Plain Language and Health Literacy

© Romina Marazzato Sparano
Plain Language 2.0 & Health Literacy
Romina Marazzato Sparano
languagecompass

LanguagesRomina Marazzato Sparano

What we’ll cover
 Health Literacy definition
 Factors that affect HL
 Context & statistics about literacy
 Plain Language definition & role
 Plain Language strategies
textuality: building sense, &
adequacy: addressing the audience
 Some extra points: readability formulas, versioning, design

Health Literacy
 Obtain
 Process
 Understand
basic health information & services
needed to make
appropriate health decisions

Health Literacy
 Gain access to
 Understand
 Use
information to
promote & maintain good health
for themselves,
their families, &
their communities

Limited Health Literacy
Emergency
Room
Hospitalizatio
n
Treatment
Preventive
Care
Health
Status

Health Communication in Plain Language
Skill,
Attitudes,
& Behavior
Skills &
Attitudes
Policy &
Services
Misperception
& Myths
Awareness
& Knowledge

Health Literacy
World & Health
Knowledge
General
Literacy &
Intelligence
Social &
Communication Skills
Providers’
Knowledge
& Skills
Culture
& Beliefs
languagecompass

Education for individuals & professionals to promote:
 Health literate citizens
 National Health Education Standards
 1995 & 2007 – Better implementation: Continuity & Scaffolding
 Partnerships for adult instruction & awareness
 Storylines, media advocacy, college
 Culturally sensitive professionals
 National Standards for Culturally and Linguistically
Appropriate Services (CLAS) in Health and Health Care

System Changes
 Policies / Federal & State Coordination
 Plain Writing Act: PLAIN is budget-less! (federal)
 §508 – Rehabilitation Act (federal)
 Quality Standards / Ethics
 Organizational Support
Ex: Process Redesign + Signage
UK Design Council:
Design Challenge to
improve patient experience

(Better) Plain Language Writing
Audience
Purpose
Structure
Design
Wording

In HL Audience
╪ Interlocutors
> Versioning?
Distressing &
Time-sensitive
Situations

Disabilities
Limited Schooling
Second Language
Expertise
Interests
Situational Literacy
Audience = Interlocutors

Situational Literacy

From Health Literacy In Clinical Research by
the Multi-regional Clinical Trials Center of Brigham and Women's Hospital
and Harvard

healthliteracy.bu.edu/all
 SAHL–S&E: Short Assessment of Health
Lit. Spanish & English
18-item – 403 sample
 REALM-SF: Rapid Estimate of Adult Lit. in
Medicine Short Form
8-item – 1500 sample
Questions on scale validation:
vocab knowledge vs. CALS

Health Literacy Levels
Below Basic
14%
Intermediate
53%
Basic
21%
Proficient & Above
12%
Identify
single item
Determine
single item
Make an
inference
Make multiple
inferences

Text Here
20%
Identify Determine Calculate Synthesize

14% Below 53% Intermediate21% Basic 12% Proficient & Above
IQ:
HL:
Health Literacy-IQ
Mismatch
2% Disability 68% Normal14% Low 16% Above Normal

What is Intelligence?
• IQ Tests & the Bell Curve
• Flynn Effect & Reversal
© Romina Marazzato Sparano 2019

14% Below 53% Intermediate21% Basic 12% Proficient
Health Literacy-IQ
Mismatch
IQ:
HL:

Japan
Finland
Netherlands
Australia
Sweden
Norway
Flanders (Belgium)
Czech Republic
Slovak Republic
Canada
Average
UK
Denmark
Germany
United States
Austria

Verbatim | Some Inference | Interpretation
50% higher level
inference
50% lower level
inference
OECD Assessment of Adult CompetenciesTOMATO SOUP
$1.15
Weight: 3.5 oz
Packaged on:
5/17/12
ORANGE JUICE
$2.99
Weight: 64 oz
Packaged on:
11/8/12
BEEF JERKY
$6.29
Weight: 16 oz
Packaged on:
2/24/12
PEANUT
BUTTER
$3.36
Weight: 28 oz
Packaged on:
3/24/12

Cater to All Readers (Consider Versions)
 25% do not understand Earth orbit
 30% astrology = science
 50% major bills have a scientific component
 Juries evaluate technical evidence
 Scientists do not reach one another
 73% more citations if in The New York Times
 No access to publicly funded research
1 year
* OECD, NSF, NCBI, & Pew Research
Public
Law
Science

