Citations

i The only national data currently available on the health literacy of the U.S. population are from 2003 (National Assessment of Adult Literacy, or NAAL).

  1. National Association of Community Health Centers. (2023). Closing the primary care gap: How community health centers can address the nation’s primary care crisis. https://www.nachc.org/wp-content/uploads/2023/06/Closing-the-Primary-Care-Gap_Full-Report_2023_digital-final.pdf
  2. U.S. Census Bureau. (2024, June 18). Computer and internet use in the United States: 2021 [Press release]. https://www.census.gov/newsroom/press-releases/2024/computer-internet-use-2021.html
  3. Pew Research Center. (2024, November 13). Mobile phone ownership over time. Fact Sheets: Tech Adoption Trends, Mobile fact sheet. https://www.pewresearch.org/internet/fact-sheet/mobile/
  4. Wang, X., and Cohen, R. A (2023). Health information technology use among adults: United States July–December 2022 (National Center for Health Statistics Data Brief, no. 482). U.S. Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/products/databriefs/db482.htm
  5. Nielsen, J. (2016). The distribution of users’ computer skills: Worse than you think. Nielsen Norman Group. https://www.nngroup.com/articles/computer-skill-levels/
  6. Sieck, C. J., Sheon, A., Ancker, J. S., Castek, J., Callahan, B., & Siefer, A. (2021). Digital inclusion as a social determinant of health. NPJ digital medicine, 4(1), 52. https://doi.org/10.1038/s41746-021-00413-8
  7. Office of the U.S. Surgeon General. (2021). Confronting health misinformation: The U.S. Surgeon General’s advisory on building a health information environment. U.S. Department of Health and Human Services. https://www.hhs.gov/sites/default/files/surgeon-general-misinformation-advisory.pdf
  8. National Academies of Sciences, Engineering, and Medicine. (2020). Addressing health misinformation with health literacy strategies: Proceedings of a workshop in brief. The National Academies Press. https://nap.nationalacademies.org/read/26021/chapter/1
  9. U.S. Department of Commerce. (1995). Falling through the net: A Survey of the "Have Nots" in Rural and Urban America. National Telecommunications and Information Administration. https://www.ntia.gov/page/falling-through-net-survey-have-nots-rural-and-urban-america
  10. Gelles-Watnick, R. (2024). Americans’ use of mobile technology and home broadband. Pew Research Center. https://www.pewresearch.org/wp-content/uploads/sites/20/2024/01/PI_2024.01.31_Home-Broadband-Mobile-Use_FINAL.pdf
  11. Office of Disease Prevention and Health Promotion. (2010). National action plan to improve health literacy. U.S. Department of Health and Human Services. https://odphp.health.gov/sites/default/files/2019-09/Health_Literacy_Action_Plan.pdf
  12. Kutner, M., Greenberg, E., Jin, Y., & Paulsen, C. (2006). The health literacy of America’s adults: Results from the 2003 National Assessment of Adult Literacy (NCES 2006-483). U.S. Department of Education, National Center for Education Statistics. https://nces.ed.gov/pubs2006/2006483.pdf
  13. National Center for Education Statistics. (n.d.). Program for the International Assessment of Adult Competencies (PIAAC): Highlights of U.S. national results (2017). U.S. Department of Education. Retrieved October 9, 2024, from https://nces.ed.gov/surveys/piaac/national_results.asp
  14. Arias López, M. D. P., Ong, B. A., Borrat Frigola, X., Fernández, A. L., Hicklent, R. S., Obeles, A. J. T., Rocimo, A. M., & Celi, L. A. (2023). Digital literacy as a new determinant of health: A scoping review. PLOS Digital Health, 2(10), e0000279. https://doi.org/10.1371/journal.pdig.0000279
  15. Seidel, E., Cortes, T., & Chong, C. (2023). Digital health literacy. U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality. https://psnet.ahrq.gov/primer/digital-health-literacy
  16. Pola, S. (2022). Medical misinformation runs rampant, and many Americans have trouble identifying it. GoodRx. https://www.goodrx.com/healthcare-access/research/medical-misinformation-survey
  17. Fleary, S. A., & Ettienne, R. (2019). Social disparities in health literacy in the United States. Health Literacy Research and Practice, 3(1), 47–52. https://pubmed.ncbi.nlm.nih.gov/31294307/
  18. Schillinger D. (2021). Social determinants, health literacy, and disparities: Intersections and controversies. Health Literacy Research and Practice, 5(3), 234–243. https://pmc.ncbi.nlm.nih.gov/articles/PMC8356483/
