Earlier this year, the Office of Disease Prevention and Health Promotion published a must-read for any web professional producing healthcare websites, “Health Literacy Online: A guide to writing and designing easy-to-use health Web sites.” [PDF] The report is 98-pages, but if you are a healthcare content strategist and Web writer like myself, it’s a fascinating read.

Millions of Americans have a hard time reading. In fact, 50 percent of the American public struggles with understanding the written word. Because of this, you cannot be sure that a reader of your healthcare Web content understands and retains the content on your site. If 9 out of 10 Americans have limited health literacy skills, as the report claims, almost every user of your hospital or healthcare website struggles to understand complex health information. This particular sentence resonated with me:

“They struggle not only with reading the content on the page, but also with retaining and managing new information as they move through a website.”

If our users have trouble retaining and managing new healthcare information, how do we make medical content memorable? What strategies can we employ while writing our content? How do we create a content strategy that informs users as they move from page to page?

Here are some tips from the report:

  1. Use short chunks of text and bulleted lists.
    This may seem obvious to the experienced Web writer, but according to this study, users skipped over any paragraph more than 3 sentences. Really keep them short.
  2. Menus are critical.
    Users with limited literacy avoid searching; they don’t know how to spell and want to avoid reading and scanning search results. Therefore, these users rely on navigation and prefer to scan alphabetical lists, even when said lists are long. Offer the option of an A to Z list, breaking up the list by letter, if it’s too long.
  3. Center focus on the page.
    Users with low literacy preferred to focus on the center of the screen. They avoided almost all right-hand menus or banners, thinking they were ads. This was fascinating to me, because for years I have argued about putting navigational links into the body copy of a page. It is critical to give users a number of different ways to navigate through a site, and not rely on their using, or even noticing,the left-hand nav.
  4. Users have limited working memory.
    Sometimes I feel like I do too. What was I about to say? Oh, now I remember. Don’t rely on context or page to page retainment of information for most users. Instead, use clear stand alone headings and independent sections. If users don’t remember from page to page, then repeat the main messages on each of pages within a section. It’s ok—stay on message is a major principle of PR—and much of online health writing is a form of public relations.
  5. Simple navigation is THE KEY
    Users with low literacy had a hard time with breadcrumbs and other navigational tools. Use numbered pages and previous and back arrows embedded within the page. Users really appreciate the ability to navigate through pages using those arrows and not hitting the browser back button.
  6. Summing up-also really important to users
    Clearly, it’s a combination of content and design that makes for a health literate website. Gather all the producers in the room from the beginning: usability experts, designers, writers and content strategists. Get to know your users. Figure out who they are, how they read and what they need, and more importantly, what they care about. Then supply good, basic, well-written, clear content in a user-friendly, simple design. Rinse and repeat, using analytics and user testing. For more information, read the report or watch the slideshow.

From page 5: “Simple navigation and clear content can help adults with limited literacy skills find, understand and use health information on a website.” My guess is following these rules will help you with ALL your audience segments, not just those who have challenged health literacy skills.


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