Clear Communication: A NIH Health Literacy Initiative
The NIH Office of Communications and Public Liaison (OCPL) and its 27 component public affairs offices work to connect research with the public. OCPL serves as liaison to the Department of Health and Human Services (HHS) on a number of issues related to health literacy. OCPL has established the NIH “Clear Communication” initiative that focuses on achieving two key objectives of health literacy:
- Providing information in the form and with the content that is accessible to specific audiences based on cultural competence, and
- Incorporating plain language approaches and new technologies.
The first phase of the “Clear Communication” program involves building upon sound research results provided by trans-NIH programs and activities. OCPL has created a number of resources to help trans-NIH communicators and health communicators outside NIH reach audiences “where they are” and overcome barriers to health literacy. 
One such program is redevelopment of a nationally recognized resource, “Making Health Communication Programs Work,” [The “Pink Book”] which comprehensively addresses clear communication and reflects the best practices of all NIH Institutes and Centers as a shared resource. OCPL also maintains a resource Web site that includes synopses of research. “Clear Communication” will serve as a resource to NIH staff, constituency public health and advocacy organizations, and to the public engaged in communicating about health in the community, school, and other arenas. The ultimate goal of the NIH “Clear Communication” program is to cultivate a growing health literacy movement by increasing information sharing of NIH educational products, research, lessons learned, and research in the area of health literacy.
Health communication is the study and use of communication strategies to inform and influence individual and community decisions that enhance health.
Health Literacy
Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. [Source: Healthy People 2010] According to the Institute of Medicine, ninety million adult Americans have limited health literacy. Health literacy is a complex phenomenon that involves individuals, families, communities and systems. The concept of health literacy extends to the materials, environments, and challenges specifically associated with disease prevention and health promotion. Health literacy incorporates a range of abilities: reading, comprehending, and analyzing information; decoding instructions, symbols, charts, and diagrams; weighing risks and benefits; and, ultimately, making decisions and taking action.
20 million Americans speak poor English; 10 million speak none [Source: 2000 Census].
More than 300 languages are spoken in the United States.
Several HHS agencies, including the National Institutes of Health, the Agency for Healthcare Research and Quality, and the Centers for Disease Control, have joined together to support research efforts on health literacy concepts, theory and interventions as these relate to HHS public health priorities outlined in its HealthierUS and Healthy People 2010 initiatives.
Plain Language
Plain language is a strategy for making written and oral information easier to understand. It is one important tool for improving health literacy. Key elements of Plain Language include:
- Organizing information so that the most important points come first;
- Breaking complex information into understandable chunks;
- Using simple language and defining technical terms; and
- Using the active voice.
Part of the NIH mission is to reach all Americans with health information they can use, and NIH strives to communicate in a way that helps people to easily understand research results. The importance of Plain Language is underscored by Government-wide directives requiring Federal agencies to incorporate plain language elements in all documents, presentations, and electronic communications intended for the public and to avoid jargon and highly technical language.
Clear & Simple
For several years, a publication of the National Cancer Institute (NCI), “Clear & Simple: Developing Effective Print Materials for Low-Literate Readers,” served as a trans-NIH document dedicated to the subject of health literacy. Clear & Simple outlines a process for developing publications for people with limited-literacy skills and features proven principles and a discussion of real life issues that individuals developing low-literacy materials face. The NIH seeks to update and expand “Clear & Simple” for contemporary use and to include in the publication of a number of important resources and materials. Many of these resources are found on the NIH “Clear Communication” Web site. The current version of the document can be accessed online from the NCI Web site.
Cultural Competency
Cultural Competency is a strategy that enables organizations to work effectively in cross-cultural situations. Developing and implementing a framework of cultural competence in health systems is an extended process that ultimately serves to reduce health disparities and improve access to high-quality health care. Cultural competence benefits consumers, stakeholders, and communities. Because a number of elements can influence health communication—including behaviors, language, customs, beliefs, and perspectives—cultural competence is also critical for achieving accuracy in medical research. NIH funds and works with researchers nationwide for the development and dissemination of resources designed to enhance cultural competence in health care systems.
Precepts About Health Communications
- Know your objectives. Make sure they are realistic and achievable.
- Audiences: Conduct research about intended audience(s).
- Strategy: Develop a communication strategy which lays out how goals and objectives will be reached.
- Partners/Collaboration: Identify potential partners and develop partnering plans.
- Messaging: Make sure your messages are appropriate/relevant for the particular audience.
- Channels/Activities: Explore and identify channels and tactics best suited to reach intended audiences with key issues.
- Working with the Media: Understand what the media like and dislike; know deadlines and understand the news cycle.
- Evaluation: How will success (of a particular program) be defined? What objectives will be used to define/measure success?
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