  19. Cutilli, C. C., Simko, L. C., Colbert, A. M., & Bennett, I. M. (2018).  Health literacy, health disparities, and sources of health information in U.S. older adults. Orthopedic Nursing, 37(1), 54–65. https://pubmed.ncbi.nlm.nih.gov/29369135/
  20. National Academies of Sciences, Engineering, and Medicine. (2018). People living with disabilities health equity, health disparities, and health literacy: Proceedings of a workshop. National Academies Press. https://nap.nationalacademies.org/catalog/24741/people-living-with-disabilities-health-equity-health-disparities-and-health
  21. Crandall, B. R., Lewis, E., Stevens, E. Y., Robertson, J. M., O'Toole, J. E., Cullen, K. A., Munger, K. A., Murray, M. S., Duffy, M. A., Dussling, T. M., & McQuitty, V. (2016). Steps to success: Crossing the bridge between literacy research and practice. Milne Open Textbooks. https://milneopentextbooks.org/steps-to-success/https://milnepublishing.geneseo.edu/steps-to-success/
  22. Altamura, L., Vargas, C., & Salmerón, L. (2023). Do new forms of reading pay off? A meta-analysis on the relationship between leisure digital reading habits and text comprehension. Review of Educational Research, 95(1). https://doi.org/10.3102/00346543231216463
  23. Digital.gov. (n.d.). Usability.  U.S. Department of Health and Human Services. Retrieved from http://www.usability.gov
  24. Colter, A., & Summers, K. (2014). Eye tracking with unique populations: Low literacy users. In J. Romano Bergstrom & A. J. Schall (Eds.), Eye tracking in user experience design (pp. 331–346). Morgan Kaufmann Publishers/Elsevier.
  25. Summers, K., & Summers, M. (2004). Making the web friendlier for lower-literacy users. Intercom, 51(6), 19–21.
  26. Kodagoda, N., Wong, B. L. W., & Kahan, N. (2009, June 23–26). Identifying information seeking behaviours of low and high literacy users: Combined cognitive task analysis. 9th Bi-annual International Conference on Naturalistic Decision Making (pp. 347–354), London, United Kingdom. https://www.scienceopen.com/hosted-document?doi=10.14236/ewic/NDM2009.58
  27. Chaudry, B. M., Connelly, K. H., Siek, K. A., & Welch, J. L. (2012, January 28–30). Mobile interface design for low-literacy populations. Proceedings of the 2nd ACM SIGHIT Symposium on International Health Informatics, Association for Computing Machinery (pp. 91–100), Miami, FL, United States. https://course.khoury.northeastern.edu/is4300f13/ssl/chaudry.pdf 
  28. Baker, D. W., DeWalt, D. A., Schillinger, D., Hawk, V., Ruo, B., Bibbins-Domingo, K., Weinberger, M., Macabasco-O’Connell, A., & Pignone, M. (2011). “Teach to Goal”: Theory and design principles of an intervention to improve heart failure self-management skills of patients with low health literacy. Journal of Health Communication, 16, 73–88. https://doi.org/10.1080/10810730.2011.604379
  29. Alton, N. T., Rinn, C., Summers, K., & Straub, K. (2014, October 13–15). Using eye-tracking and form completion data to optimize form instructions.  2014 IEEE International Professional Communication Conference (IPCC) (pp. 1–7). https://ieeexplore.ieee.org/document/7020389
  30. Birru, M. S., Monaco, V. M., Charles, L., Drew, H., Njie, V., Bierria, T., Detlefsen, E., & Steinman, R. A. (2004). Internet usage by low-literacy adults seeking health information: An observational analysis. Journal of Medical Internet Research, 6(3), 1–17. http://doi.org/10.2196/jmir.6.3.e25
  31. Modesto, D. M., & Ferreira, S. B. L. (2014). Guidelines for search features development – A comparison between general users and users with low reading skills. Procedia Computer Science, 27, 334–342. http://doi.org/10.1016/j.procs.2014.02.037
  32. Sanabria, L. (2023, April 17). How voice assistants improve digital accessibility. Accessibility.com. https://www.accessibility.com/blog/how-voice-assistants-improve-digital-accessibility
  33. Hogan, J., Montalvan, P., Diaz-Hoffmann, L., Dohrmann, S., Krenzke, T., Lemay, M., Mohadjer, L. Thornton, N., Owen, E., & Provasnik, S. (2014). Program for the International Assessment of Adult Competencies 2012: U.S. main study technical report (NCES 2014-047). U.S. Department of Education, National Center for Education Statistics. https://nces.ed.gov/pubs2014/2014047.pdf
  34. U.S. Centers for Disease Control and Prevention. (n.d.). Disability impacts all of us infographic. Retrieved April 27, 2025, from https://www.cdc.gov/disability-and-health/articles-documents/disability-impacts-all-of-us-infographic.html?CDC_AAref_Val=https://www.cdc.gov/ncbddd/disabilityandhealth/infographic-disability-impacts-all.html
