1. An Infopeople Webinar December 1, 2008 Kelli Ham, Consumer Health Librarian Finding Easy-to-Read and Multilingual Materials for Your Patrons

2. Agenda  Overview of issues surrounding health information materials for lower literacy users  Easy-to-read information resources  Multilingual health information  Community assessment and partnerships

3. Objectives Participants will be able to:  Recognize components of easy-to-read materials  Assess health information materials quickly for readability and quality  Navigate to appropriate online easy-to-read and multilingual resources  Identify community partners for innovative solutions specific to your community

4. Easy-to-Read Materials For our purposes today: Easy-to-read indicates that the words, content, and design are chosen specifically so that the material is easier to read and understand by people who have difficulties reading readily available materials.  Reading levels of health information: Only a small percentage of readily-available health information is truly written in plain language that is easy-to-read.

5. Some of the Issues  What reading level is Easy-to-Read?  Most health materials are written at higher than 6 th grade level  Who decides?  No broad standards for health-related materials  No standards exist; just recommendations  4th to 6th grade reading level  Digital divide limits access to many resources

6. Components of Easy-to-Read Materials  Plain language text without ambiguity  Take one pill with your breakfast  Pictures or illustrations:  Graphics aid in understanding  Typography  Serif-type fonts are easier to read  Times New Roman is a serif font; Lucida is not  Larger type (12-14 pt)  Design elements  Plenty of white space

7. Additional Elements  3 or 4 main concepts  Action verbs and concrete nouns  Visuals illustrate the action, tell the story  Limits use of jargon, abbreviations, symbols  Use short sentences and words with fewer syllables  Tested with target audience

8. At a Glance: Determining Readability Levels Easier Harder

9. Readable versus Understandability  Format of materials makes a difference  Text only is harder than text with pictures  Audio of text easier to understand for users  Videos and multimedia increase understanding  Involves multiple senses  Much more information transmitted through visual demonstration  Better retention of information  Seeing  Hearing  Understanding

10. Easy-to-Read Materials in MedlinePlus  MedlinePlus points to quality resources from trusted organizations on numerous health topics  The publishing organization determines if an item is “easy-to-read”  The National Library of Medicine and MedlinePlus do not make judgments as to reading levels  Thus, “easy-to-read” materials in MedlinePlus range in readability levels

11. Navigating to Easy-to-Read Materials  The Health Topics page has a link to all Easy-to-Read materials currently available

12. Finding All Easy-to-Read Materials On main Health Topics Page: Links to all Easy-to-Read and Interactive Tutorials

13. Collection of Easy-to-Read Content

14. Individual Health Topic Pages Look for Easy-to-Read designation

15. Interactive Tutorials in MedlinePlus Over 165 tutorials on Diseases, Tests, Surgeries and much more

16. Design of Interactive Tutorials  Easy to navigate  Multimedia design helps users understand  Short text content with audio on each slide  Good illustrations, some with animation  Quizzes help users check understanding  Good way to augment your circulating collection of videos and dvds  Users may need help getting started

17. Starting the Tutorial Click here to start Summary for Printing Click here to start Summary for Printing

18. Influenza - Interactive Tutorial

19. Summary Page Some of the summaries are easier than others, depending on medical terminology and nature of the topic

20. Surgery Videos  I’m having knee replacement surgery – what can I expect?  Currently, 15 videos on different knee surgeries  Transcripts available for printing From MedlinePlus.gov homepage, click here

21. NIDDK Easy-to-Read Publications National Institute of Diabetes and Digestive and Kidney Diseases http://diabetes.niddk.nih.gov/

22. NIH Publications  Advanced Search in Google publications “easy to read” site:nih.gov

23. Useful Tools: Guidelines for Writing Materials  “I’ll know it when I see it”  By learning how materials should be written, it is easier to recognize appropriate materials for your patrons.  Helpful in choosing online resources  Adds value to collection development efforts

24. Guidelines for Writing Easy-to-Read Materials

25. How to Write Easy-to-Read Health Materials  On this page, you’ll find:  Step-by-step guidelines  Information and links to several readability assessment tools, such as SMOG and Fry Graph  Links to software programs  Bibliographies and additional guidelines worthy of mention

26. Language and Culture in Your Community  What are the unique characteristics in your community?  Different communities, different needs  inner city – minorities, low income and other vulnerable populations  farming community – rural, large immigrant population  ethnic clusters in the community

27. Health Information in Other Languages  Issues for librarians and healthcare professionals  Need to know the content before recommending  Impossible to know, if you don’t speak the language

28. Multilingual Resources in MedlinePlus  Robust collection of Spanish language materials  Recent addition of materials in 40 languages  Collection is small but growing  Follow same quality guidelines  To be included in Multiple Languages collection, English translation is required  Languages content is available from Home Page and individual Health Topic pages

29. Scenario  Library user: “My father may need an angioplasty. He doesn’t read English well; do you have any information in Arabic?”

30. General Search Strategies in MedlinePlus 1 2 3

31. Other Languages on Health Topic Pages

32. Other Languages on Health Topics – cont.

33. Advanced Searching with Key Words

34. Consumer Health Manual from NN/LM nnlm.gov/outreach/consumer/

35. Health Information in Many Languages

36. Health Information in Many Languages: A Few Resources Worthy of Mention  Polyglot Multimedia Medical Spanish Translator Includes audio files so you can hear the translations polyglot.topsailmultimedia.com/polyglot.html  Refugee Health - Immigrant Health Includes cultural customs and beliefs regarding health issues bearspace.baylor.edu/Charles_Kemp/www/refugee_health.htm bearspace.baylor.edu/Charles_Kemp/www/refugee_health.htm  Ordering National Institute of Health Publications in Languages Other Than English Information for ordering NIH multilingual publications nnlm.gov/mcr/resources/community/multilingualNIH.html nnlm.gov/mcr/resources/community/multilingualNIH.html

37. Spanish Language Translator for Health Terms

38. Your Favorite Sources for Health Information  Please share your sources for easy-to-read or multilingual health materials  Online resources  Publishers of print materials  Health videos and DVDs  Other?

39. Determine Needs in Your Community  How do you know?  Education and literacy levels  Languages spoken  Census.gov for information on education levels, languages spoken at home, and other data at the county level  American FactFinder for county profiles  factfinder.census.gov/ factfinder.census.gov/  Population and Household Economic data  census.gov/population/www/popdata.html census.gov/population/www/popdata.html

40. American FactFinder  Education  Language spoken at home

41. Insights into Community Demographics census.gov/population/www/socdemo/lang_use.html

42. Innovative Partnerships  County extension agents  they interact with farm workers  could talk about use of pesticides, preventing wounds  Local environmental agencies  Air pollution control district can provide speakers about air quality, ozone, smoke from fires  Local literacy groups  Teach basic computer skills

43. For More Information  Infopeople Archived Webinars  Understanding Health Literacy  Covers more about literacy and health literacy issues, more examples and information about problem when people can’t read or understand health information  Communicating about Health  Practical guidelines for helping library users know what questions to ask and how to communicate more effectively with their healthcare providers  An In-Depth Look at MedlinePlus  Includes details on Spanish-language materials and all other special content

44. Kelli Ham, MLIS, Consumer Health Coordinator kkham@library.ucla.edu NN/LM Pacific Southwest Region UCLA Louise M. Darling Biomedical Library nnlm.gov/psr