Did you know? Only 21% of people can easily use typically designed online services. A further 53% of people use them with difficulty. For 25% of people, standard online design doesn’t work. Tips for designing web content: Try to keep content as short as possible. Web-users usually scan web pages and focus on key words or sentences. Make navigation easy by having clear headings and easy-to-see links. Make sure information is accessible for people with a disability and people using assistive technologies. Images in online documents need ‘alternative text’ for images so they can be read by screen readers used by people with poor vision. The Web Content Accessibility Guidelines provide more information.

Print signs with large, clear text. Signs need to be visible as soon as people enter the facility and direct people: From the carpark/bus stop to the main entrance To reception Directly to services To facilities like toilets, waiting areas. Signs use plain language. If medical jargon is used, provide plain language descriptions next to this on the sign. If graphics are used on signs, these are consistent throughout the facility. Write signs in English and in the primary language of your local population, if applicable. Other visual cues, like lines on the floor, can be used to help people find their way around the facility, but should not replace signs.

Improve your health information

Consumer information resources can be in the form of brochures, instructions, websites, forms or promotional material.

Reading, writing, speaking, listening, calculating, problem solving and using technology are hard for many people. If your resource assumes that readers can do all these skills, some people will not get the information they need. Use the checklist below to make sure written information is clear, easy to access, understand and act on.

On this page:

Checklist for reviewing and developing
consumer health information

Your aim is to meet most of the criteria below. If you have 3 or more “no” answers, your resource does not meet health literacy criteria.

Criteria for resources to meet health literacy standards		Yes	No	N/A
Language
1	The information is below a grade 8 reading level
2	Uses plain language (“everyday”, conversational language)
3	Uses friendly, welcoming language
4	Uses action-oriented language
Information
5	Purpose of the document is clear
6	The most important points appear first and stand out
7	Information is “need to know” rather than “nice to know”
8	Information is directly related to the document’s purpose
9	Numerical information is easy to understand
Formatting
10	Aligns text to the left (not justified)
11	Uses one font for the whole document
12	Uses at least size 12 font
13	Important information is in bold
14	Breaks text up into small chunks using headings
15	Breaks up paragraphs and lists to be shorter or separated by category headings
16	Uses images that are relevant, simple and help understanding by visually representing the main messages of the document
17	Uses plenty of white space around text
18	Uses colours to support understanding and these colours do not distract the reader
19	Tables, charts or graphs are simple, easy to follow
20	Uses visual cues to draw attention to key points, e.g. arrows, boxes, bullets, larger font
Consumer needs
21	Designed or tested with at least 5 consumers who represent the target audience
22	Considers and addresses the health, wellbeing and cultural needs of the population/s the information is aimed at

As well as our checklist, you can also use the Patient Education Materials Assessment Tool (PEMAT) to score the understandability and actionability of print and audiovisual resources.

Make sure you also check local guidelines for developing health information. Northern NSW Local Health District have their own guidelines. (You will only be able to access this link if you are a NNSW LHD staff member).

We acknowledge the work of the Tasmanian Department of Health and the Suitability of Materials Score Sheet as the source of much of our advice.

View our case studies about developing written information.

Other types of written information

Web content

Did you know?

Only 21% of people can easily use typically designed online services.
A further 53% of people use them with difficulty.
For 25% of people, standard online design doesn’t work.

Tips for designing web content:

Try to keep content as short as possible. Web-users usually scan web pages and focus on key words or sentences.
Make navigation easy by having clear headings and easy-to-see links.
Make sure information is accessible for people with a disability and people using assistive technologies.
Images in online documents need ‘alternative text’ for images so they can be read by screen readers used by people with poor vision.
The Web Content Accessibility Guidelines provide more information.

Signage

Print signs with large, clear text.
Signs need to be visible as soon as people enter the facility and direct people:
- From the carpark/bus stop to the main entrance
- To reception
- Directly to services
- To facilities like toilets, waiting areas.
Signs use plain language. If medical jargon is used, provide plain language descriptions next to this on the sign.
If graphics are used on signs, these are consistent throughout the facility.
Write signs in English and in the primary language of your local population, if applicable.
Other visual cues, like lines on the floor, can be used to help people find their way around the facility, but should not replace signs.

When to use written information

Written and visual information can help people understand information and recall and use this information later.

