Presented by Claire Foley, MA, & Tracy Torchetti, MA, on March 12, 2015 at the fifth Center for Health Literacy Conference: Plain Talk in Complex Times.

1. Editing health information for a
limited English audience:
Going beyond plain language
8:15-10 a.m. March 12, 2015
Tracy Torchetti and Claire Foley
Plain Talk, Communicating in a small world
Arlington, VA

2. Agenda
• Introduction
• Health literacy
• Plain language
• English as a second language
• Health info best practices
• Conclusion

3. What is health literacy?
From the Canadian Cancer Society:
• a person’s ability to find, understand,
evaluate, use and communicate health-related
information
• a healthcare professional’s ability to
communicate health-related information
• a person’s ability to read nutrition labels,
interpret prescriptions and follow self-care
instructions

4. Canadian literacy statistics
• 42% of adult Canadians have low literacy
skills.
• More than 15 million Canadian adults will
have low literacy skills by 2031, up 25%
from 2001.

5. Canadian diversity
• 17% of the Canadian population are
immigrants.
• 32% of Canadians don’t have English as a
first language.

6. Factors affecting literacy
• reading on small laptops, tablets, cell
phones
• multi-tasking
• visual ability
• age
• stress
• cognitive ability

7. Plain language

8. What is plain language?
• the art and science of writing clearly
• clear organization and layout
• reader-centred writing and design

9. Writing techniques
• Use the active voice.
• Write directly to your reader.
• Use a positive tone wherever possible.
• Use short words and simple sentences.
• Use common words instead of jargon.
• Use lists.

10. Formatting and style
• Watch alignment.
• Use lots of white space and short paragraphs.
• Keep lines of text short.
• Use meaningful titles, headings and
subheadings.
• Use minimal emphasis (bold, all caps, italics,
colour).
• Choose the right font.

13. Readability best practices
• know your audience
• print (average: grade 8)
• web (average: grade 6 to 8)
• context
• subject matter
• testing

14. Readability formulas
• SMOG, or Simplified Measure of Gobbledygook
• Fry Readability Formula
• Gunning-Fog Index
• Flesch Reading Ease and Flesch-Kincaid Grade Level
• New Dale–Chall Readability Formula
• readability-score.com
• specially designed software, such as Readability Calculations,
Readability Plus, Readability Studio
• checklists, such as SAM (Suitability Assessment of Materials)

15. What formulas get wrong
Examples
Dr. Smith said I should call if my child has a
temperature of 100.2.
The order of words doesn’t matter at all.
All at matter doesn’t words of order the.

16. Benefits of reading formulas
• They’re objective and easy to use.
• The scores get people’s attention.
• They show improvements that result from
editing.

18. Punctuation
• Use minimal punctuation.
• Good punctuation still matters!

19. Fussy marks
• colon (:)
• semicolon (;)
• asterisk (*)
• ellipsis (…)
• footnote symbols

20. Bulleted lists
Before
Offer lots of high fibre foods, including:
• breads, cereals, pastas and rice made from
whole grains;
• fruit, especially berries, dried fruit and citrus
fruit; and
• vegetables, especially broccoli, carrots, corn
and leafy greens.

21. Bulleted lists
After
Offer lots of high fibre foods, including:
• breads, cereals, pastas and rice made from
whole grains
• fruit, especially berries, dried fruit and citrus
fruit
• vegetables, especially broccoli, carrots, corn
and leafy greens

22. Contractions

23. Contractions
Some contractions are easier than others.
Easier
I’m, can’t, don’t, you’re, who’s, what’s,
where’s
Harder
could’ve, will’ve, shouldn’t, isn’t, aren’t,
weren’t, doesn’t, didn’t

24. Parentheses
Good
You need to take a different drug for your
diabetes (starting Monday).
Better
You need to take a different drug for your
diabetes. You start the new drug on Monday.

25. Numbers
Use digits rather than spelling out numbers.
• 18 vs. eighteen
Spell out units of measure or define them at
first mention.
• 15 min.
• 1000 IU

26. Numbers
Avoid tricky constructions with dates.
Before
Back x-rays will no longer be covered by
OHIP after 09/10/12.
After
OHIP will not cover back x-rays after
September 10, 2012.

27. Numbers

28. Numbers
Percentages can be hard to understand.
• 12% of people have side effects.
• 12 in every 100 people have side effects.

29. Numbers

30. Numbers
Avoid fractions.
• 3/8 of your normal dose.
• 5-1/4 or 5¼
But…
• Half a teaspoon of cough syrup
• 5,000 vs. 5.000 vs. 5 000

32. The ESL perspective
• verb tenses
• idioms
• phrasal verbs

34. Verb tenses
Use more common verb tenses.
• Simple present tense
You have diabetes.
• Present continuous
Are you taking medication?

35. Verb tenses
Use more common verb tenses.
• Simple future
You will go to the hospital tomorrow.
You are going to the hospital tomorrow.
• Simple past
Did you take medication yesterday?

36. Verb tenses
The present works for both present and
future situations.
Example
I take my medication at noon today.
I take my new medication tomorrow.

37. Verb tenses
The present works for both present and future
situations.
Before
When you go to the hospital, the doctor will
take your blood and will do other tests.
After
When you go to the hospital, the doctor takes
your blood and does other tests.

38. Verb tenses
Use the present instead of present
continuous.
Before
I am taking medication for my heart.
After
I take medication for my heart every day.

39. Verb tenses
Use will or be going to for the future.
Examples
I am going to have my procedure at the hospital next
week.
I will have my procedure at the hospital next week.
(I have my procedure at the hospital next week.)
.

40. Verb tenses
Use regular verbs in the past.
Example
I talked to the doctor yesterday.
I spoke to the doctor yesterday.

41. Idioms
• Are you feeling under the weather?
• You seem on the ball.
• This will cost an arm and a leg.
• Let’s get the ball rolling!
• Keep an eye out for these symptoms.

42. Phrasal verbs
A phrasal verb is a verb followed by a
preposition or an adverb. The combination
creates a meaning different from the
original verb.

43. Phrasal verbs
take over put off work out
call off check out cut out
cut down on end up rule out
figure out go on get over

44. Exercise

46. Health info best practices
Consider the patient perspective and the
context of reading:
• cognitive impairment related to stress,
anxiety and emotions (situational literacy)
• cognitive impairment related to illness
• language proficiency in English AND
medical jargon

47. Health info best practices
Write in plain language:
• clear, straightforward, informative
Write in a supportive manner:
• positive but realistic
• conversational but authoritative tone
• tips for readers to learn more

48. Health info best practices
Get experts to review:
• direction or scope
• accuracy
• need to know vs. nice to know
If you’re the expert:
• Know that you’re not your audience!
• Get help from a writer or editor.

49. Health info best practices
• test
• revise
• repeat

50. Conclusion
• Know your audience.
• Apply plain language principles.
• Learn more about health literacy.
• Think about the second language
perspective.

51. Questions?
Claire Foley
CFproofreading@hotmail.ca
@thecrimpqueen
Tracy Torchetti
tracy.torchetti@cancer.ca
@Torcherama