Article originally appears in the August 30, 2018 issue of the SNEB eCommunicator.
It has many names – low literacy, readable, plain/clear language (my preference, reader-friendly) but one goal – communicating clearly. We often point to the reading level of our audiences as the reason to write below a certain reading level – writing at or below 8th grade for the U.S. public but lower reading levels may be more appropriate for your audience. Here are 2 compelling reasons for clear communication: 1) everyone benefits from plain language because it takes less time to read and understand; and 2) clear language means less text. Here are my tips for clear communication. Additional resources follow the list.
- Use the active voice – it tells the reader who is doing the action.
- The power of 3’s – try to limit your lists to three items (think of the 3 bears or the 3 musketeers).
- Words matter – choose simple words (why use ‘cardiovascular health’ when ‘heart disease’ will do?), avoid nutrition jargon and acronyms. Also, avoid sayings that may confuse the reader/listener (imagine talking about food and you say ‘like 2 peas in a pod’ causing listeners to be distracted from your important nutrition message).
- Use readability formulas correctly (prepare your text and use the right formula – they aren’t all the same).
- Use numbers sparingly and consider using a visual to reinforce them (show 75% by a visual of 3/4 or ask 3/4 of your audience to stand up). Numeracy lags behind literacy for most Americans.
- Design matters – white space, font size, paragraph headings (they’re a ‘heads up’ for the reader to alert them to what’s coming next). Writing for the web? Be aware of reader skimming patterns when placing important information – an F pattern when reading text or a Z pattern for less text-heavy parts of a webpage explained @ http://babich.biz/zpattern/.
- Include interaction. Give the user opportunities to write on written material.
- Photos are best especially when they are of people or food. And make sure your food photos are culturally appropriate.
- Pilot even if you have limited time, resources and people available.
- Use questions. This suggestion came from a literacy expert. She noted that questions invite the reader to keep reading.
Read these articles
>>>Assessing readability formula difference with written health information materials: application, results and recommendations
Variability between readability formulas may vary by as much as 5 grade levels – SMOG is recommended for written health materials but only if the text is long enough.
>>> Appropriate language in clinical settings beneficial in diabetes care
Do words matter when working with patients? According to this literature search @ https://www.healio.com/endocrinology/diabetes-education/news/in-the-journals/%7B343d816f-644d-4538-b2f0-11f630f7092c%7D/appropriate-language-in-clinical-settings-beneficial-in-diabetes-care negative terms aren’t the best language to use in diabetic care and may lead to disengagement by patients as well as poor clinical outcomes.
>>>Federal government readability score card (2017 – 6th year)
In the early 2010’s the federal government began a plain language push due to a law requiring the federal government to write documents for the public in plain language beginning 2011. Here is one ‘report card’ on agencies’ plain language efforts.
>>>Why use plain language? (Infographic)
Short, but sweet, 10 steps to plain writing and some word substitutions.
>>>Plain language please (infographic)
Real world examples of the positive effects of plain language, some ‘before and after’ text, word substitutions.
>>>In plain language please! (infographic)
Word and phrase substitutions as well as examples of wordiness to avoid.
>>>Plain language in spoken communication
Good tips for speaking clearly.
>>>Listening and speaking
Tips for health care providers includes the reminder to ask the patient to repeat, in their own words, what they need to do.
>>>Teaching Patients with Low Literacy Skills by Cecilia Doak, Leonard Doak and Jane Root (2nd ed, 1995)
Now out of print but available for download (with the authors permission) @ https://www.hsph.harvard.edu/healthliteracy/resources/teaching-patients-with-low-literacy-skills/
>>>Health Literacy from A to Z: Practical Ways to Communicate Your Health Message by Helen Osborne (2nd ed, 2018)
>>>Health Literacy Out Loud
Several podcasts on important health literacy topics such as speaking clearly, culture and older adults.
>>>10 Minute Tech (University of Alabama at Huntsville)
Jan. 13, 2016 (11 minutes)
>>>SAM – Suitability Assessment of Materials developed by Cecilia and Leonard Doak and Jane Root in 1993 (10 pp)
A tool to evaluate health information for readability and comprehension.
>>>A link to various checklists to help you write more clearly.
>>>Best practices for creating nutrition education materials (USDA’s MyPlate)
>>>CDC’s Clear Communication Index
A research-based tool to assess and develop communication materials includes a user guide, score sheet and other materials.
>>>CDC Simply Put: a guide for creating easy-to-understand materials (44 pp, 2009)
>>>Writing and testing plain language
Before/after examples – pp. 4 – 7
>>>Advantages & disadvantages of using readability formulas
Readability formulas have their use and misuse. You are likely to get a wide variety of results when using different formulas. Using formulas can help guide your writing.
>>>How to prepare your text to help readability formulas calculate an accurate grade level
Punctuation and titles can impact your readability analysis as sentence length is part of readability analysis.
>>>Readability tools including online options and software
There are many formulas, here are more about some of them:
>>> Cloze test (tests comprehension not just readability)
>>>Kansas WIC uses Fog Index
>>>Health Literacy Innovations
Slides from a series of webinars on health literacy.
>>>CDC Health Literacy training
6 online health literacy training courses (some provide completion certificates)
>>>Other online health literacy, plain language, culture and skill-building training