Writing for the Web: What the Research Tells Us Writing for the Web: What the Research Tells Us...

Writing for the Web: Writing for the Web: What the Research Tells What the Research Tells

UsUs

Plain Language WorkshopPlain Language Workshop

April 1, 2008April 1, 2008

Sandra Williams HilfikerSandra Williams HilfikerOffice of Disease Prevention and Health Promotion Office of Disease Prevention and Health Promotion

U.S. Department of Health and Human ServicesU.S. Department of Health and Human Services

healthfinder.govhealthfinder.govhealthfinder.gov is an award-winning Federal Web site for consumers, developed in 1997 by the U.S. Department of Health and Human Services together with other Federal agencies. healthfinder.gov links to carefully selected information and Web sites from over 1,500 health-related organizations.   

healthfinder.gov Redesignhealthfinder.gov Redesign

Redesigned to be easier for the public to Redesigned to be easier for the public to useuse

Includes new prevention and wellness Includes new prevention and wellness information that is actionable and easy to information that is actionable and easy to understandunderstand

Provides links to reliable health Provides links to reliable health information and resources from trusted information and resources from trusted sourcessources

healthfinder beta available to the public in healthfinder beta available to the public in April 2008April 2008

RationaleRationale More Americans are expected More Americans are expected

to take responsibility for to take responsibility for managing their health.managing their health.

Current online health Current online health information landscape creates information landscape creates more stress than support.more stress than support.

People cannot find the People cannot find the information they seek on Web information they seek on Web sites about 60% of the time.sites about 60% of the time.

ChallengesChallenges

Adults with limited health literacy skills:Adults with limited health literacy skills:– Are not accustomed to using the Internet Are not accustomed to using the Internet

as a health resourceas a health resource– Prefer mass media or interpersonal sources Prefer mass media or interpersonal sources

of health information of health information – Are typically unable to handle many of the Are typically unable to handle many of the

multiple and complex tasks in e-health multiple and complex tasks in e-health toolstools

– Have difficulty reading and understanding Have difficulty reading and understanding most online health contentmost online health content

Evidence BaseEvidence Base

Existing research-based Existing research-based recommendations from HHSrecommendations from HHS

Leading theories of health behavior Leading theories of health behavior change and health communicationchange and health communication

Original research conducted using an Original research conducted using an iterative design process with more iterative design process with more than 600 participants ages 18-84than 600 participants ages 18-84

Original ResearchOriginal Research

– Descriptive AnalysisDescriptive Analysis– Expert Panel ReviewExpert Panel Review– Structured InterviewsStructured Interviews– Mental Models Mental Models

ResearchResearch– Card Sort StudyCard Sort Study– Prototype Evaluation Prototype Evaluation

(Web-based and in (Web-based and in person)person)

– Usability StudiesUsability Studies

Guiding PrinciplesGuiding Principles

1.1. Information on a Web site must be easy to Information on a Web site must be easy to locate, navigate, and use. locate, navigate, and use.

2.2. Health information written for the public Health information written for the public should improve understanding, build should improve understanding, build knowledge of the body and the causes of knowledge of the body and the causes of disease, and facilitate healthy disease, and facilitate healthy decisionmaking.decisionmaking.

3.3. To influence behavior change, information To influence behavior change, information must be relevant, motivating, and include must be relevant, motivating, and include specific steps for taking action.specific steps for taking action.

4.4. Web sites & content designed for those Web sites & content designed for those with limited literacy will benefit everyone.with limited literacy will benefit everyone.

What we Learned…What we Learned…

1.1. Writing contentWriting content

2.2. Navigation and site structureNavigation and site structure

3.3. Features and toolsFeatures and tools

4.4. Page layout and designPage layout and design

5.5. Usability testing & Iterative DesignUsability testing & Iterative Design

Writing ContentWriting Content

Tone and StyleTone and Style Users want “just the basics” about a topic.Users want “just the basics” about a topic. Use everyday language and examples.Use everyday language and examples. Give users positive reasons to change their Give users positive reasons to change their

behavior.behavior. Avoid blanket recommendations – be Avoid blanket recommendations – be

specific.specific. Tell users how to do the behavior. Break it Tell users how to do the behavior. Break it

down into small steps.down into small steps. Don’t dwell on barriers. Provide tools and Don’t dwell on barriers. Provide tools and

encouragement.encouragement.

Audience Segments Based on Audience Segments Based on User MotivationsUser Motivations

Users shift frequently between Users shift frequently between segments.segments.

““I want information about a topic.” I want information about a topic.”

““Should Should II be concerned?” be concerned?”

““I want to do something.”I want to do something.”

Formula: Basics, Benefits, Formula: Basics, Benefits, ActionAction

Everyday Language:Everyday Language:Be Succinct, Small ‘Chunks’Be Succinct, Small ‘Chunks’

Actionable Information: Actionable Information: Small Steps ApproachSmall Steps Approach

Instead of:Instead of: Eat a diet rich in fruits, vegetables, grains, and low-fat Eat a diet rich in fruits, vegetables, grains, and low-fat

milk products. milk products. Avoid saturated fats, sodium, and added sugars.Avoid saturated fats, sodium, and added sugars.

