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Clear & Simple: Developing Effective Print Materials for Low-Literate Readers
    Updated: 02/27/2003



Introduction






Step I: Define the Target Audience






Step 2: Conduct Target Audience Research






Step 3: Develop a Concept for the Product






Step 4: Develop Content and Visuals






Step 5: Pretest and Revise Draft Materials






References






Appendix 1: Content/Style






Appendix 2: Layout






Appendix 3: Visuals






Appendix 4: Low-Literacy Publications and Software






Appendix 5: Organizational Resources



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Appendix 4: Low-Literacy Publications and Software

Publications

Adult functional competency: A summary. University of Texas at Austin, 1975. To order, contact: University of Texas at Austin, Office of Continuing Education, Austin, TX 78712


Allensworth DD, Luther CR. Evaluating printed materials. Nurs Educ 1986; 11 (2):18-22


American Cancer Society. Cancer and the poor: A report to the Nation. 1989. To order, contact: American Cancer Society, 1599 Clifton Road, N.E., Atlanta, GA 30329 (404) 329-7634


Beyond the Brochure: Alternative Approaches to Effective Health Communications may be available from the Centers for Disease Control and Prevention (CDC). To order, contact: CDC, Technical Information Services Branch, MSA34, Atlanta, GA 30333; (770) 488-5080


Brockett RG. Developing written learning materials: A proactive approach. Lifelong Learning 1984;7(5):16-18, 28


Brown H. Literacy training and older Americans. American Association of Retired Persons, 1989. To order, contact: AARP, Public Policy Institute, 601 E Street, N.W., Washington D.C. 20049; (202) 434-2277


Centers for Disease Control. Literacy and health in the United States: Selected annotations. Atlanta, GA.1991. To order, contact: Centers for Disease Control, Center for Chronic Disease Prevention and Health Promotion, Technical Information Services Branch, MS A34, Atlanta, GA 30333; (770) 488-5080


Childers T. The information-poor in America. Metuchen, NJ: Scarecrow Press, 1975


Crawford AN. A Spanish language Fry type readability procedure: Elementary level. Los Angeles: Bilingual Education Paper Series, Evaluation Dissemination and Assessment Center, California State University, Los Angeles, 1984;7:1-17


Doak C, Doak L, Root J. Teaching patients with low literacy skills. Philadelphia: JB Lippincott,1985


Fox M. A look at illiteracy in America today-- the problem, the solution, the alternatives. Washington, D.C.: Push Literacy Action Now, 1986. To order, contact: Push Literacy Action Now, 1528 Pennsylvania Avenue, S.E., Washington, DC 20003; (202) 547-8903

Garcia WF. Assessing readability for Spanish as a second language: The Fry graph and Cloze procedure. Unpublished doctoral dissertation, Teachers College, Columbia University,1976


Gatson N, Daniels P. Guidelines: Writing for adults with limited reading skills. Washington, D.C.: United States Department of Agriculture, Food and Nutrition Service, 1988


Gilliam B, Pena SC, Mountain L. The Fry graph applied to Spanish readability. The Reading Teacher 1980;33:426-30


Hunter CJ, Harman D. Adult illiteracy in the United States. A report to the Ford Foundation. New York: McGraw-Hill, 1979


Wide Range, Inc. Wide Range Achievement Test (WRAT). Copyright 1984. To order, contact: Jastak Association, Inc., P.O. Box 3410, Wilmington, DE 19804-0250; (302) 652-4990 or (800) 221-9728


Jonassen D, ed. The technology of text, principles for structuring, designing and displaying text. Vol 2. Englewood Cliffs, NJ: Educational Technology Publications, 1985


Kirsch I., Jungeblut A. Literacy: Profiles of America's young adults, final report. Princeton, NJ: National Assessment for Educational Progress, 1986


Kirsch I., Jungeblut A, Jenkins L, Kolstad A: Adult literacy in America: A first look at the results of the National Adult Literacy Survey, National Center for Education Statistics, Department of Education, 1993


Kominski R. Educational attainment in the United States: March 1989 and 1988. US Department of Commerce, Economics, and Statistics Administration, Bureau of the Census, 1991


Kozol J. Illiterate America. Garden City, NY: Anchor Press,1985


Matiella AC. Getting the word out: A practical guide to AIDS materials development. Santa Cruz: Network Publications, 1990


Melton RJ. Developing and adapting written materials for the low literate hypertensive. Salinas, CA: Monterey City Department of Health,1990


Mettger W. Communicating nutrition information to low-literate individuals: An assessment of methods. National Cancer Institute, 1989. To order, contact: Office of Cancer Communications, NCI, Building 31, Room 10A03, 9000 Rockville Pike, Bethesda, MD 20892; (301) 496-6667


Michielutte R, Bahnson J, Beal P. Readability of the public education literature on cancer prevention and detection. J Cancer Education 1990;5:55-61


Nelson GD, Nelson B. Are your patient education materials readable? Health Educator Nov/Dec 1985;3(6):10-11.


