Andres is correct that communication research tells us repetiton is important for recall and eventual understanding. Multiple formats help appeal to different senses and ways of learning as well. 

There are many guides out there for information design, many of which have been discussed on this list in the past. It depends if people are looking for principles or explicit "do this and don't do that" type of instructions. We did do an inventory of U.S. Department of Health and Human Services' guidance on plain language and information design, and found several. A couple examples are CDC's Simply Put, which is under revision; the National Cancer Institute's Clear and Simple, which also is under revision. CMS has been revising its information design manual but its publication is still pending. 

The general principle I promote is to know your audience/customer. Your friend's experience is an illustration of why it is an important principle. Embedded in your question is the issue of dissemination. Creating informational pieces in multiple formats is important; making sure we can disseminate them is just as important. If people have ways to play CDs and DVDs and find audiovisual presentation useful to them, then that would be a good option to offer. 

On the other hand, I have been in situations where information was provided on a DVD and it was not a good choice of format. I couldn't watch the DVD and perform the behavior at the same time. I really needed a print version to lay on the counter so I could refer to that while I was doing the behavior. So the question of which format and presentation is the right or best one usually if not always comes back to a matter of usefulness for that situation.

Cynthia             

--------------------------
Sent from my BlackBerry Wireless Device


-----Original Message-----
From: healthliteracy-bounces at nifl.gov <healthliteracy-bounces at nifl.gov>
To: The Health and Literacy Discussion List <healthliteracy at nifl.gov>; The Health and Literacy Discussion List <healthliteracy at nifl.gov>
Sent: Tue Sep 18 21:38:38 2007
Subject: [HealthLiteracy 1226] Re: Intro from Cynthia Baur

David:
 
Just a note that the Institute of Medicine Health Literacy Report cited research addressing your question. It talks about several ways to present information. But, as I recall,  what was most significant was that two different interventions were necessary to see changes in literacy behaviors. 
 
So for example, if a patient had to take a certain medication, they had to see a video and they needed an additional sheet with directions. Or they had to get a sheet with directions and a follow-up call from a health provider. The research found that with only one intervention there was no significant behavior change.
 
I read the report a while back, but I thought that that point was pretty significant.
 
Andres
 
From: healthliteracy-bounces at nifl.gov on behalf of David J. Rosen
Sent: Tue 9/18/2007 3:29 PM
To: The Health and Literacy Discussion List
Subject: [HealthLiteracy 1225] Re: Intro from Cynthia Baur



Hello Cynthia,

On Sep 17, 2007, at 1:49 PM, you wrote:


> That said, we know that any improvement we see will not come solely or

> perhaps even primarily from improvement in people's literacy skills. I

> have advocated, along with many of my colleagues, for a focus on

> changing the ways we design and deliver health information, as well 

> as a

> focus on the ways health systems -public and private- deliver their

> services. There is much work to be done to improve all the patient

> education materials, forms, signage, communication with health care

> providers, self-care instructions, and public health alerts and

> recommendations that flow out of our health systems on a daily basis.



I would be interested to know more about how you think health 
information should be designed and delivered.

Several years ago a colleague was in the hospital with an acute 
disease that he had to learn about.  His well-being depended on his 
getting the information.  A hospital social worker asked him: "How 
would you like to learn, to get information about this disease?  
Would you prefer reading? Would you prefer videos?  Would you prefer 
talking with someone? Do you want to do this on your own, or join a 
group?"  Both he and I were impressed with this choices approach.  
The hospital (rightly) did not think it was their business whether or 
not someone was literate, but it was their business to see that the 
right mode of learning for the patient was available.  With this 
approach the focus is rightly on getting needed health information, 
not on whether or not someone can read, and the approach allows 
someone who cannot read well to choose the best way of learning 
without disclosing information about their literacy.

Do you like that approach?  Are there other approaches that you 
like?  Are their other modes that should be available, for example, 
Web pages, take-home CD-ROMS or DVDS, podcasts, and others?

David J. Rosen
djrosen at comcast.net



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