1. Health Literacy Online: Writing and Designing Easy-To-Use Health Web sites Sandra Williams Hilfiker, MA Office of Disease Prevention & Health Promotion, HHS

2. healthfinder.gov: Before

3. audience segmentation
Literature
Review
Mental Models Study
How do users think
about prevention?
In-depth Interviews
Motives for seeking
prevention info.—
audience segmentation
Card Sort
How to organize
information
within a topic
Prototype Study:
paper and clickable
Usability Test 1
Usability Test 3
Usability Test 2
How should topics be
categorized?
How can intermediaries
use healthfinder?
Usability Test 4
Next Step:
Repeat portion of
Process for Spanish

4. healthfinder.gov: After

5. 7 Lessons Learned from Limited Literacy Web Users
Willing and Able!
Skipping instead of scanning
Difficulty searching
Narrow field of view
Easily overwhelmed
Limited working memory
Prefer simple navigation

6. Skipping Instead of Scanning
Read every word on the page
Skip over entire chunks of dense text
< 3 lines of text triggered skipping
Numbers, %, big words triggered skipping
Start clicking on links instead of reading the content
May land in the middle of the page
Sources: Summers and Summers 2004; Zarcadoolas et al; ACS Healthcare Solutions for ODPHP 2006, 2007; Z-Tech for ODPHP 2007(b); Summers 2008

7. Example
Users didn’t read this
Users did read this

8. Difficulty Searching Avoid searching
Prefer to browse topics using an alphabetical or topic list (even if the list is long)
Provide multiple ways to browse (by A-Z and by topic)
List topics under multiple categories
Struggle with spelling when using the search function
Sources: Summers and Summers 2004; Z-Tech Corp for ODPHP 2007(b); ACS Healthcare Solutions for ODPHP 2008; Zarcadoolas et al 8

9. Example

10. Narrow Field of View & Easily Overwhelmed
Focus on the center of the screen
Content in right hand margin mistaken for ads and/or ignored
Rarely scroll
Even content written in plain language can look overwhelming
Summers and Summers 2004, 2005; Zarcadoolas et al; ACS Healthcare Solutions for ODPHP 2007; Summers 2008; UserWorks for ODPHP
Summers and Summers 2005, UserWorks for ODPHP
Summers and Summers 2004; Zarcadoolas et al; Summers 2008; UserWorks for ODPHP 10

11. Example

12. Limited Working Memory
Information Overload – takes concentration and effort to read the text on the page
Less likely to remember content from previous pages and are rarely looking ahead or back on a page
Difficulty making the connection between the results page and the data they entered on the previous screen
Summers and Summers 2004; ACS Healthcare Solutions for ODPHP 2007; Summers 2008; Z-Tech Corp for ODPHP 2007(b)
[ii] ACS Healthcare Solutions for ODPHP 2007owing

13. Example

14. Prefer Simple Navigation
Unfamiliar with – and often ignore – common navigational elements like drop-down menus and breadcrumbs
Success with simple tabbed navigation with linear (numbered) pages
Need to be able to use the back button
Summers and Summers 2005; Zarcadoolas et al; UserWorks for ODPHP; Z-Tech Corp for ODPHP 2008; ACS Healthcare Solutions for ODPHP 2007; Summers 2008
[ii] ACS Healthcare Solutions for ODPHP 2008; Summers 2008; UserWorks for ODPHP

15. Example

16. Coming Soon: “Health Literacy Online: A Guide to Writing and Designing Easy-to-Use Health Web sites” Thank you!