Plain Language 2.0
LOCATE UNDERSTAND ACT UPON
relevant information

Plain Language
The idiomatic and
gramatical use of
language that that most
effectively
presents ideas
to the reader

SP War Corp.
1944
Consumer Affairs
1973
Plain English Campaign
1979
Land Management
1966
plainlanguage.gov
1994
Plain Writing Act
2010
Maury
Maverick
Kathryn
Catania
Katherine
Spivey
Chrissie Martin
Maher CuttsJohn O’Hayre
Bess
Myerson
Space + Time + MoneyPL Milestones

Oratory
~70CE
Spanish
~1250
English
~1420
Do not simply promote understanding,
prevent misunderstanding…
And, in matters of style, indulge in elegance,
for a writer wins but trivial praise if he gives
no more than clarity: his text seems free from weakness rather
than full of strength.
Quintilian Alphonse X Henry V

©

Address your readers needs
from their point of view

Simple English
Wikipedia

Regular Wikipedia

Links to Journal

Acceptance by the Bank of payments in arrears shall not constitute a
waiver of or otherwise affect any acceleration of payment hereunder or
other right or remedy exercisable hereunder. No failure or delay on the
part of the Bank in exercising, and no failure to file or otherwise
enforce the Bank’s security interest in or with respect to any Collateral,
shall operate as a waiver of any right or remedy hereunder or release
any of the undersigned, and the Obligation of the undersigned may be
extended or waived by the Bank, any contract or other agreement
evidencing or relating to any Obligation or any Collateral may be
amended and any Collateral exchanged, surrendered or otherwise dealt
with in accordance with any agreement relative thereto, all without
affecting the liability of any of the undersigned.
You can delay enforcing any of your rights
under this note without losing them.

Rhode Island Dep. of Health -
Division of Community Health
and Equity
And MAXIMUS Center for
Health Literacy
SPANISH
“Brexit means Brexit and we’re going to
make a Titanic success of it.”
British Politician

Dig Deeper: into the inner workings of text

Adequacy + Textuality
Wording
Grammaticality
Connectivity
Syntax
Word Order
Punctuation
Cohesion
Lexical
Grammatical
References
Recasting
Connectors
Coherence
Subject matter
Information Flow
Relationships
Better Plain Language Writing

Migraine is a disabling condition that affects nerves and blood vessels.
Its main symptom is sudden pounding pain usually on one side of the
head. Migraine also includes other symptoms like sensitivity…
Audience: More than lay term substitutions
Migraine is an incapacitating disorder of neurovascular nature,
characterized by paroxysmal attacks of unilateral throbbing headache
and autonomic nervous system dysfunction, including sensitivity…
Migraine is a type of headache that:
• causes pounding pain, often on one side of the head, and
• includes symptoms like sensitivity to sound, light, or smell.

What are polyps?
A colonoscope, the flexible device used to inspect the colon, can
grab and snip off polyps if they are relatively small. The timing of
follow-up depends on what kind of polyps the doctor finds, how
many, and how big they are.
What are colon polyps?
A polyp is a small clump of cells that forms on the lining of the
colon. Most colon polyps are harmless. But over time, some can
develop into colon cancer, which is often fatal when found in its
later stages.
Purpose: scaffold understanding with topic consistency

Topic, Frames & Isotopies
Semantic Frames
Conceptual Pragmatic

The procedure is actually quite simple. First you arrange items into
different groups. Of course one pile may be sufficient depending on how
much there is do. If you need to go somewhere else due to a lack of
facilities, then this is the next step; otherwise, you are pretty well set. It
is important not to overdo things. That is, it is better to do too few things
at once than too many. In the short run, this may not seem important
but complications can easily arise. A mistake can be expensive as
well. At first, the whole procedure will seem complicated. Soon, however,
it will become just another facet of life. It is difficult to foresee any end to
the necessity for this task in the future, but then, one can never
tell. After the procedure is completed, one arranges the materials into
different piles again. Eventually they will be used one more and the
whole cycle will then have to be repeated. However, that is part of life.
What is the passage about?