Nitzke S, Shaw A, Pingree S, Voichick J.- Writing for reading: A guide for developing print materials in nutrition for low-literacy adults. Department of Agricultural Journalism, University of Wisconsin-Madison, 1986. To order, contact: Human Nutrition Information Service, Nutrition Education Division/GERB, Federal Building, Room 353, 6505 Belcrest Road, Hyattsville, MD 20782; (301) 436-5194


Ontario Public Health Association and Frontier College. The literacy and health project-- phase one. 1989. To order, contact: The Ontario Public Health Association, 468 Queen Street, E, Suite 202, Toronto, Ontario M5A lT7; (416) 367-3313


Pichert JW, Elam P. Readability formulas may mislead you. Patient Educ Couns 1985;7(13):181 -91


Rasmuson M, Seidel R, Smith W, Booth E. Communication for child survival. Academy for Educational Development, 1988. To order, contact: AED, 1255 23rd Street, N.W., Washington, D.C. 20037, Attention: Heathcom; (202) 884-8700


Research and Training Center on Independent Living. Guidelines for reporting and writing about people with disabilities. 1990. To order, contact: Media Project, Research and Training Center on Independent Living, Bureau of Child Research, University of Kansas, 4089 Dole Building, Lawrence, KS 66045; (913) 864-4095 (voice/TDD)


Rice M, Valdivia L. A simple guide for design, use, and evaluation of educational materials. Health Educ Q 1991; 18 (1):79-85


Ross Laboratories. Nutrition education opportunities: Strategies to help patients with limited reading skills. Second Ross Roundtable on Current Issues in Public Health, 1988


Smith SB, Alford BJ. Literate and semi-literate audiences: Tips for effective teaching. J Nutr Educ 1988;20(5)


Spaulding S. A Spanish readability formula. The Modern Language Journal 1956;40:433-41


Spaulding S. Two formulas for estimating the reading difficulty of Spanish. Educ Res Bull 1951; 30:117-24


Srinviasan L. Perspectives on nonformal adult learning. World Education, 1977. Functional Education for Individual, Community, and National Development. To order, contact: CBIS/EDRS, 7420 Fullerton Road, Suite 110, Springfield, VA 22153-2852; 1-800-443-3742 (publication no. ED329218)


US Department of Agriculture, Food and Nutrition Service, Office of Information. Guidelines: Writing for adults with limited reading skills. 1988. To order, contact: The Office of Information, 3101 Park Center Drive, Alexandria, VA 22302; (703) 305-2276


US Department of Health and Human Services. Center for Substance Abuse Prevention (CSAP). Numerous materials are available through CSAP's Clearinghouse. Especially relevant materials are: You Can Prepare Easy-To-Read Materials and You Can Use Communications Principles to Create Culturally Sensitive and Effective Materials. To order, contact: CSAP's National Clearinghouse for Alcohol and Drug Information, P.O. Box 2345, Rockville, MD 20847-2345; 1-800-729-6686 (1-800-SAY-NO-TO-DRUGS)


U.S. Department of Health and Human Services. Guide to preparing easy-to-read materials. Bethesda MD, National Heart, Lung, and Blood Institute, Smoking Education Program, 1989. To order, contact the NHLBI Information Center at (301) 251-1222.


US Department of Health and Human Services. Making health communication programs work: A planner's guide. Bethesda, MD: National Cancer Institute, Office of Cancer Communications,1989. To order, contact: NCl's Cancer Information Service at 1-800-4-CANCER


Venezky RL Kaestle CF, Sum AM. The subtle danger: Reflections on the literacy abilities of America's young adults. Princeton, NJ: Center for the Assessment of Educational Progress, Educational Testing Service, 1987


Walker A. Teaching the illiterate patient. J Enterostomal Ther 1987;14(2):83-6


Werner D. Where there is no doctor. A village health care handbook. 1982. To order, contact: The Hesperian Foundation, P.O. Box 1692, Palo Alto, CA 94302


White JV. Graphic design for the electronic age: The manual for traditional and desk top publishing. El Segundo, CA: Serif Publications: Xerox Corporation, 1988


Wileman R. Exercises in visual thinking. New York: Hastings House, 1980


Zimmerman M, Newton N, Frumin L, Wittet S. Developing health and family planning print materials for low-literate audiences: A guide. Washington, D.C.: Program for Appropriate Technology in Health,1989. To order, contact: PATH, 1990 M Street, N.W., Suite 700, Washington, D.C. 20036; (202) 822-0033




Software for
Determining
Reading Levels


Note to Reader: Each of these software programs should be available from your local computer store. Mention of these products does not constitute an endorsement by the National Cancer Institute.


Grammatik
Checks grammar and punctuation; assesses readability via sentence length, paragraph length, word length, use of technical terms, and use of passive voice. Can flag each "error" for review and correction.
To order, call local software store.


Readability Calculations
Analyzes a document's readability level using nine different readability formulas. To order, contact: Micropower and Light Company, Readability Calculations, 8814 Sanshire Avenue, Dallas, TX 75231; (214) 553-0105

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