Information that is given without context or engagement is less likely to be read. Unless people are seeking their own information outside of a health encounter, written information should be used to support health communication, not be the sole form of communication.

When seeing people in a health encounter, use written and visual information to help you discuss information. Always check for understanding before finishing the encounter and leaving the resource with people.

Just like all forms of communication, we don’t want to give people too much information all at once. Giving people an overload of information all at one time can be overwhelming and confusing.

6 Step review and development process

Search for existing information about the topic and check if it is suitable using the above checklist.
Plan the time and money needed for development and distribution.
Engage with stakeholders (your colleagues, other health services, and consumers who will be using your resource) to see what their needs are for this resource.
Develop content using the checklist and the information on this page to guide you.
Make sure people know how to access your finished resource.
Review the resource regularly to update information.

References

Carolan M. Health literacy and the information needs and dilemmas of first-time mothers over 35 years.
J Clin Nurs. 2007;16(6):1162-1172. doi:10.1111/j.1365-2702.2007.01600.x
Shoemaker SJ, Wolf MS, Brach C. Development of the Patient Education Materials Assessment Tool (PEMAT): a new measure of understandability and actionability for print and audiovisual patient information. Patient Educ Couns 2014;96(3):395-403. DOI: 10.1016/j.pec.2014.05.027. ncbi.nlm.nih.gov
Department of Health. Health Literacy. Tasmanian Government. 2021.
Suitability of Materials Score Sheet

Designed or tested with at least 5 consumers who represent the target audience

The best way to find out who your audience is, what they want and need to know, and what language they prefer, is to ask them!
Engaging consumers at the design stage makes sure your resource meets consumer needs.
Seek consumer feedback on draft documents. These feedback form and feedback documentation templates can help.

Tables, charts or graphs are simple, easy to follow

Includes instructions for how to use the tables/charts/graphs to take action
See more about presenting numerical information

Uses colours to support understanding and these colours do not distract the reader

Uses high contrast colours for text and background, e.g., black text on white background
Colours can be used to create visual interest, but should not be used for differentiating between ideas, e.g. do not use different colours to represent different variables on a graph; use different types of lines or textures. This is because some documents are printed in black and white, and some people have colour blindness.

Uses plenty of white space around text

Have blank space around text so your information is not crowded.
Have large gaps between columns of text.

Uses images that are relevant, simple and help understanding by visually representing the main messages of the document

Includes captions for images
Use diagrams or pictures only if these improve understanding of the text. Do not use irrelevant images or decorations.
If using images of people, try to find images that reflect the age and cultural diversity of the population you are writing for.
Make sure you follow copyright law when using images found online. You may need to seek permission to use images, or buy images from a stock image library.
If taking photographs of people, you need written consent to publish their image.
Example – plate portion sizing

Breaks up paragraphs and lists to be shorter or separated by category headings

Lists have just 3 to 5 items each
Lists have only one idea per dot point

Breaks text up into small chunks using headings

Question and answer headings work well

Important information is in bold

Does not use capitals or italics

Uses at least size 12 font

You may have to use larger font for people with poor vision

Uses one font for the whole document

Plain font, e.g. Public Sans, Arial, Times

Aligns text to the left (not justified)

Titles can be centred or left aligned

Numerical information is easy to understand

Does not make the reader do any calculations
Uses relatable comparisons
- Stories can help people relate to the information we are giving them
- Present numbers or measures in a way that is easy for the general public to understand. E.g. use “a shopping trolley apart” rather than “1.5 metres apart”, and “a lump the size of a pea” rather than “lumps about 5 to 6 millimetres in diameter”.
More advice on presenting numbers and risk information can be found here.

