Health Literacy - When Plain Language is not enough

When plain language isn’t enough

To ensure that the intended users of health information understand it, communicators must know how to reach them. Writing and speaking clearly are critical steps to achieve that goal. At the same time, communicators must also be aware of additional barriers to understanding. Intended users of the information may speak a different language or be unfamiliar with the situation; there may be critical cultural differences between sender and receiver; and intended users may have communication or development disorders.

Limited English Proficient speakers – Plain English won’t necessarily help individuals who do not speak English as their primary language and who have limited ability to read, write, speak, or understand English. Simply translating health information, such as written medical instructions, into a person’s native tongue does not guarantee that non-English speakers will be able to read or understand it. To better ensure understanding, health information for people with limited English proficiency needs to be communicated plainly in their primary language, using words and examples that make the information understandable in their language.

Cultural differences – Culture affects how people understand and respond to health information. In addition to the use of plain language, the cultural competency of health professionals can contribute to health literacy. The Office of Minority Health, U.S. Department of Health and Human Services, defines cultural competency as the ability of health organizations and practitioners to recognize the cultural beliefs, values, attitudes, traditions, language preferences, and health practices of diverse populations, and apply that knowledge to produce a positive health outcome. Cultural competency includes communicating in a manner that is culturally and linguistically appropriate.

Lack of knowledge and experience – People with limited health literacy skills often also lack knowledge or have misconceptions about critical health topics, such as the body, its functioning, and the nature and cause of disease. Without accurate and appropriate knowledge, they often fail to understand the importance of lifestyle factors—diet and exercise, for example. They may read commonly used directions, like “take on an empty stomach,” and not understand what the terms mean (17). Even with clear directions, if the audience has no context or prior experience, they can still misunderstand. For example, when instructions say, “Give two drops, three times a day for earache,” it may not be clear whether the drops should be swallowed or placed in the ear.

Communication and developmental disorders – Plain language and other clear communication techniques may not be effective or appropriate for audiences with communication or developmental disorders. Approximately one in six Americans has a disorder or difference in communication resulting in unique challenges.¹ There are also challenges for individuals suffering with mental health diseases and disorders that impair or obstruct clear communication, no matter how plain the language. These individuals will require strategies that are tailored to their needs and abilities. Developing improved ways to communicate health information to these audiences is a crucial component to addressing health literacy.

source: http://www.health.gov/communication/literacy/plainlanguage/PlainLanguage.htm

Health Literacy - Plain Language Information

Writing that is clear and to the point helps improve communication and takes less time to read and understand. Clear writing tells the reader exactly what the reader needs to know without using unnecessary words or expressions. Communicating clearly is its own reward and saves time and money. It also improves reader response to messages. Using plain language avoids creating barriers that set us apart from the people with whom we are communicating.
Health literacy incorporates a range of abilities: reading, comprehending, and analyzing information; decoding instructions, symbols, charts, and diagrams; weighing risks and benefits; and, ultimately, making decisions and taking action. The concept of health literacy also extends to the materials, environments, and challenges specifically associated with disease prevention and health promotion.

TIPS FOR USING PLAIN LANGUAGE:

Certain qualities characterize plain language. These include common, everyday words, except for necessary technical terms. Other qualities include the use of personal pronouns; the active voice; logical organization; and easy-to-read and understand design features, such as bullets and tables.

1. Engage the reader.

• First, consider who the reader is. Often, there is more than one reader.
• Consider what the reader needs to know. Organize content to answer the reader's questions.
• Write for the appropriate reading level.

2. Write Clearly. Use common, everyday words whenever possible.

• Word Choices:
  • Use common, everyday words
  • Use other personal pronouns such as "you"
  • Use "must" instead of "shall"
  • Avoid using undefined technical terms
  • Use positive rather than negative words
  • Avoid using gender-specific terminology
  • Avoid long strings of nouns

• Verb Forms:
  • Use active voice
  • Use action verbs
  • Use the present tense

• Structure:
  • Use parallel construction
  • Be direct
  • Avoid using unnecessary exceptions

3. Display Material Correctly

Appearance is an important aspect of clear communication. If a document is pleasing to the eye, it will be more likely to attract your reader's attention. Appearance can also be an aid to the reader, improving comprehension and retention. There are four main aspects of appearance:

• Organization. Strong, logical organization includes an introduction followed by short sentences and paragraphs. Organize messages to respond to reader interests and concerns.
• Introduction. In lengthier documents, use an introduction and a table of contents to help the reader understand how a document is organized.
• Short sentences and paragraphs. Sentence length should average 15-20 words. Sentences that are simple, active, affirmative, and declarative hold the reader's interest. Generally, each paragraph should contain only one topic. A series of paragraphs may be used to express complex or highly technical information. The more writing deviates from a clear and to-the-point structure, the harder it will be for the reader to understand what is being conveyed.
• Layout. Layout includes margins, headings, and white space. Provide white space between sections to break up text and to make it easier for readers to understand. Use headings to guide the reader; the question-and-answer format is especially helpful. Try to anticipate the reader's questions and pose them as the reader would. Use adequate margins.
• Tables. Tables make complex information readily understandable. Tables can help the reader see relationships more easily. They may require fewer words than straight text.
• Typography: Typography relates to fonts and typographical elements used for emphasis, such as bullets or italics.

4. Evaluate Your Document

To ensure that you are communicating clearly, evaluate the document or have another person read it and offer suggestions for clarification. Look over the document for:

• Correct spelling, grammar, and punctuation;
• Inclusion of appropriate devices, such as dating, page numbering, and consistency;
• Visual appeal;
• Consistency and effectiveness of layout and typographical devices (avoid overuse); and
• Line breaks that inadvertently separate part of a name or date in a way that reduces clarity.

Source: http://www.nih.gov/clearcommunication/plainlanguage.htm