  35. Krug, S. (2010). Rocket surgery made easy. New Riders Publishing (p.13).
  36. Amresh, H., Ash, A., Gazmararian, J., Wolf, M., & Paasche-Orlow, M. (2008). The Demographic Assessment for Health Literacy (DAHL): A new tool for estimating associations between health literacy and outcomes in national surveys. Journal of General Internal Medicine, 23(10), 1561–1566.
  37. Chisnell, D., Lee, A., & Redish, J. (2004). Recruiting and working with older participants in usability studies. https://redish.net/wp-content/uploads/recruiting_and_working_with_older_participants.pdf
  38. Munteanu, C., Molyneaux, H., & O’Donnell, S. (2014). Fieldwork with vulnerable populations. Interactions, 21(1), 50–53. https://dl.acm.org/doi/abs/10.1145/2543579
  39. Agency for Healthcare Research and Quality. (2009). AHRQ informed consent and authorization toolkit for minimal risk research (AHRQ Publication No. 09-0089-EF). U.S. Department of Health and Human Services. https://www.ahrq.gov/sites/default/files/publications2/files/ictoolkit.pdf
  40. Bandura, A. (1997). Self-efficacy: The exercise of control. W. H. Freeman.
  41. Baker, D. W., Gazmararian, J. A., Sudano, J., Patterson, M., Parker, R. M., & Williams, M. V. (2002). Health literacy and performance on the Mini-Mental State Examination. Aging & Mental Health, 6(1), 22–29. http://doi.org/10.1080/13607860120101121
  42. Gelles-Watnick, R. (2024). Americans’ use of mobile technology and home broadband. Pew Research Center. https://www.pewresearch.org/internet/2024/01/31/americans-use-of-mobile-technology-and-home-broadband/
  43. Pew Research Center. (2024, November 13). Internet use over time. Fact Sheets: Tech Adoption Trends, Internet/broadband fact sheet. https://www.pewresearch.org/internet/fact-sheet/internet-broadband/#who-is-smartphone-dependent
  44. Schade, A. (2014). Responsive web design (RWD) and user experience. Nielsen Norman Group. https://www.nngroup.com/articles/responsive-web-design-definition/
  45. Microsoft. (n.d.). Inclusive Microsoft design. https://inclusive.microsoft.design/tools-and-activities/Inclusive101Guidebook.pdf
  46. The Pew Charitable Trusts. (2022, July 7). How do Americans connect to the internet? Fact sheet. The Pew Charitable Trusts. https://www.pewtrusts.org/en/research-and-analysis/fact-sheets/2022/07/how-do-americans-connect-to-the-internet
  47. Glover, E., & Saddler, L. L. (2024, June 13). What is internet throttling and how can you test it? Forbes. https://www.forbes.com/home-improvement/internet/what-is-internet-throttling/ 
  48. U.S. General Services Administration. (n.d.). Section508.gov IT accessibility key performance indicators (KPI). Office of Governmentwide Policy. www.section508.gov
  49. Bureau of Internet Accessibility. (2024). WCAG conformance and third-party web content. https://www.boia.org/blog/wcag-conformance-and-third-party-web-content
  50. Office of Disease Prevention and Health Promotion (final report, prepared by ACS Healthcare Solutions). (2006). MyHealthfinder usability testing for ODPHP, fall 2006. U.S. Department of Health and Human Services.
  51. Office of Disease Prevention and Health Promotion (report prepared by Z-Tech Corp.). (2007). Healthfinder.gov redesign: Prevention prototype usability study results report. U.S. Department of Health and Human Services.