Wording: Go beyond bulleted advice
• Write as if you were speaking?
- Planned vs. Extemporaneous
- Tight vs. Loose Structure
- Productvs. Process
• Use active voice?
Charrow & Charrow:
“passives do not impede comprehension”
• Apply readability formulas?
Not a clear measure of comprehensibility

Wording: Grammaticality + Connectivity
GRAMMAR:
Syntax – Word Order – Semantic Roles – Punctuation
COHESION:
LEXICAL: Repetitions – Definitions – Associations
GRAMMATICAL: References – Recasting – Connectors
COHERENCE:
INFO FLOW: Topic – Frames – Conceptual Links
RELATIONSHIPS: Resemblance – Contiguity – Cause & Effect

Medical Text Features – Beyond the Lexicon
Colorectal cancer (CRC) is associated with a considerable mortality
rate that can be reduced by using different prevention strategies.
Among such strategies, endoscopic surveillance of high-risk
individuals and population-based endoscopic screening of average-
risk individuals enables detection and removal of premalignant
lesions (adenomas) as well as presymptomatic detection of cancer.
Similarly, implementation of cancer detection tests such as fecal
occult blood tests (FOBTs) is another strategy to reduce cancer
mortality by early detection of CRC. We hypothesize that
personalized management, based on information concerning
environmental and lifestyle factors, and phenotype in combination
with a variety of genotipic biomarkers will become more important as
a strategy to optimize CRC prevention in the future.

colorectal, implementation
similarly
that can be reduced
strategies
[exemplification] among such
strategies
we hypothesize
Technical Texts Features
complex terms
complex syntax
discourse markers
anaphoric reference
text organization
metalinguistic vocabulary

Grammaticality: “Miss stakes wee May knot sea”
Migraines strike twice as many women as do men.
The patient was side-swiped by a car riding a bicycle.
We advised the patient to force fluids through his interpreter.
Administer 4IU insulin.
4 international
units?
41 units?

Scaffolding is breaking up the learning into fragments and
then
you provide a tool, or structure, with each fragment.
Grammar: Parallel Structure
Occam’s Razor: SIMPLIFY
Scaffolding is breaking up the learning into chunks
and then providing a tool, or structure, with each
chunk.

Grammar: Garden Paths & Ambiguity
The new data convinced her students have the maturity to
talk about difficult subjects.
her that students have…
Object + Subordinate Clause
her students
NP: possessive + noun
convinced…
Small Word Matter!

Punctuation: The $5M Comma (?)
 Truck drivers sued a dairy for 4 years of due overtime pay
 Maine law exempts overtime pay for:
The canning, processing, preserving, freezing, drying,
marketing, storing, packing for shipment or distribution of:
(1) Agricultural produce;
(2) Meat and fish products; and
(3) Perishable foods.
No series comma!
No parallel structure, either!
-ing form

Commas are a pause
for the mind!
About Commas
Use commas with
 Lists
 Coordinated clauses
 Transition expressions
 Parenthetical expressions
Non-restrictives, appositives, etc.
 Displaced expressions (away from canonical position)
 but NEVER between a subject and its verb!

Noun Piling
Buried cable technician

Let’s Practice: Ambiguity & Noun Piling
Cell/Oxygen Research British-American Trio Medicine Nobel
Prize Winner
British-American Trio Awarded Nobel Prize in Medicine for
Cell/Oxygen Research
It plays a more important role in learning content delivery.
It plays a more important role in the delivery of learning
content.
…delivering educational content.

Cohesion: strategies to shorten & link sentences
Several techniques are available for removal of large
colorectal polyps found in the early stages which are
oncologically and technically successful for most such
polyps and remain one of the most effective interventions
for colorectal cancer prevention.
Several techniques are available to remove large
colorectal polyps early. Early removal of these
polyps remains one of the most effective
interventions for colorectal cancer prevention.

= Cohesion ≠ Adequacy
Several techniques are available to remove large
colorectal polyps early. Early removal of these polyps
remains one of the most effective interventions for
colorectal cancer prevention.
Doctors use different techniques to remove large
polyps (lumps or growths) from the bowel early.
Taking away these polyps early is one of the best
ways to prevent colon cancer (cancer in the bowel).

Nominalization is not Evil!
PRODUCT
PROCESS
The jaw replacement helped her
regain her confidence.
The surgeons replace the diseased jaw
with a titanium plate.
1. Abstraction: density
agent + action
2. Rhetorical organization:
process vs product

Nominalizations
3. Cohesive device:
information flow
Most importantly I strongly believe in the mission, vision
and direction of this project. These beliefs inspire me to
take on this new challenge....
LEXICAL
pronouns, repetitions
synonyms, hyponyms, hypernyms
definitions, explanations
word families & topical lexicons
GRAMMATICAL
ellipsis
references & substitutions
recasting: fronting, passive, cleft
discourse markers & punctuation
TAM system

Recasting Nominalization
 Reverse abstraction to habitual verbs
 Use a sensory experience (participant + process)
 Find an alternative cohesion strategy
shared knowledge and understanding all be on the same page
improvement / postponement bring up, put off
bring up, put off

Clinical Trial Text for Patients – BEFORE
Participants who were assigned to a study treatment group
will make 10 visits over a 7-week period. These visits will be
paid for by the study. Regardless of group assignment, all
participants will be contacted at 2, 6, and 12 months after the
start of the study for about a 20-minute telephone interview.

