Reading Between the Lines in Health Literacy: 5 Tips from the Experts
// By Lisa D. Ellis //
Are your marketing messages living up to their full potential? If not, you may need to think more about the concept of health literacy and how to reach your target audience on a deeper and more personal level, by talking about things they care about in a simple, direct language that they can understand.
The Value of Health Literacy
Health literacy is a critical component when marketing in health care, but many professionals aren’t exactly sure how to use it efficiently, according to Kat McDavitt, Vice President of Dodge Communications based in Atlanta, Georgia.
McDavitt points out that for many health care marketers in the life sciences and digital health sectors, it can be surprisingly difficult to tell an effective story to the target audience, rather than discussing the science behind a product. Yet she finds that using fewer words actually adds up to more in the end.
Why Simple Is Always Better
Deb Bruce, Senior Content Writer for AVID Design
Perhaps no one knows this better than Deb Bruce, a senior content writer for AVID Design, who also writes for a number of consumer health websites, organizations, and medical device companies. In addition, Bruce has more than 30 years of experience writing health trade books. Over the course of her career, she has seen firsthand how easy it is for people providing medical information for consumers to get too complex with their language, and, as a result, their material doesn’t resonate. Bruce tries to reign in messages to keep them easier to understand.“My background is in conveying the written word to consumers so they can make a difference in their own health and lives,” she explains. Most of the time, it is more important to give people information they can understand and apply to their own situations rather than trying to impress them with technical jargon that they won’t know how to translate into anything meaningful. And while ‘health literacy’ is the formal title, Bruce prefers even to break that down into basic terms that anyone—even if they aren’t working in health care or marketing—can understand. “I call it ‘information that meets people where they are,’ and that’s how I write. I think to provide health literacy to the consumer you’ve got to make sure they’ve got an educational level you’re going to write to.”
Math Skills Increase Health IQ
Further, while there is growing awareness about health literacy and writing material to a very basic reading level, there’s been less attention paid to consumers’ math skills, even though Bruce says this is another factor that is important to consider, too, since so many concepts in health promotion come down to basic calculations that people need to be able to manage.
“You’ve got to know about people’s math skills because so much in health literature is about calculating, whether it’s a pharmaceutical or whether it’s their blood pressure or whether it’s their blood sugar each morning that they take,” she says.
She adds that in practical terms, it all boils down to one simple thing: providing people with information that empowers them to be healthier in some way. “Health literacy would mean people can take what I write and make a difference, and then ask their doctors intelligent questions.” That’s what it’s really all about.
Building on the Basics
Liz Carden, Senior Vice President of Behavioral Strategy at New Solutions Factory
Liz Carden, senior vice president of behavioral strategy at New Solutions Factory, agrees, pointing out that it’s also important to remember that health literacy is really a starting point, not the finish line, when it comes to communicating with consumers.
“I’m a behavioral strategist and in the marketing world I’m somewhat more of the traditionalist from the health literacy perspective. So it’s my job to understand what different barriers, motivators, and experiences a patient or a consumer has as a whole to drive them to work with a specific product or action or behavior,” Carden says. “In other words, health literacy is a core function, a core tenet of pretty much everything we do in the strategy world to make sure that it is not only understandable, but actionable as well.”
She adds that all too often, marketers “think of health literacy as a set of criteria that helps people understand content better.” While this is true, efforts to create effective material needs to go much further than this. “It’s not just about understanding. It’s about enabling a patient to understand, connect with the content, and then enabling a skill or behavior set. So it’s great if they can read it, but if they can’t act on it and if you’re asking them to do something, then you’re not really meeting their core skills,” she stresses.
Try These Tips to Step Up Your Efforts
The good news is that health literacy is something every organization can incorporate into their efforts. Here are 5 key steps to help your health literacy communications succeed:
1. Know Your Audience
“Clients typically have their health literacy checklist,” Carden says. “They know they have 25 sets of criteria they have to accomplish in order to be health literate. It’s the reading level of 6th to 8th grade; it’s appropriate white space. With digital it’s even more—like 50-something.” But she points out while these requirements can be a great place to start, one size shouldn’t fit all. “Why isn’t a child with neuroblastoma’s health literacy needs different than a 55-year-old using an ED medication or trying to choose what genetic testing he needs?” she says. Health care organizations need to think through their intended audience for a project and make sure their information is tailored for their unique needs and experiences.
2. Market to the Entire Care Team, Not Just the Patient
When you think of creating marketing and informational material, you might instinctively direct your messages directly to the patient, but often there’s also a caretaker and other family members or friends involved in the care process. Educating all of those people is important, according to Bruce.
