The federal plain language standard: communication your audience can understand the first time they read or hear it. Problem: Inaccurate information that people *do* understand the first time they hear. Misinformation is very understandable but inaccurate. #PlainLanguageSummit
Dr. Baur's work from another pandemic was to create the CDC Clear Communication Index, part of the reaction to the 2009 pandemic flu. Tested terms after the pandemic and found the public still didn’t know and understand terms. #PlainLanguageSummit
Essential elements: main message, clear action steps, numerical and risk explanations. #PlainLanguageSummit
Search engines may be contributing to an acceleration of misinformation spread. If you type in "iv" into Google, the first suggestion is "Ivermectin." #PlainLanguageSummit
Where we started: US officials said virus was “low risk” to the public in Jan/Feb 2020.
“Low” and “risk” are both short, single-syllable words. But does “low risk” as a term pass the principal plain language standard? #PlainLanguageSummit
“Low” has to be relative to something. What is low risk to one person may be high to another. We need more information to pass the principal plain language standard. #PlainLanguageSummit
Summer 2020 pandemic communication trends:
•jargon: “containment,” “mitigation,” “flatten the curve”
•reliance on digital channels to distribute information
•lots of information but little tested with audiences
•reliance on morbidity and mortality stats. #PlainLanguageSummit
Changing recommendations compound linguistic challenges:
•Who’s at risk? Older adults or everyone?
•Mask or no mask? What kind of mask?
•Indoor, outdoor, or both?
•What types of ventilation?
•How much distancing? When?
•What types of tests? How often? #PlainLanguageSummit
There’s a high level of uncertainty with a new virus. It can be challenging for us to strike a balance as clear communicators in these situations of high uncertainty. #PlainLanguageSummit
Example: Emergency Use Authorization (EUA). The word “emergency” is common and familiar though multisyllabic. But testing has shown people don’t trust or accept something with EUA because it sounds like the process (e.g., vaccine approval) was rushed. #PlainLanguageSummit
EUA for vaccines seems to have bred more distrust than EUA for other treatments. #PlainLanguageSummit
The hope was that eventually “approval” would convey a different meaning than EUA. FDA press release used “approved,” in contrast with “authorized”—but media used “fully approved” to distinguish it from EUA. #PlainLanguageSummit
“Vaccines are safe and effective”
•Uses familiar words, is a short sentence
•Aligned with audience question: Why should I get vaccinated?
•But missing “How do we know vaccines are safe? Have they been tested on ppl like me? Are we being experimented on?” #PlainLanguageSummit
Recommendations:
We need:
plain language standards
+
accuracy
+
humility
+
deep knowledge of audiences’ beliefs, values, and prior knowledge #PlainLanguageSummit
Takeaway: Plain language is a necessary but not sufficient requirement in complex communication situations. Plain language itself wasn't going to save us.
But more plain language explanations might have given us a firmer foundation for shifting science. #PlainLanguageSummit
Next up: "How Feedback and Partnerships Helped IRS Respond to COVID-19" with Jose Vejarano #PlainLanguageSummit
IRS.gov has 30,000+ HTML pages, 140,000 multimedia files. Also offering multilingual pages; many offered in 7 principal languages other than English through a dropdown menu. Recent effort to translate basic tax information to 20 languages. #PlainLanguageSummit
Writing in plain language has not yet been embedded in the fabric of the agency’s content and sometimes ends up being an afterthought. #PlainLanguageSummit
The pandemic brought a lot of economic hardship to people in America. Stimulus package passed in the Senate was reported in the media, but people didn’t understand that “passed in the Senate” was only part of the process. #PlainLanguageSummit
The legislation hadn’t even been finalized, and media were already telling people to go to IRS.gov to sign up for direct deposit. The agency had to respond quickly to create an alert box to direct people to information they had at the time. #PlainLanguageSummit
IRS.gov got 7M views on April 15 (tax deadline) in 2019; in 2020, the site saw a record-breaking 78.8M sessions on April 15. That was the date payment application was launched. Had to develop info quickly and get it approved even faster. #PlainLanguageSummit
Collaborative review process:
•listen to what people are saying—looked at news coverage, social media, survey responses available on the web
•respond to their feedback—answering frequently asked questions… #PlainLanguageSummit
•review with stakeholders—“we must get this out there”
•share daily actions and decisions—recap to ensure stakeholders were aligned #PlainLanguageSummit
For the first time, the entire agency was looking to the digital strategies team to lead the communication effort. #PlainLanguageSummit
People call the "Affordable Care Act" "Obamacare," but, being a federal agency, the IRS cannot put "Obamacare" on their site. That doesn't stop people from searching for "Obamacare" on the site. #PlainLanguageSummit
Similarly, people were searching for "stimulus check" and not the more formal name of "Economic Impact Payment." The digital strategies team put words that people were using in metadescriptions so they'd end up on the right page. #PlainLanguageSummit
Lessons learned:
•Listen: tune in to user needs
•Learn: make changes along the way
•Connect: use words people understand
•Lead: don’t wait for other to do it #PlainLanguageSummit
Next up: "Plain Language: Accessibility and Environmental Justice for All" with Angie Fuoco #PlainLanguageSummit
Fuoco's role at the EPA involves public engagement, which entails a lot of communication.