Give action steps:Give action steps:

Small Steps Approach, Small Steps Approach, cont’dcont’d

Include simple Include simple actions that users actions that users can do right away.can do right away.

This reinforces This reinforces behavior and behavior and improves self-improves self-efficacy.efficacy.

Using Everyday Language: Using Everyday Language: Avoid JargonAvoid Jargon

HealthfulHealthful Physical ActivityPhysical Activity Moderate Intensity Moderate Intensity Vigorous Vigorous SupplementSupplement Reduce the Risk OfReduce the Risk Of

Be Positive and MotivationalBe Positive and Motivational

““Can protect you”Can protect you” ““Losing just 10 pounds” Losing just 10 pounds” ““Make time just 3 times a week”Make time just 3 times a week” ““Help you look and feel your Help you look and feel your

best”best” ““It feels good to know you are It feels good to know you are

making changes…”making changes…”

User FeedbackUser Feedback

“It actually tells you what

to do!”

“I like this Web site because it gives

you the information you

want right away. It gives the basics, not too much to

read.”

“It’s easy for everyday people like me to read. No big words or medical terms.”

“ This [Web site] makes me want

to get busy today. “

Navigation and Site Navigation and Site StructureStructure

Simple Home Page DesignSimple Home Page Design

Old DesignOld Design

Stay “Above the Fold”Stay “Above the Fold”““Above the fold” refers to the portion of a Web Above the fold” refers to the portion of a Web

page that is visible without scrolling.page that is visible without scrolling.

Fold

Linear Information PathsLinear Information Paths

Web Features and Web Features and ToolsTools

Interactive ToolsInteractive Tools

Provide access to interactive tools:Provide access to interactive tools:– Customized calculatorsCustomized calculators– QuizzesQuizzes– Activity logsActivity logs– Menu plannersMenu planners– Personal assessmentsPersonal assessments

my healthfindermy healthfinder

Quizzes, Calculators, PlannersQuizzes, Calculators, Planners

Printer & Email Friendly Printer & Email Friendly ContentContent

User FeedbackUser Feedback

“I would like to print this page

and share it with family members who need this information.”

“[This is] good information because a lot of times, I take information to the

doctor and ask questions about diet issues, what to avoid,

and medications.”

Page Layout and Page Layout and DesignDesign

Using GraphicsUsing GraphicsUsers prefer pictures of ‘real people’ and pictures that aid in understanding..

Make Content Easy to Scan & Make Content Easy to Scan & DigestDigest

Early PrototypeEarly Prototype

Usability BasicsUsability Basics

Improve SearchImprove Search

Usability TestingUsability Testing

Iterative Design & Usability Iterative Design & Usability TestingTesting

You do not have to have a finished You do not have to have a finished product to start testing!product to start testing!

The only way to develop an eHealth The only way to develop an eHealth tool that is usable, easy to tool that is usable, easy to understand, and engaging is to understand, and engaging is to involve the target audience early and involve the target audience early and often.often.

Going Beyond Traditional Going Beyond Traditional Usability: Sample QuestionsUsability: Sample Questions

Where would you click to learn more Where would you click to learn more about risk factors? about risk factors? (navigation)(navigation)

Would you print out any of these Would you print out any of these pages to give to someone? pages to give to someone? (relevance)(relevance)

Would a dictionary be helpful? Would a dictionary be helpful? (plain language)(plain language)

Does the information on this page Does the information on this page inspire you to take action? If so, what inspire you to take action? If so, what action would you take? action would you take? (actionable, (actionable, engaging)engaging)

RecruitingRecruiting

People with limited health literacy are People with limited health literacy are more likely to:more likely to:– Have only a high school diploma/equivalent or Have only a high school diploma/equivalent or

lessless– Live below the poverty thresholdLive below the poverty threshold– Be uninsured or have public insurance Be uninsured or have public insurance – Have limited English proficiencyHave limited English proficiency– Be older than 65Be older than 65– Not actively seek out health informationNot actively seek out health information– Not use the Internet for health informationNot use the Internet for health information

Iterative Design: Iterative Design: Developing ‘my Developing ‘my healthfinder’ healthfinder’

my healthfinder Results: U.S. my healthfinder Results: U.S. Preventive Services Taskforce Preventive Services Taskforce

RecommendationsRecommendations

Additional ConsiderationsAdditional Considerations

Content Review: Communication Science vs. Content Review: Communication Science vs. Health ScienceHealth Science

Accessibility—508 Compliance & PrivacyAccessibility—508 Compliance & Privacy Continual Quality Improvement—Your Work Continual Quality Improvement—Your Work

is Never Done!is Never Done! Build partnershipsBuild partnerships to incorporate Web sites to incorporate Web sites

into contexts where people ‘are’into contexts where people ‘are’

Thank You!

Sandy HilfikerSandraw.hilfiker@hhs.gov

240-453-8268