  52. Office of Disease Prevention and Health Promotion (prepared by Z-Tech Corp.). (2006). Prevention content prototype development: ODPHP card sort study report. U.S. Department of Health and Human Services.
  53. Redish, J. (2012). Letting go of the words: Writing web content that works (2nd ed.). Morgan Kaufmann Publishers/Elsevier.
  54. U.S. Department of Health and Human Services & U.S. General Services Administration. (2006). Research-based web design and usability guidelines. U.S. Government Printing Office.
  55. Lefebvre, R. C., Tada, Y., Hilfiker, S. W., & Baur, C. (2010). The assessment of user engagement with ehealth content: The eHealth Engagement Scale. Journal of Computer-Mediated Communication, 15(4), 666–681. http://onlinelibrary.wiley.com/doi/10.1111/j.1083-6101.2009.01514.x/full
  56. Office of Disease Prevention and Health Promotion (prepared by Abt Associates). (2004). Literature review about prevention content literature. U.S. Department of Health and Human Services.
  57. Office of Disease Prevention and Health Promotion (report prepared by Health Communication Research Laboratory & Abt Associates). (2006). Structured interview analyses. U.S. Department of Health and Human Services.
  58. Summers, K., & Summers, M. (2005). Reading and navigational strategies of web users with lower literacy skills. Proceedings of the American Society for Information Science and Technology, 42(1). http://doi.org/10.1002/meet.1450420179
  59. Keating, S. (2024, April 12). What is a good average time on page & how to increase it. Jetpack. https://jetpack.com/resources/average-time-on-page/
  60. Nielsen, J. (2011). How long do users stay on web pages? Nielsen Norman Group. https://www.nngroup.com/articles/how-long-do-users-stay-on-web-pages/
  61. Office of Disease Prevention and Health Promotion (report prepared by Z-Tech Corp.). (2007). Prevention content prototype development: ODPHP prevention content prototype evaluation results report. U.S. Department of Health and Human Services.
  62. Office of Disease Prevention and Health Promotion (final report, prepared by ACS Healthcare Solutions). (2008). 2008 healthfinder.gov redesign usability test. U.S. Department of Health and Human Services.
  63. Alexandria Health Department. (2008). Parent and caregiver discussion groups (discussion group report for ODPHP). U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion.
  64. Office of Disease Prevention and Health Promotion (report prepared by Z-Tech Corp.). (2008). Results of usability testing and design preference interviews on ODPHP physical activity finder tool. U.S. Department of Health and Human Services.
  65. Courage, C., & Baxter, K. (2004). Understanding your users. Morgan Kaufmann/Elsevier.
  66. Cooper, A., Reimann, R., & Cronin, D. (2007). About face: The essentials of interface design (3rd ed.). Wiley.
  67. Office of Disease Prevention and Health Promotion (report prepared by Z-Tech Corp.). (2009). Formative research: Report on subject matter expert interviews. U.S. Department of Health and Human Services.
  68. Janz, N., Champion, V., & Strecher, V. (2002). The health belief model. In K. Glanz, F. M. Lewis, & B. K. Rimer (Eds.), Health behavior and health education: Theory, research, and practice (3rd ed.) (pp. 45–66). Jossey-Bass.
  69. Plain Language Action and Information Network. (2011). Federal plain language guidelines. U.S. General Services Administration. https://www.plainlanguage.gov/guidelines/
  70. Office of Disease Prevention and Health Promotion (PowerPoint presentation, prepared by Summers, K.). (2008). Usability review of healthfinder.gov (beta). U.S. Department of Health and Human Services.
  71. Office of Disease Prevention and Health Promotion (final report, prepared by ACS Healthcare Solutions). (2007). 2007 healthfinder.gov usability testing. U.S. Department of Health and Human Services.
  72. National Center for Education Statistics. (2003). National Assessment of Adult Literacy: Key findings. U.S. Department of Education. http://nces.ed.gov/naal/kf_demographics.asp
  73. Zarcadoolas, C., Pleasant, A. F., & Greer, D. S. (2006). Advancing health literacy: A framework for understanding and action. Jossey-Bass.
