Health Literacy Online: How to Simplify the User Experience

Xanthi Scrimgeour and Stacy Robison of Communicate Health

Online Health information should incorporate:

• Plain language
• Health Education Theory
• Usability
• User-centered design

90% of adults are online in the U.S.

Those who don’t have broadband are accessing internet on their phones.

72% of internet users looked online for health info in 2013.

Half of people looking for health info are looking for someone else.

69% said their most recent search had an impact on their health or the way they care for someone else.

More often it’s a poorly designed website, rather than user’s poor health literacy that get in the way.

Voice features can help with dexterity and communication challenges.

Alerts and auto reminders can help compensate for short-term memory loss.

http://health.gov/healthliteracyonline (second edition) See the class handout.

What we know about users with limited literacy skills:

• Web users with limited literacy skills are on line and willing to look for info there.
• They are prone to skipping and focussing on the center of the screen.
• They are easily overwhelmed and have a limited working memory.
• They struggle with search functions. Spelling is an issue, ads get in the way, not knowing what to look for, not knowing what sites are reputable. They will only click on 1 or 2 results.
• Low-literacy users are more likely to be smartphone dependent. 1 in 5 adults rely on their phones for internet access. Visually impaired people often prefer the smaller screen of a smartphone.

Strategies for clear online communication:

1. Write actionable content. (Information, not documents)
2. Answer users’ questions
3. Help users complete a task
4. Help users make a decision
5. You have about 15 seconds to grab the user’s attention.
6. Put the most important information first.
7. Provide specific action steps (bite, snack, meal – user can drill down as far as they want).
8. Limit paragraph size, use bullets and short lists
9. People will often skip paragraphs of 3 lines or more.
10. Chunking information is important for people with limited working memory.
11. It’s critical to design for small screens! Website needs to be responsive to variable screen sizes.
12. Place key info and buttons either near enter or center bottom. Many people cover lower right corner with hand.
13. Limited lit users like radio buttons. Make as much of the choice active as possible (more than just the circle).
14. Make your site accessible (works with screen readers and other assistive technologies, navigate with keyboard only; strong color contrast, etc.).
15. Create a linear information path: Give meaningful labels, such as “track meals ->” rather than “next”
16. Label information clearly.
17. Include a simple search function. Some users just hit the search button without entering any text. Allow for common misspellings, using auto-complete, most actionable content should come up first, avoid scrolling, clear page titles, brief plain language descriptions of URL.
18. Limited literacy users like to browse more than they like to search. Putting the alphabet across the top is helpful.

Engage users with interactive content:

1. Let them share and print info; give them info about themselves, e.g., calculate the user’s BMI index, etc.
2. You can use multi-media online.
3. Super simple quizzes work well.
4. Online information can be tailored by collecting just a little information such as age and sex.
5. Make the content printer-friendly.
6. Test your site with users.
7. Usability testing with 5 participants will reveal 85% of usability problems.