Plain Language Overview March 6, 2015 SW Washington and Oregon Health Literacy Conference Joan Center for Health Literacy MAXIMUS 1
I have no financial relationships with commercial entities producing healthcare related products and/or services. 2
Barriers to comprehension Limits of software formulas Elements of plain language Writing in plain language Conclusions and questions 3
Test it! 4
I can read it, but I don t understand it. The pitch is one chain with three stumps surmounted with bails with four creases. The middle stump is in dead center of the bowling crease. The bowler s front foot must land on the popping crease. He can be stumped out if he is out of his ground. Sundries include byes and leg byes. Some specialist wicket keepers are allrounders. LF and LBG bowlers specialize in the run-up, the leg break and the Googly. The two batmen face each other at opposite ends of the pitch. The bowler throws to the batman, who tries to prevent it from hitting the wicket by striking it with his bat. The batman is dismissed if the bowler hits the wicket, or if the batman strikes it and the fielder catches it. If the batman strikes the ball, the two batmen run across the pitch and switch positions. The batman risks dismissal if the fielder retrieves the ball before the batman reaches the end of the pitch. After an over, a new bowler faces the opposite wicket. The openers might hit an edge but the batman might pad away. The fielder is run out if he breaks the wicket while the batsman is out of his ground, not behind the popping crease. There can be limited overs using the Duckworth-Lewis method or a no-result. 5
Barriers to understanding Unfamiliar words Unfamiliar concepts Long sentences Long paragraphs Too many messages 6
What do good readers do? Chunking Familiar words Inferences Background knowledge The pitch is one chain with three stumps surmounted with bails with four creases. The middle stump is in dead center of the bowling crease. The bowler s front foot must land on the popping crease. He can be stumped out if he is out of his ground. Sundries include byes and leg byes. Some specialist wicket keepers are all-rounders. LF and LBG bowlers specialize in the run-up, the leg break and the Googly. The two batmen face each other at opposite ends of the pitch. The bowler throws to the batman, who tries to prevent it from hitting the wicket by striking it with his bat. The batman is dismissed if the bowler hits the wicket, or if the batman strikes it and the fielder catches it. If the batman strikes the ball, the two batmen run across the pitch and switch positions. The batman risks dismissal if the fielder retrieves the ball before the batman reaches the end of the pitch. After an over, a new bowler faces the opposite wicket. The openers might hit an edge but the batman might pad away. The fielder is run out if he breaks the wicket while the batman is out of his ground, not behind the popping crease. There can be limited overs using the Duckworth-Lewis method or a no-result. 7
Overcoming barriers to understanding Write in plain language Give a few messages at a time Target the reading level so everyone can understand Consider readers experience, culture and background knowledge 8
Before: The eagle soars above the deep chasm. His hoary head swivels laterally. Does he feign placid apathy? Does he abhor this alien invading his realm? Would he abort his flight? Would he halt it at its height? Plunge into the abyss? Drop a plumb line and seize his prey? Then wing again into the azure sky? After: The eagle flies over the canyon. His old head turns. Does he fake calm indifference? Does he hate this stranger invading his kingdom? Will he land? Or will he keep hunting and fly off into the blue sky? 9
Simplify It has come to our attention that it will be necessary for you to provide further documentation verifying your residency. Please send proof that you live in [State]. 10
STEP 1 Identify purpose, audience and key messages Five Steps to Plain Language STEP 2 Arrange key messages in order of importance STEP 3 Write in plain language STEP 4 Add organizational aids STEP 5 Design the format 11
STEP 1 Identify purpose, audience and key messages What is the goal? Who are the readers? What are the main points? 12
Inform Describe Purpose What is the goal? Educate Instruct Explain Request Persuade 13
Patients Audience Who are the readers? Physicians Experts Novices General public Specific consumers 14
Key messages What are the main points? Here s what to do Here s why Here s how Here s when Here s where 15
What is the goal? Who are the readers? What are the messages? 16
STEP 2 Arrange key messages in order of importance Determine the main message Consolidate to three or four key messages Put messages in order, most to least important 17
What is the main message? Consolidate messages. Put messages in order. 18
STEP 3 Write in plain language Addresses the reader directly Is clear, concise and friendly Sounds conversational when read aloud 19
Plain language Active voice Friendly tone Short paragraphs Simple sentences Familiar words 20
Active voice An order for your lab work will be placed for you at the Legacy outpatient lab. We will order your lab work at the Legacy outpatient lab. 21
Friendly tone Failure to follow your prescribed exercise regimen may result in slower recovery. You ll feel better sooner if you do the exercises your doctor gave you. 22
Short paragraphs Each insurance carrier has different requirements that need to be met prior to approval for surgery. Your insurance may require additional appointments to those listed above. In addition, any one of our providers may require additional visits prior to surgery; this is to ensure you are prepared for surgery and will achieve the best possible outcome. Your insurance may require more appointments before they approve your surgery. Our doctor may also want to see you before surgery. We want you to be ready and have the best results. 23
Simple sentences To carry on this work satisfactorily, it is important that we have your complete cooperation with this office. We need your cooperation. 24
Familiar words Teach vocabulary! Reduce your sodium intake to manage hypertension. Cut down on salt to lower your blood pressure. Cut down on salt if you have hypertension (high blood pressure). 25
Instructions 26
Brief introduction We may be able to help you pay your medical bills. To find out if you qualify, follow these steps: 27
1. Complete the application. Brief Clear One step at a time Beginning with an action verb In the order that they must occur 2. Sign the application. 3. Attach the checked proofs for each household member who is 18 years old or older: _ Last year s W2 and tax return _ All pages of your last two checking or savings bank statements _ Pay stubs for 3 months _ Other: 4. Mail the application and proofs to us in the envelope that came with this letter. 5. Call us if you cannot send the information by. RAM1 28
Slide 28 RAM1 Change these bullets to a line that people could check; Ryan A. Miller, 2/20/2014
Active voice Friendly tone Short paragraphs Simple sentences Familiar words 29
Descriptive titles Greetings and closings STEP 4 Add organizational aids Headings Q/A format Organized in sections Limited number of messages Key messages first Bold Bullets or numbers 30
Font STEP 5 Design the format for readability Text size White space Line length Images 31
We want you to be safe with us! Your risk of falling is greater your first few days here. Here s what you should know: Why is there a risk of falling? You just had a major medical event and may feel weak or off balance. You re in a new place and may be taking new medications that make you dizzy. You may have tubes or machines that keep you from moving. You may forget that you can t move around easily yet. What do we do to keep you safe? We have special training to help keep you safe. We check on you to make sure you re comfortable and safe. We have special beds or wheelchair seatbelts for your use. We will help protect you from hurting yourself in a fall. 32
Potential consequences of a plan or decision one cannot reverse should be heeded prior to the time an action is effectuated. (Look before you leap.) -New York Times Crossword Puzzle May 13, 2013 33