Clinical Trial Text for Patients – 1ST DRAFT
If you are in a study treatment group, you will make 10
visits over a 7-week period. The study will pay for these
visits. No matter which group you are in, we will call you
for three phone surveys that will last about 20 minutes
each. These surveys will take place 2, 6, and 12 months
after you join the study.

Clinical Trial Text for Patients – AFTER
You will answer three phone surveys at 2, 6, and 12
months after you join the study. These surveys will last
about 20 minutes each. If you are in a study treatment
group, you will also make 10 office visits over a period of
7 weeks. These visits will be free of charge.

Theme Rheme
Participants who were
assigned to a study
treatment group
will make 7 visits over a
7-week period.
These visits will be paid for by the study.
Regardless of group
assignment,
all participants
will be contacted at 2, 6, and
12 months after the start of the
study for about a 20-minute
telephone interview
Coherence: Flow & Hierarchy

Theme Rheme
If you are in a study
treatment group
you will make 7 visits over a
7-week period.
The study will pay for these visits.
No matter which group
you are in, we
will call you at 2, 6, and 12
months after the start of the
study for about a 20-minute
telephone interview
= Issues ≠ Adequacy

Theme Rheme
You will answer three phone surveys at 2, 6,
and 12 months after you join the study.
These surveys will last about 20 minutes each.
If you are in a
study treatment
group,
you will also make office visits once a
week for 7 weeks.
These visits will be free of charge.
Coherence + Adequacy (lay version)

Before & After: Streamlining the message
when
patients actions when cost
all survey months time
some visit weeks money (free)

Theme Rheme
All participants answer three phone surveys at 2, 6, and
12 months after joining the study.
These surveys last about 20 minutes each.
Participants in
a treatment
group
also make office visits once a week for 7
weeks.
These visits are free of charge to participants.
= Coherence ≠ Adequacy (technical version)

Abstract: Reassessing Hyterectomy
The surgery performed to remove the uterus is called a
hysterectomy. The removal of the uterus relieves symptoms caused
by medical conditions affecting this organ. It is usually only
considered if other treatments aren’t effective enough. It is a major
surgical procedure that is associated with risks and side effects.
Hysterectomy may be necessary to remove the tumor if a woman
has uterine or ovarian cancer.

Theme Rheme
The surgery
performed to remove
the uterus
is called a hysterectomy
The removal of
the uterus
relieves symptoms caused by medical
conditions affecting this organ.
So it [hysterectomy] is usually only considered if other
treatments aren’t effective enough.
It [hysterectomy]
Hysterectomy
is a major surgical procedure that is
associated with risks and side effects
may be necessary in order to remove the
tumor if a woman has uterine or … cancer
cancer © Romina Marazzato Sparano 2019

Abstract
A hysterectomy is a surgery to remove the uterus. The removal of
the uterus relieves symptoms caused by medical conditions
affecting this organ. If a woman has uterine or ovarian cancer, for
instance, a hysterectomy may be necessary in order to remove the
tumor. But it is a major surgical procedure that is associated with
risks and side effects. Because of these risks, it is usually only
considered if other treatments aren’t effective enough.

Theme Rheme
A hysterectomy is a surgery to remove the uterus.
The removal of
the uterus
relieves symptoms caused by medical
conditions affecting this organ.
If a woman has
uterine… cancer
hysterectomy may be necessary in order
order to remove the tumor.
But it
Because of these
risks, it
is a major surgical procedure that is
associated with risks and side effects.
is usually only considered if other
treatments aren’t effective enough.

Recasting: Syntactic Redistribution
Rearrange structure
Preserve semantic roles
Old before new
References
Bad neighbors
Memory
Effect Subject ≠ Agent ≠ Topic
My keys disappeared.

