Categories: Usability
July 25th, 2012 5:23 pm ET -
Cynthia Baur
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?
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Categories: Usability
July 17th, 2012 10:23 am ET -
Cynthia Baur
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?
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Categories: Plain language
July 9th, 2012 11:31 pm ET -
Cynthia Baur
How many of you work in organizations that have plain language policies? If you work for a federal executive branch agency, the Plain Writing Act of 2010 requires you to use plain language in public communication. The law says that federal agencies must train their staff in plain language and report annually on plain language practices and products.
You can find information on CDC’s plain language practices and read the U.S. Department of Health and Human Services’ first annual report on plain language. At CDC, we train staff who create and clear public communication products in plain language. You can comment on the agency’s use of plain language through our toll-free public information number, 1-800-CDC-INFO.
The Plain Writing Act positions federal agencies to serve as leaders and role models for plain language. Last week, I wrote about the Ten Attributes of Health Literate Health Care Organizations. Several attributes rely on plain language as a technique for clear communication. The large-scale training and monitoring processes that federal agencies are putting in place may help other organizations see how they can do something similar.
Plain language will not solve all the miscommunication that occurs in health. But, plain language policies bring attention to the issue and help clear away the verbal clutter that confuses, distracts and bogs down health communication. Plain language policies can be important catalysts for organizational change.
Please post your comments about plain language policies in your organization. If you have plain language policies, are they working? What are your successes and ongoing obstacles? If you don’t have a policy, what do you need to help create a policy?
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Categories: National Action Plan to Improve Health Literacy
July 3rd, 2012 1:47 pm ET -
Cynthia Baur
Welcome to a re-launch of the CDC Health Literacy blog. The blog is a forum for news, activities and research relevant to health literacy and public health. We aim for weekly posts to keep the information current.
A new contribution to the health literacy field is the Ten Attributes of Health Literate Health Care Organizations. This discussion paper provides steps health care organizations can take to make it easier for people to use the health care system. The Institute of Medicine publicly vetted the idea of health literate attributes in a commissioned white paper and at a November 2011 workshop.
The ten attributes fit with Goals 1, 2 and 4 of the National Action Plan to Improve Health Literacy (Action Plan), which marked its second anniversary in May 2012. The attributes paper lists many of the strategies and actions in the Action Plan and expands the number of actions to reflect new information since the Action Plan was developed.
In addition to the Action Plan, the attributes list draws on other resources and tools that include the
Our knowledge about how to improve health literacy as a means to improve the quality, safety and outcomes of healthcare services is well-developed and growing steadily. Now we need leading health care organizations to apply the tools and resources in a systematic and comprehensive manner and evaluate and publicly report the results.
Although the body of knowledge about health literacy in public health situations is not as well developed, how can the Ten Attributes of Health Literate Health Care Organizations help public health organizations? How can a health literacy focus improve the quality and safety of public health services and population health outcomes?
Please send us your comments on these questions and suggestions for topics of future blogs.
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