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HHS logoThis is a guest post by Jessica Mark, and Outreach Program Manager, Health Communication and eHealth Team in the Office of Disease Prevention and Health Promotion at the U.S. Department of Health and Human Services

We all struggle with complex health information. In fact, as many as 9 out of 10 adults experience limited health literacy skills at one time or another. How does this affect the way we find, understand, and use health information on the Web? This is a critical question for the e-patient era.  After all, it’s only a matter of time before we are all e-patients.

Designing for Health Literacy Online

Susannah Fox recently highlighted the health information divide in her February 1 post. As we work to expand access to the Internet for all Americans, we must work in parallel to improve the quality and usability of health information on the Web. For many information seekers, the Internet can be stressful and overwhelming—even inaccessible. Much of this stress can be reduced through the application of evidence-based best practices in user-centered design. As health communicators and public health professionals, we have much to learn from the field of usability. (For starters, how about the fundamental belief that the problem lies with the Web site—and not the person using the Web site?) As more health information and services move into the online environment, Web developers and health professionals must find new and better ways to engage with the public in more meaningful ways.

At the Office of Disease Prevention and Health Promotion (ODPHP), we have taken this to heart. For the development of, ODPHP conducted 15 studies over 4 years with more than 750 people age 18 to 84, many with limited literacy skills. Findings from these studies drastically changed the way we present health information on our Web sites. For example, we learned valuable information about simplifying navigation (”back” and “next” buttons work great), keeping content in the center of the screen (many users ignore text in the right-hand margin), and offering multiple search and browse functions.

More research is needed to better understand how people with limited literacy skills and limited health literacy skills use the Web.

A National Priority

On December 2, 2010, the U.S. Department of Health and Human Services (HHS) unveiled Healthy People 2020, thereby setting a 10-year agenda for improving the Nation’s health. The goals and objectives included in Healthy People 2020 will determine national public health priorities for the decade—influencing everything from public health research to resource allocation. For this reason, I am both excited and optimistic about the increased focus on improving health communication and health information technology (IT) in Healthy People 2020. The Health Communication and Health IT topic area outlines 13 objectives for the year 2020, focusing on improving health literacy, patient-provider communication, and accessibility of online health information.

  • In the coming months, ODPHP will join with Health Literacy Missouri to host a series of Twitter chats about improving health literacy. During a recent Twitter chat, the discussion focused on what Healthy People 2020 means for health communications and health IT. A summary of the conversation is available from Health Literacy Missouri.

Moving Forward

Over the course of the decade, the e-patient community will have opportunities to influence developments in health IT that will lead to more productive patient-provider interactions, enhanced access to evidence on the effectiveness of treatments and interventions, and personalized tools to promote health and prevent disease.

One area of opportunity is where health and digital literacy meet—much of this lies in yet unexplored territory.  We encourage exploration and research in order to:

  • Fully define digital literacy and understand its influences on health literacy.
  • Improve our current understanding of how people with limited health literacy use and apply the technologies of our digital age.
  • Discover more ways to make information accessible—regardless of Internet experience, comfort with technology, and online search and navigation skills.

Ultimately, the evolution of information and technology should be driven by users. We need to be listening to them, working to better understand them, and co-designing the next generation web-based health guidance. My colleagues at ODPHP and I support this charge. With your help, we can build a truly patient- and public-centered health system.



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