Recasting with Passive Voice: shedding light on the object
The baby, Jack tells his wife, had been brought to the
hospital by a fireman, who had been dissuaded from
adopting the child himself.
When agent is
Unknown
Ir/Relevant to object view
(Process vs. Product)
Heavy and new!

Sequence Timeline
Cause
Effect
Question
Answer
Hierarchy
Message Structure

Design & Data Visualization
 Credit: Wellcome Collection

Design
0
10000
20000
30000
40000
Most Populated Cities in M
38000
28000 25700
22700 22000 21700 21500 20000 19700 18700
Most Populated Cities in M
in M
City Population
in M
Tokyo 38,000
Delhi 28,000
Shanghai 25,700
Beijing 22,700
Mumbai 22,000
Sao Paulo 21,700
Mexico City 21,500
Cairo 20,000
Dakha 19,700
New York 18,700

Design

Trebecular Bone
Trebeculae: 3D Lattice
• Structural support and flexibility
• Lighter than compact bone
Inspired in a presentation by Dr. Genevieve Brown

Show, Don’t Tell
Work
Education
Eating
Self-care
Sleeping
Phone Calls
Religion
Sport
s
Leisure
Shopping
Prof. Svc.
Non-
household
Household
Homework
Misc.
Volunteering
Traveling
1,000 people
average day

Accessibility
 Section 508 of the Rehabilitation Act:
provide ICT accessible to people with disabilities
Do not take
a bath

Scaffolding New Attitudes
Hey guys, I don’t even feel any
rain! Why are you doing this
again? Just put down the
stupid umbrellas—they’re bad
for your arms anyway.
Immunization Campaign
&
Herd Immunity

Use of Metaphor
 Conceptual metaphors
 Structure most basic understanding of experience
 Shape perceptions & actions without us noticing
 Metaphors We Live By - Lakoff & Johnson
• Time is Money: spend/save time
• Status has height: lofty/lowly position
 Teaching thinking by analogy
• Explain how MRI works

Amenable mortality:
preventable by timely and
effective health care inside
and outside of hospitals.
Caution about
Simplification
Inefficacy of the
Health Care System

Summary
1. Health Literacy encompasses:
• Individual Skills
• Providers’ Skills
• System Features
• Plain Language Use
2. Room for improvement in every dimension
3. In Plain Language > Strategies for a deeper dive into:
• Textuality:
grammar, structure, cohesion/coherence, design
• Adequacy:
suitability to the audience

Wording
Audience
Purpose
Structure
Design
Dig Deeper! Better Plain Language Writing
Review for and adequacy

Plain Language is Also for Health Experts!

Readability Formulas
Flesch Reading Ease
Flesch-Kincaid Grade Level
SMOG
Fry’s Readability Graph
New Dale-Chall
Robert Gunning’s Fog Index
Fry’s Readability Graph
FORCAST
Spache

SMOG Formula
Count polysyllables in 30 sentences
 10 from START
 10 from MIDDLE
 10 from END
~ Grade = #polysyllables√ + 3
Grade =
#polysyllables
#sentences
+ 3.1291√30 x1.0430

Dale-Chall
Raw Score = 0.1579 x PDW + 0.0496 x ASL
PDW: Percentage of Difficult Words
ASL: Average Sentence Length in Words
If PDW > 5%, use Adjusted Score (> 4th gr)
Adjusted Score = Raw Score + 3.6365

Flesch’s Reading Ease RE = (hard) 0-100 (easy)
( )total words
total sentences
1.015 x ( )total syllables
total words
206.835 - - 84.6 x
( )total words
total sentences
0.39 x ( )total syllables
total words
+ 11.8 - 15.59
Flesch-Kinciad Grade Level

Don’t Let Readability Formulas Fool You!
Before scoring text:
 Strip formatting
 Watch out for poor manipulation
 Check grammaticality
 Ensure cohesion and coherence of the content

Scoring Text
We need to talk about dealing with
distractions and, um… interruptions when
we’re trying to work. Yeah, I mean, it’s really
important. And I think, nowadays, you know,
for people with families.
Transcript
Great Readability Scores?!

Scoring Text
The Virginia opossum is alone. In North
America like kangaroos. Female opossums
have babies. They use a pouch like
kangaroos. They have thumbs and tail.
They can grasp easily. They use them to
help themselves climb. While hairless they
are cute. They have a pointy snout and look
like rats, opossums are not even in the
same family as rodents.