She herself uses reading glasses and has hearing loss, helped but not corrected with a hearing aid.
Many environmental indicators disproportionately affect Indigenous communities, low-income communities, and communities of colour (e.g., blood lead levels in children, homes near hazardous waste sites, climate change indicators higher) #PlainLanguageSummit
People with disabilities: how many of us are there?
•1 in 4, according to CDC’s six questions
•1 in 5 have mental health disability, according to SAMHSA
•mental illnesses are increasing due to COVID-19
•Long COVID recognized as a possible disability #PlainLanguageSummit
Fuoco likes the definition of accessibility from the UK Gov Blog: Accessibility means people can do what they need to do in a similar amount of time and effort as someone that does not have a disability…#PlainLanguageSummit
… It means that people are empowered, can be independent, and will not be frustrated by something that is poorly designed or implemented. #PlainLanguageSummit
Environmental justice: EPA’s definition is the fair & meaningful involvement of all people regardless of race, colour, national origin, or income with respect to the development, implementation, & enforcement of environmental laws, regulations and policies #PlainLanguageSummit
3 points to think about:
1. Power
Need to serve the public with all their beliefs about our power as a federal agency. (Most believe we have too much power.) #PlainLanguageSummit
Good antidote to power imbalance: Infuse our writing, speaking and interactions with cultural humility. #PlainLanguageSummit
3. Prepare the paths
•set up files accessibly
•use readability checker often
•prepare for translations as you right
•prepare for as many formats as possible
•learn and do all you can to serve the 100% #PlainLanguageSummit
Points to do:
•acknowledge land, community, racial justices
•acknowledge the situation
•increase respect with order and prominence
•use the current language of your audience
•use ADA-recommended “people first” language*
•avoid trigger words and topics #PlainLanguageSummit
*(Iva popping in here to editorialize that this is not what many disabled communities prefer!) #PlainLanguageSummit
•Plan and advertise all access pathways the same
•Consider online accessibility—wth captions, audio description, etc.
•Turn hard concepts into questions & answers
•Write for all abilities using ADA guidance #PlainLanguageSummit
Next up: “Is an online glossary right for your website?” with Alison Kohler from the General Services Administration #PlainLanguageSummit
With audiences have different levels of understanding when it comes to jargon, technical, or slang language, an online glossary is a possible solution. #PlainLanguageSummit
Two main options for the GSA: 1. a static option like on the US Citizenship and Immigration Services page—includes a search function, and each entry has an accordion menu that people can click on to access the definition #PlainLanguageSummit
2. terms defined in references throughout the site, like on the Paperwork Reduction Act site. Definitions pop up on a sidebar when people click. #PlainLanguageSummit
A third option is a glossary widget on every page like on FOIA.gov; GSA did not consider this option #PlainLanguageSummit
Pros of static page option:
•If your site is the only one talking about a term, that page should come up when people search for it.