Make information and numbers relatable

Check that all the information included is relevant for the purpose of your document and delete anything not relevant. If you have information that will only be useful for other health staff and not consumers, consider creating a separate resource for this audience.
Information should be about what the reader has to do, rather than ‘nice to know’ facts
Write: Drink a total of 2 Litres of water each day. Not: Limit how much you drink to avoid excess fluid building up in your body
You can provide further sources of information for those people who want more background.
Break information into manageable steps
Provide instructions or tools if they will help people to take action

Information is “need to know” rather than “nice to know”

Consumer actions are clear
Background information is limited (can include alink to further information, e.g. videos)
Information should be about what the reader has to do, rather than ‘nice to know’ facts
Write: Drink a total of 2 Litres of water each day.
Not: Limit how much you drink to avoid excess fluid building up in your body
You can provide further sources of information for those people who want more background.
Break information into manageable steps
Provide instructions or tools if they will help people to take action
E.g. “drink __cups of water a day” instead of background information about the impact of excess fluid build up

The most important points appear first and stand out

Includes a summary if a longer resource
Limit the number of messages. 4 or less is a good target

Know the purpose of your document

Purpose stated in title or introduction
Know who it is for and what they need or want to know
Make this clear at the beginning, in the title or introduction
Limit the number of messages. 4 or less is a good target

Uses action-oriented language

Uses active voice rather than passive voice
Addresses the user when describing actions, e.g. ‘’Take your medicine with food” instead of “medicine should be taken with food”

What is active voice?

Sentences in the active voice: the subject performs the action. For example:

“The needs assessment showed that community members prefer a consultation approach.”
“The nurse will check your blood pressure. “

Sentences in the passive voice: the subject receives the action. For example:

“It has been shown by the needs assessment that a consultation approach was preferred by community members.”
“Your blood pressure will be checked by the nurse.”

Uses friendly, welcoming language

Uses ‘you’, ‘we’, and ‘us’ instead of ‘the patient’ and ‘hospital staff’
Uses inclusive and trauma informed language

Use the words ‘you’, ‘we’ and ‘us’ instead of ‘the patient’ or ‘hospital staff’.
Use language that is trauma informed
Use language that is culturally appropriate for Aboriginal and Torres Strait Islander people and Culturally and Linguistically Diverse populations
Use positive rather than negative language (“should”, “do not”), e.g.
- Use: “wash your hands before taking off your bandage” Not: “do not remove the bandage without thoroughly washing your hands”.
- Use: “keep weight off your injured foot to help recovery. Resting will help the injury to heal.” Not: “don’t do any activities that put weight on the injured foot. You should rest.”

Uses plain language (“everyday”, conversational language)

Replaces or explains technical terms, jargon or acronyms

Write in the same way that you speak, using “everyday” or “living room” language. If you have to use jargon, explain any words that may be unfamiliar to people. Even better is to ask your target audience what words they are familiar with and prefer to use when speaking of your topic. Using plain language gets your message across in the simplest terms and the shortest time, which benefits everyone! These Plain Language Resources can help:

For example:

Instead of:	Use:
Condition	How you feel
Avoid	Do not do/use
Chronic	Long term/life-long
Adequate	Enough
Monitor	Keep an eye on/watch out for
Referral	Ask to see another health professional
Cardiac	Heart

Hard to understand: “Initial consultation with health professionals and subsequent community consultation regarding changes to the regulations was undertaken. This project stands to benefit community members through implementation of recommendations proposed by the contributing parties.”

Easy to understand: “We asked doctors and people in the community what they thought about the plans. We’re making positive changes based on that feedback.”

Easy English: Plain language is different to Easy English. Easy English is for anyone that has difficulty reading English, including people with low literacy, a learning disability, or those who use a language other than English. The Easy English Style Guide by Scope can help you develop Easy English resources.

The information is below a grade 8 reading level

Sentences are about 20 words or less
Paragraphs are about 5 sentences or less

Jargon	Plain Language
Pre-op	Before surgery
ECG	Electrical picture of your heart
PRN	When needed
Supine	On back
Discharge planning	Making a plan to get out of hospital
Fast	Do not eat during this time
Sats	Oxygen in blood
Restoration	Filling
Fracture	Break
Pathology	Something is not working right
Verbal comprehension	Understanding what other people are saying
Febrile	High temperature
IVF	Drip
Gait	Walking pattern
Bilateral	Both sides
Abstain	Don’t do
UF goal	How much fluid we want to take off
Primary health assessment	Health check with GP
Prophylactic	To prevent
QID	4 times a day
Pivot	Changing from an old strategy
AF	(atrial fibrillation) Heart flutter/irregular heart rate
Nil by mouth	Nothing to eat or drink
Upper limbs	Arms
Screening	Checking/testing
Dyspnoea	Shortness of breath
Analgesia	Pain relief

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Improve your health information

Checklist for reviewing and developing
consumer health information