I Still Can’t Understand You

confused-face1Last month, Ivan Oransky of ReutersHealth published a piece on a new article in JAMA Internal Medicine that looked at the quality of patient education materials.

And what they found wasn’t pretty. The researchers downloaded online materials from sixteen different disciplines in an attempt to see which medical discipline was best at crafting materials that their population could understand. Unfortunately, none of them were very good at it. Plain language and health literacy best practices dictate that we should be writing for a fourth- to sixth-grade reading level. The researchers found that the reading levels:

fell anywhere from ninth grade to the sophomore year of college.

This, in itself, is bad enough, but the article goes on to say that many of the downloaded materials depend on cliches and passive voice. Passive voice is a tool used by researchers and academics in an attempt to separate themselves from the work, to continue to stand objectively aside from the topic. The vast majority of the public, though, find this voice to be confusing and indirect.

But for me, the passive voice and too-high reading level can be fixed, I think. The cliches, on the other hand, are worrisome because:

“You go from region to region in the U.S., people aren’t familiar with what each cliche refers to,” said [study author] Agarwal.

This is problematic because of what our government communications teams look like these days, especially at the local and state level. We don’t have the time or staff we need to craft, refine and perfect our documents. So, we depend on help from other professional and governmental organizations to help fill in the gaps. My emergency friends reuse stuff from the American Red Cross and FEMA. We, in public health, use CDC materials (some of us even let the CDC publish right to our websites!). And the cliches that they use might not translate to your neck of the woods. It was probably written in Washington, DC or Atlanta and those places can be very different from where you live.

Take, for example our earlier discussion about tornadoes and what you should do when the siren goes off. If I wrote advice for getting to a safe place, I’d say run to your basement, because I have a basement, and so does everyone else I know. For people in Moore, Oklahoma, though, that advice is useless.

So, my call to you, communicator-brethren and friend-of-communicators, is this: take advantage of the amazing free resources available to supplement your messaging portfolio. But before you hit the publish button, make sure to review them. Look for, and update, turns of phrase that seem out of place. Look for, and fix, language that is confusing. Get rid of the jargon and speak like your audiences speak. Having confusing or unreadable information available is just as bad as having no information available.

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Profile Photo Arnold Gertonsn

It is a sad commentary on our education system when we are told to write at a fourth to sixth grade level. Parents need to get their kids away from the video games and limit the use of the social media, i.e. texting, tweeting, facebook, etc. and have them read books and practice writing – with a pen and paper. I have had/have grandchildren that can read and comprehend at a sixth to eighth grade level when they were/are in second grade so I know from experience.

Profile Photo Jim Garrow

Not necessarily, Arnold. The 4th- to 6th grade reading level is also intended for people who either don’t speak English or are learning, for folks with diminished mental capacity, and for folks in crisis situations (like when diagnosed with a life-changed disease or condition, or alternatively, during an emergency situation). Just because we can read at a higher level, doesn’t mean we should be forced to.