  74. U.S. Centers for Medicare and Medicaid Services. (n.d.). Guidelines for effective writing. U.S. Department of Health and Human Services. https://www.cms.gov/training-education/learn/find-tools-to-help-you-help-others/guidelines-for-effective-writing
  75. Danielson, W. A., & Lasorsa, D. L. (1989). A new readability formula based on the stylistic age of novels. Journal of Reading, 33(3),194–196. https://eric.ed.gov/?id=EJ402132
  76. Nielsen, J., & Loranger, H. (2006). Prioritizing web usability. New Riders.
  77. Keselman, A., & Arnott Smith, C. (Eds.). (2022). Combating online health misinformation: A professional's guide to helping the public. Medical Library Association Books Series. Rowman & Littlefield Publishers.
  78. National Center for Education Statistics. (2018, August). Literacy and numeracy skills of U.S. men and women. Data Point. U.S. Department of Education. https://nces.ed.gov/pubs2018/2018164/index.asp
  79. Zarcadoolas, C., Blanco, M., Boyer, J. F., & Pleasant, A. (2002). Unweaving the web: An exploratory study of low-literate adults’ navigation skills on the World Wide Web. Journal of Health Communication, 7(4), 1, 309–324.
  80. Office of Disease Prevention and Health Promotion (report prepared by UserWorks). (2009). Usability evaluation of healthfinder.gov Quick Guide to Healthy Living. U.S. Department of Health and Human Services.
  81. Haile, T. (2014, March 9). What you think you know about the web is wrong. Time. http://time.com/12933/what-you-think-you-know-about-the-web-is-wrong/
  82. Schade, A. (2015). The fold manifesto: Why the page fold still matters. Nielsen Norman Group. https://www.nngroup.com/articles/page-fold-manifesto/
  83. Smith, A. (2015). U.S. smartphone use in 2015. Pew Research Center. http://www.pewinternet.org/2015/04/01/us-smartphone-use-in-2015/
  84. WebAIM. (2019). Links and hypertext. Retrieved October 9, 2024, from https://webaim.org/techniques/hypertext/link_text
  85. U.S. Web Design System. (n.d.). Components: Link. U.S. General Services Administration. Retrieved October 9, 2024, from https://designsystem.digital.gov/components/link/
  86. U.S. Web Design System. (n.d.). Components: Link: What you should do. U.S. General Services Administration. Retrieved October 9, 2024, from https://designsystem.digital.gov/components/link/#what-you-should-do-2
  87. Loranger, H. (2015). Beyond blue links: Making clickable elements recognizable. Nielsen Norman Group. http://www.nngroup.com/articles/clickable-elements/
  88. Meppelink, C., van Weert, J. C. M., Haven, C. J., & Smit, E. G. (2015). The effectiveness of health animations in audiences with different health literacy levels: An experimental study. Journal of Medical Internet Research, 17(1), e11. https://doi.org/10.2196/jmir.3979
  89. Woloshin, S., Yang, Y., & Fischhoff, B. (2023). Communicating health information with visual displays. Nature Medicine, 29(8), 1085–1091. https://doi.org/10.1038/s41591-023-02328-1
  90. Web Content Accessibility Guidelines 2.0. (2008). W3C World Wide Web Consortium Recommendation. Retrieved October 9, 2024, from http://www.w3.org/TR/2008/REC-WCAG20-20081211/
  91. U.S. Centers for Disease Control and Prevention. (2014). The CDC Clear Communication Index. U.S. Department of Health and Human Services. http://www.cdc.gov/ccindex/index.html
  92. Makoul, G., Cameron, K. A., Baker, D. W., Francis, L., Scholtens, D., & Wolf, M. S. (2009). A multimedia patient education program on colorectal cancer screening increases knowledge and willingness to consider screening among Hispanic/Latino patients. Patient Education and Counseling, 76(2), 220–226. https://doi.org/10.1016/j.pec.2009.01.006
  93. Jay, M., Adams, J., Herring, S. J., Gillespie, C., Ark, T., & Feldman, H. (2009). A randomized trial of a brief multimedia intervention to improve comprehension of food labels. Preventive Medicine, 48(1), 25–31. https://doi.org/10.1016/j.ypmed.2008.10.011
  94. Sobel, R. M., Paasche-Orlow, M. K., Waite, K. R., Rittner, S. S., Wilson, E. A. H., & Wolf, M. S. (2009). Asthma 1–2–3: A low literacy multimedia tool to educate African American adults about asthma. Journal of Community Health, 34(4), 321–327. https://doi.org/10.1007/s10900-009-9153-9
  95. Doak, C. C., Doak, L. G., & Root, J. H. (1996). Teaching patients with low literacy skills. Lippincott Williams & Wilkins.
