• The Basics
• Actions
  • 2.1. Put the most important information first.
  • 2.2. Describe the health behavior—just the basics.
  • 2.3. Stay positive and realistic. Include the benefits of taking action.
  • 2.4. Provide specific action steps.
  • 2.5. Write in plain language.
  • 2.6. Check content for accuracy.
• Iterative Design Methods and Tips

The Basics

Writing for the Web is different than writing for print. Most Web users are looking for specific information or an answer to a question.⁷ They typically don't stay very long on one page (the average time on a home page is about 27 seconds).^7,35

When it comes to health information, users want to quickly and easily:

• Understand the health problem or behavior
• Find out how to take action^14,16,36

Content is the most important element of your Web site.^7,13 Aim for health content that is:

• Brief and to the point
• Actionable and engaging

"Actionable" means you are focusing on health behavior. Tell users what you want them to do and how to do it.

Engagement is the process of involving users in health content in a way that motivates them to take action. Interactive tools and checklists are examples of engaging content. When applied to online health information, high levels of engagement can lead to health behavior change.³⁷

Take note: Plain language is not enough. If you want your users to adopt healthy behaviors, you must write actionable health content. Plain language alone will not get you to your desired outcome.

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Actions

2.1. Put the most important information first.¹³

Many users with limited literacy read only the first few words on a page or paragraph. If they think the content will be easy to get through, they may keep reading. If they think it might be too difficult, they will skip to a different spot on the page.^{4,5,14,16,18,20,38}

This NHLBI Diseases and Conditions Index Web page puts the most important information about this lung disease—just the basics—first. Additional information about lung function comes later.

In card-sorting exercises, Web users with limited literacy skills prioritized the following types of health information as most useful:

• Basics I need to know (Understanding)
• I would like to learn more (Assessment)
• I can do this (Overcoming Barriers)
• How will this help me? (Motivators)
• Ways I can take action (Strategies)
• Where can I go for help? (Community Resources)

Common comments from users included:

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2.2. Describe the health behavior—just the basics.

Start by introducing the prevention behavior. Users want specific behavioral guidance.^{16,17,19,21,34} In other words, tell users what to do and how to do it. Focus on behavior rather than background information and statistics.

Health information does not need to be comprehensive. Instead, usability research has shown that many users prefer to learn "just the basics" about a health topic.³⁶ What do your users need to know to take action? Keep your information direct and to the point.

• Make your information actionable and specific.

The first sentence on this page from healthfinder.gov includes the behavioral recommendation (regular screenings after age 50).

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2.3. Stay positive and realistic. Include the benefits of taking action.

Users overwhelmingly prefer a positive tone. During card-sorting exercises, in addition to basic health information, users prioritized information on motivators and overcoming barriers to behavior change over information on risks and barriers.^{12,14,19,21,23,25,36,39}

• Tell users what they can gain from adopting the desired behavior.

This healthfinder.gov Web page clearly lists the social, physical, and financial benefits of quitting smoking, instead of focusing on the risks and consequences of continuing to smoke.

Be positive. Instead of telling people what not to do, give them positive reasons to change their behavior.

• Limit the use of the following words when writing health recommendations:

• Don't
• Unless
• Not
• Should

People must overcome many perceived and actual barriers on the road to health behavior change. It's important to acknowledge these barriers and offer encouragement and motivation.⁴⁰

• Focus on tips and tools for overcoming barriers rather than on the barriers themselves. Be realistic.

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2.4. Provide specific action steps.

Give users the tools they need to get started. Users gravitate toward action steps, especially things they can do immediately.^{16,17,19,21,34}

• Instead of telling users what to do, tell them how to do it.

Breaking behaviors down into smaller steps improves users' self-efficacy.^{16,17,19,21,34} Self-efficacy is an individual's judgment of his or her ability to succeed in reaching a specific goal. Self-efficacy is an important predictor of health behavior.^40,41 Breaking behaviors into smaller steps gives users choices about which steps feel realistic and doable.

• Include steps users can take immediately.

This healthfinder.gov Web page uses a Start Today box with specific action steps. These steps are concrete and easy to achieve.

• As part of your action steps, engage users with interactive content such as menu planners, printable checklists, and questions to ask a doctor (see Strategy 5).

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2.5. Write in plain language.

Keep paragraphs and sentences short and simple. Use language that is familiar to your users.^{4,7,12–15,18}

Use familiar language and an active voice. Writing in an active voice means that the subject of your sentence performs the action. An active sentence is easier to understand and generally requires fewer words.^3,7,13,38

Active:	Check your blood pressure every 2 years.
Passive:	Blood pressure should be checked every 2 years.

• Use everyday examples to explain medical or technical concepts, and write in a conversational tone. Use words and images that users can relate to.

• When introducing a medical term, clearly define the term the first time you use it. Define the word in context rather than use a glossary or scroll-over definition.

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2.6. Check content for accuracy.

Have a subject matter expert or panel periodically review your health content for accuracy.

• Indicate the date the content was last reviewed and the reviewer's name and contact information. This gives your content more credibility with Web users.

The date the content was last reviewed, as well as the name and contact information of the reviewer, is clearly displayed on this Web page from the Office on Women's Health.

• Use a style guide to keep your content consistent.

A style guide is a document that lays out the rules for writing content for a specific Web site. A style guide can help you keep track of grammar, spelling, and writing preferences. (For example, is it "Web site" or "website"?)

You also can use a style guide to keep track of headings and font size.

A style guide should be an evolving document. Writers and editors will likely add to it over time. Be sure to keep it easily accessible.

Keep a style guide online as a wiki, a Web site that allows for the easy creation and editing of Web documents via a Web browser.

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Iterative Design Methods and Tips

Methods

• Card sorting
• Prototypes
• Usability testing

Tips for designing and testing your Web site with users

• Use card sorting to find out how users rank content by most to least useful or most to least likely to do.
• Build a paper prototype to find out what content users are most likely to "click" on.
• Test user comprehension using content in a paper prototype (see Section 6.3).

Refer to Research-Based Web Design & Usability Guidelines (PDF, 20.64 MB) sections: 1:1; 2:5; 15:1–5; 15:7; 15:9–11