•One dedicated place to point other hyperlinks or references from any digital content
•Less resource intensive #PlainLanguageSummit
Pros of site-wide option:
•More user friendly; users don’t have to navigate the glossary
•Data from the pilot indicate good engagement rate. About 15,000 users clicked on the icon in first 30-day period with 20 terms defined #PlainLanguageSummit
GSA used:
•Google Analytics to track most-viewed pages and determine terms on those pages that people need to have defined.
•Top queries from the search to consider which terms people need information about. #PlainLanguageSummit
•SiteImprove to look up terms and see how many occurrences there are sitewide. #PlainLanguageSummit
Use a spreadsheet with:
•terms (to alphabetize)
•plain definitions
•URL source (for back end)
•occurrence count
Also include:
•a legal disclaimer
•a way to give feedback on missing terms or problems with the definitions. #PlainLanguageSummit
GSA used accordion menus to prevent cognitive overload. If people see both term and definition at once, it can feel overwhelming.
Limit the list of defined terms (they chose a max of 200) and prune regularly. #PlainLanguageSummit
Be user centred:
•Use search query and SiteImprove occurrences to develop what terms to include
•Avoid asking subject matter experts for their recommendations on what terms to include #PlainLanguageSummit
Question from the audience: Which of the options is more accessible?
Kohler says web team vetted options for web design standard, not sure about ADA standards. #PlainLanguageSummit
What about screen readers?
Kohler says in the pilot, they really wanted people to click on the terms so they would have the data to measure engagement. When it's launched, they're hoping not to force people to click; people can just hover for the definition. #PlainLanguageSummit
Do accordion menus interfere with SEO?
Kohler's not sure; accordions can be problematic but not sure of a solution to prevent cognitive overload. #PlainLanguageSummit
How to handle senior leaders who insist on a legal review?
Kohler worked w/ many levels of leadership to tell them why using subject matter experts & legal reviewers doesn't work for users. Added legal disclaimer, invited everyone to give feedback on terms. #PlainLanguageSummit
Next up: "Hazard Simplification: The Transition to Plain Language" with Danielle Nagele from the National Oceanic and Atmospheric Administration (NOAA) #PlainLanguageSummit
About the National Weather Service's efforts to simplify the "watch, warning, advisory" system. #PlainLanguageSummit
•Watch: issued when a life- or property-threatening event is possible but not yet certain
•Warning: issued when a life- or property-threatning event is happening or about to happen #PlainLanguageSummit
•Advisory: issued when an event less serious than a warning is happening or about to happen
•Special weather statement: issued when an event less serious or shorter than an advisory is happening or about to happen. #PlainLanguageSummit
Road to simplification:
•2014: focus groups found people want change. There are too many NWS headlines, and “advisory” is least understood #PlainLanguageSummit
•2015: case study survey and 3-day workshop found that they should simplify alerting system, focusing on impacts. Embrace formatting like bullets and easier-to-understand language #PlainLanguageSummit
•2017: Institutionalization survey found “warning” headline is more embedded in current law and policy; “advisory” is least embedded, and most organizations could adjust #PlainLanguageSummit
•2018: public surveys found “advisory is least understood and conflated with “watch”
•2020: partner webinars, surveys, and focus groups found public participants supporting eliminating “advisory” #PlainLanguageSummit
Not intuitive for people to know which is worse: warning or advisory. Instead, just describing the hazard and impact in plain language is easier to understand. #PlainLanguageSummit
Major change: keeping “watch” and “warning.
•Watch: What should I do? Prepare!
•Warning: What should I do? Take action! #PlainLanguageSummit
Instead of "advisory" and "special weather statement," they are using plain language descriptions to tell people what they need to do.
