Simple language helps convey health information

Liz Seegert

About Liz Seegert

Liz Seegert (@lseegert), is AHCJ’s topic editor on aging. Her work has appeared in NextAvenue.com, Journal of Active Aging, Cancer Today, Kaiser Health News, the Connecticut Health I-Team and other outlets. She is a senior fellow at the Center for Health Policy and Media Engagement at George Washington University and co-produces the HealthCetera podcast.

Photo: Ed Yourdon via Flickr

As I was scanning posters during last spring’s American Society on Aging’s conference, I spotted one presentation that stopped me in my tracks. It wasn’t about a novel piece of research or a study which made overarching claims about a new drug or program.

Rather, it was a simple, straightforward demonstration from Alzheimer’s Los Angeles on the importance of communicating with family caregivers in plain language.

It got me thinking about how journalists might better help their audience — whether print, radio or television — by taking a step back to consider language and health literacy, too. Our stories must be understood by the widest possible audience; sometimes we forget that we’re not just writing for ourselves and our editors.

“It was really important for us to pay attention to who our audience is, and to make sure that our materials are understandable, and that people can actually use them, because the basic tenet of health literacy is not only being able to understand, but to use the information,” said Cathy Ladd, vice president, programs, Alzheimer’s Los Angeles.

There are so many other factors, such as:

  • Are they taking medication?
  • Do they have other chronic diseases and conditions?
  • What’s their language?
  • What’s their culture?
  • Have they had good sleep?
  • Are they eating properly?
  • Are they exhausted?
  • Are they stressed?

“All those kinds of factors go into how somebody understands the information you’re trying to convey,” Ladd explained in a phone interview.

Many writers mistakenly assume our audience has similar backgrounds or education as we do. Most health information is written at or above a 10th-grade reading level, according to Ladd. But almost half (45%) of Americans actually read at or below 6th-grade level; one-third of U.S. adults, regardless of reading level, have trouble acting on health-related information, she said.

With family caregivers so pressed for time and energy, it can be an effort for even the most educated among them to digest and practice health advice. Of course, this isn’t a universal principle, and if you write for a professional journal, your audience’s knowledge level will likely be vastly different than someone who reads the local daily newspaper. However, clear and concise writing, regardless of venue, still matters.

Making hard facts easy reading

“I had to learn that good writing did not equal long, dramatic narratives,” wrote retired Poynter instructor Roy Peter Clark, reminiscing on what he learned in his 40 years of writing and teaching the craft. One strategy for taking responsibility for what readers know and understand was setting an easy pace. ”That meant shorter words, sentences and paragraphs at the point of greatest complexity.”

That’s good advice for those of us seeking to impart health information to anyone pressed for time, has a minimal attention span, and is likely doing or thinking about several other things simultaneously.

According to the Department of Health and Human Services, “The health literacy capacities of a 50-ish English-speaking woman with two years of college and a head cold who is buying a familiar over-the-counter medicine are different in that moment [their emphasis] from the capacities of that same woman when she undergoes diagnostic tests, learns she has breast cancer, and has two different treatment options, neither of which she really understands.”

Now imagine you’re that same 50-ish woman (or man), who works outside the home full time at a demanding job, has a teenager or two living at home, and care for your 80-year-old mother with moderate Alzheimer’s. You’re flipping through the newspaper while coordinating your teen’s ride home from practice and encouraging your parent to eat some of the dinner you so painstakingly prepared, and cut into small bites because mom is no longer able to safely use a knife.

The last thing you have time for is looking up medical definitions, or re-reading that complex paragraph to fully understand why the latest, most promising drug for dementia has failed a Phase II clinical trial.

You may be extremely competent at your day job, but when it comes to health care, you may struggle with the complexity of information presented, unfamiliar use of scientific and medical jargon and the difficulty that people of all literacy levels have in understanding information when confronted with their own or a loved one’s stressful or unfamiliar situation. Any useful information in that story likely goes by in a blur, if it is understood at all.

“Caregivers are so busy, they’re so stressed. And even the ones that have things under control, we all want to consume information now quickly, That’s the way things are just moving in society now,” Ladd said.

The organization developed simple tip sheets addressing numerous Alzheimer’s-related behaviors, like agitation and keeping the home safe. Each takes a three-step approach: identify the behavior, explore and understand the meaning and the cause of the behavior, and then as a caregiver, adjust by adapting to what is happening to the person. “Our goal was to give them these tips, give them some basic information without overwhelming them,” she said.

Caregivers are expected to navigate the health system, manage medical appointments, treatment, participate in decision making, keep on top of insurance and take care of their own health simultaneously. According to Sue Stableford, co-founder, University of New England Health Literacy Institute, poor health literacy can result in uneven adherence in managing chronic conditions, resulting in poor outcomes, decreased likelihood of getting preventive care, increased hospitalizations, higher costs, and higher risk of death.

That’s where plain language writing comes in. It works for anyone seeking to convey complex health information, including journalists. It doesn’t mean “dumbing down” what you write, but rather, keeping the writing clear, brief and inclusive. It’s about tone as much as language.

The Agency for Healthcare Quality and Research suggests using or defining common words and avoiding undefined technical terms; using positive words and avoiding a long string of nouns. They recommend active voice, present tense and action verbs.

As journalists, we have a responsibility to provide health information without overwhelming our readers/listeners/viewers. Keeping our writing focused, simple and clear is one way to do that.

As Roy Peter Clark wrote, “journalism, at its best, seeks the largest possible audience, thinking of readers as citizens, inviting them into a public conversation.”

Resources

This tip sheet has ideas for helping older adults get the most value from your writing.

Even the best writers need a little editorial help. Online tools such as Hemingway Editor and Grammarly, (available as a browser extension) make it easy to catch and correct errors, and make writing more simple and powerful.

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