• The Basics
• Actions
  • 5.1. Include printer-friendly tools and resources.
  • 5.2. Simplify screen-based controls and enlarge buttons.
  • 5.3. Include interactive content that users can tailor—but not too much.
  • 5.4. Incorporate audio and visual features.
  • 5.5. Explore new media such as Twitter or text messaging.
• Iterative Design Methods and Tips

The Basics

Invite Web users to customize content to their interests and provide feedback about their experiences. Examples include:

• Printing information out or e-mailing it to a friend
• Taking a poll or rating the quality of information on the site
• Entering personal data such as age or weight to get tailored information
• Using calorie or body mass index (BMI) calculators, activity logs, recipe finders, personal assessments, and quizzes

Interactive tools increase user engagement.³² Section 2 introduced the idea of engagement. Engagement is the process of involving users in health content in a way that motivates them to take action.³⁷ Interactive tools that provide personalized health content can engage users and promote learning.

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Actions

5.1. Include printer-friendly tools and resources.

Many Web users with limited literacy skills prefer to print pages from a Web site rather than read text on a computer screen.^6,13,16,34 Also, they may want to share health information with family members or friends who don't have access to a computer or post it on their refrigerator.

• Provide a link to printable pages. Make the link or icon clearly visible. If possible, give users the option to print a single page, a complete section, or just a portion of the text.

Users of NIH SeniorHealth's Web site can print an entire topic or select specific pages. They also can choose whether to include images in the printout.

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5.2. Simplify screen-based controls and enlarge buttons.

Design buttons that are easy to find and click on by making them:

• Large
• Bright
• Contrasting color from the surrounding text and background
• Obviously clickable^3,13,18,20

Keep in mind that widgets and tools that are too flashy are often interpreted as advertisements.²¹

• Some users with limited literacy skills did not understand the term "submit." Use an alternative label such as "go" or "get started" for buttons.

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5.3. Include interactive content that users can tailor—but not too much.

Users want personalized health information, but they don't want to enter a lot of personal data.^14,15,19

This interactive Ovulation and Due Date Calculator from the Web site for the Office on Women's Health asks for the date of the user's last menstrual period and the number of days in her menstrual cycle.

The myhealthfinder tool on healthfinder.gov prompts users to enter their age, sex, and pregnancy status to get personalized recommendations. Users can specify whether they are searching for information for themselves, a child, or someone else.

Create a link between the information entered by users and their results.¹⁵ This can help compensate for users' limited working memory.

The myhealthfinder results page from healthfinder.gov includes a summary of the user's personal information entered on the previous screen.

• Keep required information to a minimum, and avoid creating accounts or sign-in pages.

If your content requires a registration page, ask for the minimum amount of information. Be sure to:

• Distinguish between logging in and registering.
• Make the username an e-mail address.
• Keep registration to no more than three screens, and provide cues (for example, "page 1 of 3").
• Display input fields as a vertical list.
• Include a final results page with questions and responses.
• Display fields that need corrections on a new page. Include instructions for correcting information.^46–48

This registration form for the MyPyramid Tracker Web site displays fields as a vertical list.

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5.4. Incorporate audio and visual features.

Whenever possible, provide health information in multiple formats, such as audio clips, video clips, or slide shows. Be sure to include a text alternative or transcript. There is some evidence that audio and video can enhance comprehension and retention of online information; however, more research is needed.^49–51

NIH SeniorHealth offers short video clips on popular health topics. Each video includes a transcript and a help tool.

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5.5. Explore new media such as Twitter or text messaging.

Text messaging, blogs, Twitter, and Webcasting are examples of new media. To date, there has been little testing of new media with users with limited literacy. We expect this will change in the near future.

What we know about new media leads us to believe it holds potential for reaching people with limited literacy skills for several reasons:

• Communications are shorter (a message on Twitter is 140 characters or less).
• The tone is conversational.
• Most messages are user-generated.

healthfinder.gov links to news releases through Twitter updates.

Text messages, also known as SMS (short-message services), are increasingly being used to reach the public with health messages.^52,53 Text messages can be used for one-way messaging (tips and reminders) or two-way communication.

Many of the groups receptive to the use of text messaging for health, such as adults below the poverty threshold and immigrants and refugees, are also likely to have limited literacy skills.^2,52,54

Instructions appear on AIDS.gov for mobile phone users to send a text message with their ZIP code to "KNOWIT" (566948). Within seconds, they will receive a text message identifying an HIV testing site near them.

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Iterative Design Methods and Tips

Methods

• Prototypes
• Usability testing

Tips for designing and testing your Web site with users

• During testing, observe participants using the input fields for interactive or personalized tools.
• Give users a sample task to perform with the tool. Do users know how to use the tool without prompting?

Refer to Research-Based Web Design & Usability Guidelines (PDF, 20.64 MB) sections: 2:12; 2:15; 13:2; 14:4