Last week’s blog post discussed insights that connect web usability testing to the challenges people face with health literacy tasks. Finding health information or using health services are some examples.  In web usability testing, end users try to complete standard tasks. Their successes and failures inform changes to the web site.

The idea that people face health-related tasks – some informational, others related to products and services – comes from the field of education, specifically literacy assessment and adult education. The National Assessment of Adult Literacy (NAAL), the benchmark study of the health literacy skills of adults in the U.S., includes various literacy tasks, some health-related, with different degrees of difficulty.

The NAAL tasks are based on an analytical approach to understanding how people interact with print materials that is not common in health communication and health education.  An exception has been the work of Dr. Rima Rudd, Harvard School of Public Health. She suggests we consider how and why people use what we provide and then structure the tasks so they can accomplish them with greater ease. For example, think about the number of items in a 4 column, 10 row table. Finding relevant information is not easy if the table is too complex.    

A tool developed by educators helps us analyze the structural complexity of some of our documents. The PMOSE-IKIRSCH tool can be used to analyze document formats by counting the elements in lists, charts, graphs, and labels to produce a score, letting us know how easy or complex a document is.  

The formula directs our attention to the importance of analyzing and reducing task complexity. Task analysis requires us to stop and consider:  what are we asking our intended end users to do with the health information, products or services we create? How complex are the tasks? How likely is it that users can be successful?

Please share your ideas about using a task analysis approach to health literacy work. Have you already tried this approach? How did it work for you?

If you want to address limited health literacy and haven’t made Jakob Nielsen’s periodic reports on usability a regular read yet, you should. Usability methods place the person who needs to complete a task or use a product at the center of the design and testing process.

Health literacy is also about how people complete tasks and use products and services. Some of the tasks are informational, such as knowing the warning signs of a heart attack. Other tasks involve information and products, such as preparing a family emergency kit. Other tasks involve services, such as free preventive health screenings.  

Nielsen says that usability has two dimensions. One, usability is a quality attribute of “user interfaces”, or the part of a product that a person interacts with. Two, usability is a method to make it easier for end users to complete tasks. If we want someone to know the three most important signs of a heart attack, we can use usability methods to find out how to make it easy for our end users to find and extract that information from our fact sheet.   

The July 16, 2012 Alertbox is highly relevant for health literacy practitioners.  Nielsen poses the question, what if you only have time and money to do one type of usability test? Should you observe users in action at the beginning of the design process, or should you wait and test a prototype with actual users? Although it might seem most effective to catch all flaws at the beginning, Nielsen says that given the parameters, letting users try out your prototype is the only way to know if you’ve created something they can use.  

Even when we don’t have all the resources we’d like to test health information, products or services, Nielsen reminds us we must commit to test with our intended users. If we want people to find, use and make decisions based on what we create, then we need to know what they can and can’t do with our creations.  

How can you apply the principle of user testing in your work? If you already apply usability methods, what works best  and what cause problems for you? Are there special considerations for different types of end users?