
3. Clear communication is more effective. It saves times, cuts down on errors, and helps reduce costs. There are plenty of studies showing the benefits.

Why are you on Team Plain Language? Share your favorite reasons in the comments.

And for a closer look at which federal agencies are excelling at writing in plain language, check out the Federal Report Card from the Center for Plain Language.

The bottom line: Make sure you’re prepared to defend plain language. It’s the law, it’s good for business, and it’s more effective.

Tweet about it: I’m on Team Plain Language! Here’s why: bit.ly/1jTT69m via @CommunicateHlth #HealthLit

If you’re a plain language writer, you may shudder at the word “contaminated.” It’s a word that many audiences struggle to understand, and yet it shows up a lot in environmental health writing.

Typically, the first line of attack when encountering a tough word is to avoid using it altogether. But, in this case, what word can you use instead?

“Polluted” might work, but that’s not particularly plain language either — and sometimes it won’t technically be a correct substitution. And if a consumer has to deal with an ongoing contamination situation, then it can be a term worth knowing. What’s a clear communicator to do?

To best explain this concept to your readers, focus on the outcome: If something is contaminated, what does that mean for them? Usually, the contaminated thing isn’t safe — to eat, drink, use, touch, and so forth. So, contaminated = unsafe.

If you have to write about something that’s contaminated, check out these examples that may make your life easier:

• The germs contaminated the food (made it unsafe to eat).
• Community members were concerned about contaminated (unsafe) water.
• Put the contaminated (unsafe) items in a trash bag right away.

Now, go forth and write about things that are contaminated — with ease and simplicity!

The bottom line: “Contaminated” can be a difficult word, but people may need to know what it means. If you have to use it, define it in parentheses. We like “unsafe.”

We’re taking this Thursday off to give thanks for our enthusiastic readers. Enjoy your turkey (or tofurkey)!

And if there are any topics you’d like us to tackle in 2014, please email wehearthealthliteracy@communicatehealth.com.

We all know change isn’t easy. So when we want our audiences to change their health behaviors, we can’t rely solely on plain language and human-centered design — we also have to get inside their heads.

Here at We ❤ Health Literacy Headquarters, we often turn to trusted theoretical models to help us understand how and why people change. And today, we’re talking about one of our favorites: the Health Belief Model.

Over 50 years ago, social psychologists wanted to find out why people weren’t participating in programs to prevent or screen for disease. After all, these programs were in everyone’s best interest, right? The Health Belief Model was born from this investigation. It explains the desires and beliefs that make people take action to prevent, screen for, and control disease.

The gist of the model is that a person’s behavior depends on their perceived benefits and barriers (also known as a cost-benefit analysis). Knowing these perceptions can help us anticipate how people will respond to recommended health behaviors.

To make your content more effective, try helping your readers answer these questions — all based on elements of the Health Belief Model:

• What’s my chance of getting sick?
• How serious is the potential health problem?
• What’s in it for me if I change?
• What are the costs of changing (like an insurance co-pay or the cost of face masks)?
• Can I actually do the behavior?
• What will help me remember to do it?

If your content answers these questions, you’ll give your readers the understanding, tools, and confidence they need to make positive, healthy changes.

The bottom line: If you want readers to change their behavior, make sure your health content explains the benefits and barriers to change.

Tweet about it: How can #PublicHealth and #HealthComm professionals use the Health Belief Model to promote behavior changes, like wearing masks during #COVID19? @CommunicateHlth explains: https://bit.ly/3fj30lz

This is Episode 1 of our journey into space. For more adventures, check out Episode 2 and Episode 3.

If you’re a health communicator, it’s important to know that space is your friend. Learn to love space. Don’t see it as an area to fill up with content, but rather as an area to show off the content you already have. Use it strategically.

As we’ve said before, dear readers, people are more likely to skip over content that looks overwhelming or hard to read — even if it’s written using simple words. One trick we’ve already shared is picking the right font. Another trick is to leave more space above your headers than below them.

Why is this a helpful technique? Because having more space above a header than below it creates “chunks” of content that are easy to scan, making your content appear more accessible.

If you have an equal amount of space above and below a header, the header will seem to float and your readers won’t be able to quickly associate it with the body text below.

Who needs to get the flu shot?

Everyone age 6 months or older.

When should I get the flu shot?

As soon as possible, usually in the fall.

But if you don’t leave any white space between headers and body text, your readers won’t be able to scan the content quickly.

Who needs to get the flu shot?
Everyone age 6 months or older.
When should I get the flu shot?
As soon as possible, usually in the fall.

If you leave more space above the header than below it, your readers will thank you.

Who needs to get the flu shot?
Everyone age 6 months or older.

When should I get the flu shot?
As soon as possible, usually in the fall.

The bottom line: Make your content look easy to read by leaving more space above headers than below them.

Most of us public health geeks probably know what a body mass index (BMI) is. As a refresher, it’s a number calculated based on a person’s height and weight. Although it seems like a simple concept, for lots of people, it isn’t.

For starters, it’s a calculation, which means you have to do math. Even if you use the chart that calculates it for you, reading the chart still requires math skills.

Then take its use: health professionals essentially use it as a “red flag” for weight issues. That means when you’re talking about BMI, you’re talking about risk — about what might be true.

And as if that’s not enough, it might not mean anything. That’s right, BMI is an accurate indicator for most — but not all — people.

So you can see, when you take a step back, BMI can be pretty confusing. And you know what else can be confusing? The chart we’re supposed to use to calculate it. Take a look:

For people who have trouble with numeracy, which is most of us (public health professionals included), this chart is anything but easy to use. The color on this “simple” version helps, but try finding your BMI without touching the screen to follow the row and column — it’s not easy. And this is a simple version!

So the next time you find yourself mentioning BMI in a written material, you might want to make sure you’re explaining how and why BMI is used as a screening tool.

Oh, and let’s redesign that chart!

The bottom line: Proceed with caution when mentioning BMI. Be sure to explain what it means, and what it doesn’t. And don’t rely on your readers being able to understand the chart.