  96. Krause, R. (2023). Using imagery in visual design. Nielsen Norman Group. https://www.nngroup.com/articles/imagery-in-visual-design/
  97. Gottfried, J. (2024). Americans' social media use. Pew Research Center. https://www.pewresearch.org/internet/2024/01/31/americans-social-media-use/
  98. Meyer, E. (2002). CSS Design: Going to Print. A List Apart. http://alistapart.com/article/goingtoprint/
  99. Krammer, C. (2011). How to set up a print style sheet. Smashing Magazine. http://www.smashingmagazine.com/2011/11/24/how-to-set-up-a-print-style-sheet/
  100. Jarrett, C., & Gaffney, G. (2009). Forms that work: Designing web forms for usability. Morgan Kaufmann Publishers/Elsevier.
  101. Summers, K. (2006). Designing online forms for users with lower literacy skills. Presented at User Focus Meeting, Washington, DC, United States.
  102. Wroblewski, L. (2008). Web form design. Rosenfeld Media.
  103. Li, H., Rau, P. L. P., Fujimura, K., Gao, Q., & Wang, L. (2012). Designing effective web forms for older web users. Educational Gerontology, 38(4), 271–281. http://doi.org/10.1080/03601277.2010.544578
  104. Broderick, J., Devine, T., Langhans, E., Lemerise, A. J., Lier, S., & Harris, L. (2014). Designing health literate mobile apps. NAM Perspectives. Discussion Paper, National Academy of Medicine. https://nam.edu/wp-content/uploads/2015/06/HealthLiterateApps.pdf
  105. Bishop, S. (2014). Adobe Dreamweaver Creative Cloud revealed (pp. 3–24). Cengage Learning.
  106. Everdell, I. (2014). Web content. In J. Romano Bergstrom & A. J. Schall (Eds.), Eye tracking in user experience design (pp. 163–186). Morgan Kaufmann Publishers/Elsevier.
  107. Rello, L., & Baeza-Yates, R. (2013). Good fonts for dyslexia. Proceedings of the 15th International ACM SIGACCESS Conference on Computers and Accessibility - ASSETS ’13 (pp. 1–8). https://dl.acm.org/doi/10.1145/2513383.2513447
  108. Maceri, K. (n.d.). Document design for users with reading disorders. The University of Memphis. http://www.angelfire.com/tn3/writing/DesignUsersReadDis.pdf
  109. T, A. (2012). Finger-friendly design: Ideal mobile touchscreen target sizes. Smashing Magazine. https://www.smashingmagazine.com/2012/02/finger-friendly-design-ideal-mobile-touchscreen-target-sizes/
  110. He, J., Siu, C., Chaparro, B., & Strohl, J. (2014). Mobile. In J. Romano Bergstrom & A. J. Schall (Eds.), Eye tracking in user experience design (pp. 255–290). Morgan Kaufmann Publishers/Elsevier.
  111. Budiu, R. (2015). Progress in mobile user experience. Nielsen Norman Group. http://www.nngroup.com/articles/mobile-usability-update/
  112. Medhi, I., Patnaik, S., Brunskill, E., Gautama, S. N. N., Thies, W., & Toyama, K. (2011). Designing mobile interfaces for novice and low-literacy users. ACM Transactions on Computer-Human Interaction, 18(1), 1–28. http://doi.org/10.1145/1959022.1959024
  113. Hoober, S. (2013). How do users really hold mobile devices? UX matters.  http://www.uxmatters.com/mt/archives/2013/02/how-do-users-really-hold-mobile-devices.php
  114. U.S. Web Design System. (n.d.). Checkbox components. U.S. General Services Administration. https://designsystem.digital.gov/components/checkbox/
  115. U.S. Web Design System. (n.d.). Radio buttons components. U.S. General Services Administration. https://designsystem.digital.gov/components/radio-buttons/
  116. National Institute on Aging & National Library of Medicine. (2009). Making your Website senior friendly. U.S. Department of Health and Human Services, National Institutes of Health. https://www.datachieve.com/wp-content/uploads/2021/07/Making-Your-Website-Senior-Friendly-Tip-Sheet.pdf
  117. Gogh, P. B., & Tunmer, W. (1986). Decoding, reading, and reading disability. Remedial and Special Education, 7(1), 6–10. https://doi.org/10.1177/074193258600700104 

Last updated: June 20, 2025