Tara Auclair, Senior Marketing Communications Manager at Modernizing Medicine
“We think of a patient [when we create information], but generally speaking [we need to address] really anyone who’s consuming health care information,” says Tara Auclair, Senior Marketing Communications Manager at Modernizing Medicine. “So we don’t want to keep a patient in isolation as one single point in time. What are all the experiences on the longitudinal journey that we have a clinical interaction, interaction with a care partner or a support network … maybe that’s a discussion board even? How do we supply them with the information they need to enable health literacy?” she asks.
3. Design Matters
It’s important to consider not just the language you use for your messages when it comes to your health literacy efforts, but also the design you use to convey them.
“Many times, design holds a slightly heavier weight than copy in the sense that we know many patients, if not all, are highly literal. They skim content, they prefer images because they appear to be easier,” Carden says. “If you’re designing for or producing content that’s global or if you have an audience whose English is a second language, or even quite frankly if you have speakers that know just more than one language in general, then you can really rely heavily on graphics and iconography, although you’re always going to need copy, too,” she says.
4. Connect with Health Care Professionals
Also remember that in addition to the patients and caregivers you need to reach with messaging, you will need to communicate with physicians and other health care professionals, too. When targeting professionals, the language can be more complex, but most experts agree that health literacy principles should still be incorporated into your marketing materials.
“Overall, when you’re teaching a new skill to a health care professional, the general rules apply,” Carden says. “You can use more complex language, of course—multiple-syllable words. You’re not going to write to a 6th to 8th grade level, but you still need white space. You don’t want to clutter the pages. Basic design principles very much apply, even though your marketing messages can have a higher complexity. But the less complex you make it for someone, the better they will learn and they will build skills with greater ease,” she says. The key, she reiterates, is to remember that health literacy is not just about reading level. Are you providing opportunity for skill building? Are you letting them practice new techniques? Are you modeling behaviors? Are you using motivational interviewing at times? Things like that all come through in your final product and results, she stresses.
5. Some Is Better Than None
Finally, if you need to step up your health literacy efforts, you don’t have to feel overwhelmed by the magnitude of this endeavor.
“If there’s time to audit the current material—even if it’s just a simple web page or a simple brochure—and call out things that could be done better or could be done to increase health literacy as a whole, I think that’s probably your first step and you can go on from there,” says Carden. “A lot of my business is rescue, so people call me and say, ‘Oh my God, I don’t know what to do, FDA kicked this back.’ Or, ‘My patients are saying they don’t understand this. My product isn’t being purchased the way I want it to or as fast as I want it to, etc. What do I do now?’”
She also points out that many companies believe they don’t have the time or budget to invest in redoing their website or marketing material. But the thing is, they don’t need to redo everything all at once. “The best approach is picking apart small chunks and going from a weighted fashion. So rewriting all your content to a 6th to 8th grade reading level is probably one of the more difficult things you do. It’s also going to be one of the most expensive things you do. So how do you bite off chunks? Is it first to replace the culturally sensitive information? And to make sure the design is actually supporting the copy rather than distracting from it? Is it increasing your white space and your margins or changing your headers or footers or navigation as a whole without breaking your template?”
The answer may be different for every organization, as well as for every project. But regardless of where you start, she says the bottom line is to let your efforts build over time, as you continue to make strides in reaching your target audience and providing them with the knowledge they need to live healthier lives.
Spreading a Health Promotion Message Statewide
Not too long ago, the Maine Health Management Coalition had a tall order to fill: educating people about how to choose health care providers based on quality and be good health care consumers.
“I was working with large employers who just kept seeing their health insurance costs go up and up and up. They felt so out of control and they didn’t know how to try and keep the costs down,” says Tara Auclair, who is currently affiliated with Modernizing Medicine but previously worked with the Maine Health Management Coalition, where she had a unique chance to teach people how to advocate for themselves and be better patients.
“When the costs go up, you can employ fewer people, but they needed more people to keep the work going. So the employers who joined the Maine Health Management Coalition wanted to help employees become healthier and try to rein in their costs,” she says.
The benefits managers, the HR managers, and the wellness managers of the biggest employers in the state came together through the Coalition’s employee activation users group and they brainstormed how to move forward in a more effective way.
“They shared best principles and as a coalition created collateral to educate people using a plug-and-play model. There were newsletters, email blasts, pamphlets, and many different materials to really get to where their employees were,” she says.
The results were impressive, ultimately leading to lower health care costs for the organizations involved. Employees also felt more empowered. “Their employees were coming to them and saying, ‘Thank you so much for giving me these [suggested] questions that basically give me permission to ask my doctor questions.’” Ultimately, she says, this had a huge impact in the state.
Lisa D. Ellis is Editor of Strategic Health Care Marketing.