Still considering what these will look like. Should hazard lead the message? Caution? Or no leading term? #PlainLanguageSummit
Likely will transition both to bulleted list outlining What, Where, When, and Impact for advisories and special weather statements. #PlainLanguageSummit
In the past 6 years or so, NWS has consolidated the number of products/headlines. So instead of both a winter weather advisory and a freezing rain advisory, they are using only a winter weather advisory and putting freezing rain in the body. #PlainLanguageSummit
Aim: to launch new system in 2024. Want to make sure the public and partners need time to adjust and educate their stakeholders, time to do testing. #PlainLanguageSummit
Next up: "Getting GAO’s Message Across in the Digital Age" with Eden Savino and Melanie Fallow from the Government Accountability Office #PlainLanguageSummit
GAO is the oversight arm of Congress. They issue about 700 reports, testimonies, and other publications each year. Important work that helps people understand how the federal gov't can save money or improve. #PlainLanguageSummit
Reports on the GAO blog with plain language summaries/highlights had more engagement and encouraged people to stay on the GAO site longer. In 2016, GAO launched the “Fast Facts” pilot to make those messages even more concise. #PlainLanguageSummit
The need came from:
•Digital age » deluge of information, new platforms
•Peer review » auditors were having trouble understanding Highlights on landing page
•Low engagement » data showed that people spent little time on GOA pages #PlainLanguageSummit
Developed Fast Facts: 650-character online introductions to GAO reports, designed for mobile first, features engaging visuals. #PlainLanguageSummit
For the pilot:
•Collected Google Analytics data and internal feedback
•Tested Fast Facts with people the agency wanted to read their work #PlainLanguageSummit
Results:
•readers spent 70% longer on GAO.gov and nearly 700% longer on mobile devices
•40% more report shares
•30% more report downloads #PlainLanguageSummit
Each Fast Fact gets shown to several cold readers. And if anyone pauses on something, the team knows they have to change it, not explain why the person shouldn't have paused on it. #PlainLanguageSummit
Today I'm attending the symposium "Adapting Comics for Blind and Low Vision Readers" and will try to live-tweet. (At my in-laws' where the internet isn't super reliable, so I may be fading in and out.)
I'll be using the hashtag #ComicsA11y, so mute or follow along as desired!
Nick Sousanis (@Nsousanis), who wrote his dissertation in comic book form and aimed to make his work as accessible as possible but knew that there were people he was still leaving out. He began collecting resources on making comics more accessible. #ComicsA11y
Ting Siu (@TVI_ting) is an educator of people with low vision. "My dream is to have my students walk into a classroom and not encounter any barriers to their education." #ComicsA11y
I ALSO HAVE THIS ANGLERFISH MASK. I GET LOTS OF "I LIKE YOUR MASK"S WHEN I WEAR THIS. MAYBE GETTING COMPLIMENTED ON YOUR MASK WILL MAKE YOU MORE LIKELY TO WEAR A MASK.
Last day of this conference! I had to miss the first session, but now I'm in "Best Practices for Communicating through Imagery" with speakers Kathleen Walker and David Pearl. #ihahlc21
Pictograms vs. icons—what's the difference?
Pictograms must be a literal representation. Icons may be literal or abstract.
Pictograms convey a complete idea with no additional explanation needed. #ihahlc21
Pictograms have a lot of different applications—e.g. with COVID-19: showing steps to wash hands, show symptoms, give instructions, showing social distancing. #ihahlc21
Now tweeting from the session "Connecting the social determinants of health and health literacy" with speakers Speaker: Lauri J. DeRuiter-Willems and Jennifer Cannon. #ihahlc21
They recognized a connection between social determinants of health and health literacy, but the connection wasn't as clear to their students. Came up with a privilege activity for participants to self-reflect. #ihahlc21
Activity: 40 questions about privilege with yes/no answers. People move forward with a yes, backward with a no.
It can be intimidating or emotional to end up at the end or the front of the line.
Our history doesn't necessarily reflect our success. #ihahlc21
Last session for the day! (I might duck out early to catch the BC COVID press conference.)
Integrating Patient Stories in Health Literacy Training
Speakers: Farrah Schwartz, Sophia Wong & Jack (John) R. Ireland, University Health Network, Toronto, Ontario, Canada #ihahlc21
The University Health Network's patient engagement portfolio supports UHN to provide equitable, clear, accessible, timely and compassionate care. #ihahlc21