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CPL Workshop-Fall 14: Plain Language: A Tool to Promote Health Literacy (Karen Baker)


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Center for Plain Language Workshop
Fall 2014

Plain Language: A Tool to Promote Health Literacy
Karen Baker

In this interactive workshop, you will learn the many ways that plain language can help people understand health information and engage with the health care system. Understand who struggles with health literacy and why. (It can happen to any of us.) Learn how to use plain language techniques to promote understanding.

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CPL Workshop-Fall 14: Plain Language: A Tool to Promote Health Literacy (Karen Baker)

  1. 1. Karen Baker, MHS September 30, 2014 Plain Language: A Tool to Promote Health Literacy
  2. 2. First: Health Literacy • What is health literacy? • Why is it so important? • How can we address it?
  3. 3. Engagement Depends on Health Literacy …”capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.” --Healthy People 2010, 2000; IOM, 2004
  4. 4. Health Literacy by the Numbers 16, 21, 14 77,000,000 53 238,000,000,000 2030 5
  5. 5. A Human and Economic Toll • Patient safety • Rx adherence • ER utilization • Hospitalization • Prevention • Disease management • Costs • Mortality 6
  6. 6. Trends That Affect Health Literacy • More focus on prevention, self-care. • Aging population = more interventions. • Outcomes are being measured, incented. • Affordable Care Act mandates use of plain language. • Insurance industry is responding. • Patients are assuming more responsibility. • President signed Plain Writing Act in 2010. • Patients have access to EHRs.
  7. 7. An Unfamiliar Landscape… 8
  8. 8. …And a Foreign Language • “Your prostate biopsy was positive for cancer.” (In office) • “You should either take ciprofoxacin 1-2 hours before eating or drinking dairy products or avoid eating and drinking these products for four hours after taking ciprofoxacin.” (Drug leaflet) • “We’re going to draw some blood…” (In lab) • “The left atrium is markedly abnormal.” (EHR note) • “Anterior abdominal wall defect in region of umbilicus consistent with fat-containing umbilical hernia.” (Ultrasound report)
  9. 9. Why Does It Matter?
  10. 10. Health Literacy Universal Precautions Structure the delivery of health care as if everyone may have limited health literacy. • You can’t tell by looking. • Higher literacy skills ≠ understanding. • Health literacy is a state, not a trait. • Everyone benefits from clear communication. --Dean Schillinger, MD
  11. 11. Plain Language: A Solution That Works Steps To Success 1. Know your audience. 2. Organize your message. 3. Write clearly. 4. Design for your audience. 5. Test with users.
  12. 12. 1. Know Your Audience
  13. 13. Can You Read It? Dloh eldnah, dna ediug ssolf neewteb hteet gnisu a eltneg kcab-dna-htrof noitom. Evom ssolf pu dna nwod tsniaga ruoy htoot ot pleh evomer euqalp dna doof selcitrap evoba dna woleb eht enilmug. Esnir ssolf sa dedeen, dna taeper rof hcae htoot. Ot esu eht kcip, ecalp eht pit fo eht kcip neewteb ruoy hteet ta eht enilmug…
  14. 14. How Did You Do? • How did reading this make you feel? • Would you know what to do?
  15. 15. Readers With Lower Skills: • Take words literally. • Read slowly and miss meaning. • Skip over unknown words. • Miss context clues. • Tire quickly. • Get frustrated and give up.
  16. 16. Readers of Health Content May: • Feel stressed or fearful. • Be shocked at a diagnosis. • Not feel well at this moment in care. • Worry about how they’ll pay their medical bills. • Have limited time with the doctor. • Be on medicine that impairs them.
  17. 17. Know Your Audience… It’s Not Just About the Words • Race/Ethnicity • Age • Gender • Socioeconomic status • Body type • Relationship depicted • Provider (if shown) ethnicity and gender
  18. 18. 2. Organize With the User in Mind • Put most important information first. • Have a purpose, and highlight it. • Chunk it! Use lists, bullets, tables, etc. • Write headings and subheadings that tell people what is coming and that they can scan.
  19. 19. 3. Write Clearly (Think Living-Room Language) • Use active voice. • Break up long sentences. • Focus on one idea. • Use pronouns. • Use familiar words. • Do not rely only on grade level to judge readability.
  20. 20. Get Active • It Was Heard Through the Grapevine By Me (Marvin Gaye) • You Will Always Be Loved By Me (Whitney Houston) • My Heart Was Left by Me in San Francisco (Tony Bennett) • You Are Loved by Her (The Beatles) • You may have been told by your doctor that you have osteoarthritis.
  21. 21. Shorter Is Better • Watch for long, complex sentences. Break them up into short sentences that focus on only one idea. Maybe you’ve heard about different treatments for knee osteoarthritis and wondered which ones work and what you can do to help yourself. Many people can manage knee pain for a long time without surgery. Nonsurgical treatments are generally safe, and you can do many of them on your own.
  22. 22. Get Personal
  23. 23. Find a Plain Alternative Contribute Lead to; Help cause; Add Demonstrate Prove; Show; Teach; Explain Difficulty Trouble; Problems Effective Works well; Useful; How well it works Evaluate Check to see if; Check; Rate; Decide; Think about Monitor Watch for; Keep track of; Check; Look for
  24. 24. Avoid Jargon Consider your audience. Now that you’re off book, remember how we blocked it. Enter up left, in front of the cyc. Cross down center, but arc the cross. When you get to the hot spot, cheat out, or your comic bit with the prop won’t read. And make sure to pick up your cues.
  25. 25. Beware the Formula Reading level is 5.8 Reading level is 5.8
  26. 26. If You’re Using a Formula… • What’s the quickest way to lower reading level? • What should you always do after you rewrite? • If the reading level is 6th-grade or lower, does it mean that your content is plain?
  27. 27. 4. Design to Help Users • Use headings and subheadings. • Use white space. • Pictures and/or videos help people learn. • Color and font can help people navigate. • Lists and bullets and boxes attract attention.
  28. 28. 5. Test With Target Audience • Test early, test often. • Test with people who are like your audience. • Test content, design, functionality. • Use test results to improve product. • Any testing is better than no testing!
  29. 29. The Results Are In… • “I did not know a lot of this information. Thank you for sharing it with me.” (Low-Salt Diets) • “This info was very helpful, since I had never had this condition explained to me.” (Diabetic Ketoacidosis) • “Give more background and information on the three tests listed.” (Tests for ADHD) • “Add some hope.” (Depression and Suicide)
  30. 30. To Sum It Up: 5 Things to Remember 1. Know your audience. (Anyone can have low health literacy.) 2. Organize your message. (Make it easy to follow.) 3. Write clearly. (You are in your living room…) 4. Design for your audience. (Use visual cues.) 5. Test with users. (Make sure you achieved the goal.)
  31. 31. It’s more fun to talk with someone who doesn’t use long, difficult words but rather short, easy words like “What about lunch?” -Winnie The Pooh
  32. 32. Thank you! If you have questions for the instructor or about the workshop, please contact: Karen Baker Healthwise 208-345-1161 To learn more about the Center for Plain Language, go to: Or contact: Rebecca Gholson