These rescission risks for an investor are more prevalent during swift upward
price movement periods. The market conditions which favor speculator
activity are precisely the same conditions that cause a seller of a property to
demand their home be returned. A profit has come about within two years
which is now sought by both the investor, who speculated and gained by a
flip, and the seller, who believes they were ripped off of the profit taken by
the investor..
Realty Publications

Investor
These rescission risks for an investor are more prevalent
during swift upward price movement periods. The market
conditions which favor speculator activity are precisely the
same conditions that cause a seller of a property to demand
their home be returned.
Seller
A profit has come about within two years which is now
sought by both the investor, who speculated and gained by
a flip, and the seller, who believes they were ripped off of
the profit taken by the investor.

Readability Formulas
Word Length
Sentence Length
Need Proper Text Manipulation
 Grammaticality & Connectivity?
 Structure & Design?
 Meaningful & Interesting?

Bonus Practice: Polycytemia vera
 Panhyperplastic, malignant, and neoplastic marrow disorder.
Spleen

Not about jargon!
With disease progression splenomegaly occurred in
most cases and the bone marrow is showing increasing
signs of fibrosis, which causes extramedullary
erythropoiesis during the disease course.
As the disease progresses, the size of spleen increased
in most cases. The bone marrow shows more and more
scar tissue. The body produces red blood cells outside
of the bone marrow.

Normal
Erythropoiesis
Extramedullary
Erythropoiesis

Plain Language for Experts
With disease progression splenomegaly occurred in
most cases and the bone marrow is showing increasing
signs of fibrosis, which causes extra medullary
erythropoiesis during the disease course.
In most cases, the bone marrow undergoes varying
degrees of fibrosis, forcing the spleen into extra
medullary erythropoiesis and resulting in
splenomegaly.

Plain Language for Lay Audiences
In most cases, the bone marrow undergoes varying
degrees of fibrosis, eventually forcing the spleen into
extra medullary erythropoiesis and resulting in
splenomegaly.
In most cases, scar tissue takes over the bone
marrow. Normally, bone marrow produces blood
cells. But the scarred bone marrow cannot produce
blood cells. Because of this, the spleen has to work
harder to produce red blood cells outside of the bone
marrow. This causes the spleen to enlarge.

Techniques
 Align verb tenses for consistent time reference
 Use parallel structure for equivalent ideas
 Repair and express logical relations
Rearrange sequential order
Indicate similarity and contrast
Express cause/effect
 Adapt register and terminology different audiences

Plain Language for Experts: Tighten your Wording
 Smoking Cessation Programs Comparative Study
 Comparative Study on Smoking Cessation Programs

Smoking Cessation Text: BEFORE
The requirement participants must meet will change each day but
if they keep meeting the criterion, the payment escalated by 10
pesos (equivalent to $.50). If participants ask how to meet the
specified condition, they were advised that they will definitely
meet the criterion if they stop smoking completely; nevertheless,
they may still meet the criterion by cutting down on their
smoking. Answering any of the participant's questions, the
scheduling of morning and afternoon appointments proceeds for
each of 5 consecutive days, regardless of workdays or weekend
days, in the next week.

Smoking Cessation Text: Target AFTER
The requirement that participants must meet changes every day,
but, if they keep meeting the requirement, participants receive
an additional 10 pesos (equivalent to $.50).
If participants ask how to meet the requirement, they are advised
that:
• they will meet the requirement if they stop smoking
completely, and that
• they may meet the requirement if they reduce their smoking.
After answering questions, the research assistant proceeds to
schedule morning and afternoon appointments for each
participant on 5 consecutive days during the following week.

Smoking Cessation Text: Target AFTER – LAY AUDIENCE
The goal for you will change every day, but, if you meet each new
goal, you will receive an additional 50 cents.
How to meet your goal
• stop smoking completely, or
• reduce your smoking. But know that this may not be enough
to meet your goal.
Questions?
Ask our research assistant! They will be happy to answer.
…

Techniques
 Use consistent terminology
 Abide by collocations:
“someone meets a requirement“
 Match verb tenses for logical time reference
 Create lists for structural clarity
 Use parallel structure for equivalent ideas
 Add headings to guide the reader
 Apply economy of words: include only relevant content
Grice's Maxims: quantity, quality, relevance, manner

THANK YOU!!!
Follow me on
@LanguageCompass
Image Attributions
• Used for education
• For-fee accounts at 123rf.com &
Clipart.com
• Collaboration with illustrators
• Logos and Trademarks belong
to their owners

Plain Language and Health Literacy

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