Health Literacy Online: A Guide to Writing and Designing Easy-to-Use Health Web Sites

Background: 

More Americans are going online than ever before. According to a 2006 survey, 80 percent of Internet users have looked for health information on the Web. As a result, both public and private institutions are using the Internet to streamline the delivery of health information and connect people and services in exciting new ways. Yet the transition to online health information and services poses a unique set of challenges for Web users with limited literacy skills or limited experience on the Internet. For many of these users, the Web is stressful and overwhelming—even inaccessible. Much of this stress is the result of complex health content and poorly designed Web sites.

Program background: 

The U.S. Department of Health and Human Services’ Office of Disease Prevention and Health Promotion (ODPHP) has written a research-based how-to guide for creating health Web sites and Web content for the millions of Americans with limited literacy skills and limited experience using the Web. The strategies in the guide complement accepted principles of good Web design and thus have the potential to improve the online experience for all users, regardless of literacy skills.

Evaluation Methods and Results: 

Drawing on experience with healthfinder.gov, the guide synthesizes lessons learned from ODPHP’s original research with more than 750 Web users and the small but growing body of literature on the Web experiences of users with limited literacy skills. The strategies outlined in the guide are also supported by the Research-Based Web Design and Usability Guidelines, 2nd edition.

Conclusions: 

Many adults with limited literacy skills have had little training and experience searching the Web. They struggle not only with reading the content on the page, but also with retaining and managing new information as they move through a Web site. Several key characteristics and common behaviors of users with limited literacy skills affect how they perform on a Web site. These characteristics include:

1. Successful in accomplishing their tasks when Web sites are designed well

2. Have difficulty scanning headings and subheadings to grasp and manage the information on a Web page

3. Tend to avoid search

4. Tend to have a narrow field of view

5. Can become easily overwhelmed

6. Reach“information overload” more quickly than users with stronger literacy skills

7. May be unfamiliar with—and often may ignore—common navigational elements

Implications for research and/or practice: 

Although the problem remains largely invisible, millions of Americans have a hard time reading. As many as half of U.S. adults have limited literacy skills. Even more Americans—as many as 9 out of 10—have limited health literacy skills. This means they have trouble understanding complex health information. As more health information and services move online, Web developers and professionals must find new and better ways to communicate health information to the public.

Health Literacy Online: A Guide to Writing and Designing Easy-to-Use Health Web sites presents specific strategies with examples for writing and designing health Web sites that are accessible to users with limited literacy skills.