Transcript Principles of Plain Language

Principles of Plain Language
Dr. Annetta L. Cheek, Chair
Center for Plain Language
Presented at the University of Maryland
Horowitz Center for Health Literacy
3-10-09
What is Plain Language?
Material is in plain language if readers can
• Find what they need
• Understand what they find
• Use it to fulfill their needs
And they should be able to do this the first
time they read or hear it!
Think about your
audience!
• You must understand your audience’s
knowledge of and familiarity with a topic.
• What is plain language for one audience may
not be plain language for another audience.
Why do we recommend plain
language?
• There is lots of evidence showing that
plain language benefits the writer and the
reader.
• Readers save time and are more likely to
get the information or benefit they are
seeking.
• Writers save money, because readers
make fewer mistakes, respond more
quickly, ask fewer questions, comply more
fully with requirements.
We’ll look at just a couple examples
Veterans Benefits Administration
• One office, in Jackson, MS, decided to
rewrite one standard benefits letter into plain
language.
• Significantly fewer calls from customers.
• More veterans applied for benefits.
Fewer calls from customers
Old letter
Plain
Language
letter
Calls to each
counselor
each month
91.4
16
Total calls
each year, 10
counselors
10,968
1920
Another VBA example
• Every several years the Veterans Benefits
Administration sends a letter to all veterans,
asking them for an up-to-date beneficiary.
• If a veteran dies and the beneficiary listed
in his VA file isn’t valid, the VA must find a
valid beneficiary.
• It costs the VA several thousand dollars to
do the research to find a valid beneficiary.
Higher response rate, lower costs
Response
rate
Original letter 35%
Plain
language
letter
58%
Estimated
savings
$8 mil every
mailing cycle
Federal Communications
Commission
• Revised regulations about radio operations
on pleasure boats to improve their clarity.
• A Washington-based firm studied the
ability of users to find answers to questions
in the old and new versions.
• The test groups included both new and
experienced users.
Less time for users to solve a
problem (in minutes)
Type of user
Old rule
New rule
Experienced
2.43
1.50
Inexperienced
3.51
1.73
FCC pleasure boat radio regulation
Overview of Plain Language
Techniques
None of the techniques we’ll discuss
define plain language – rather, they are
ways to achieve plain language
Together, these techniques help you be
clear and concise.
Use:
Logical organization
Informative headings
Active voice
Pronouns
Lists and tables
Common words
Avoid:
Abbreviations, jargon, legal terms, Latin
Long sentences
Unnecessary words, redundancy
Information the audience doesn’t need
A general principle – Less is more!
Plain language usually – but not
always – helps you be more concise.
Organize logically for the reader
There are several standard ways to
organize:
Chronological
Most important first
General first, special and exceptions last
If you find material more than once, suspect
poor organization
Headings
There are three types of headings
Questions – Why should we use headings?
Statements – Headings help guide readers
Topics - Headings
The most useful headings
• Are question headings, because people
generally come to our documents with
questions.
• But don’t make up the questions – use question
headings only if you know the audience’s
questions.
Use active voice
• The best sentences are like the ones you
first learned in school.
• Subject, verb, predicate – Who, does what, to
what or whom.
We charged the incorrect amount.
Avoid passive voice
• Passive voice is one of the major
problems of bureaucratic writing.
• Passive voice is harder to understand.
• Passive voice can confuse the audience
because it’s not clear who does what.
What is passive voice?
The actor follows the verb.
Some form of the verb “to be” is
combined with the past participle of
another verb.
The frog was swallowed by Fred.
Passive Voice
Can disguise who does what:
A frog was swallowed.
Active Voice
Makes it clear who does what:
Fred swallowed a frog.
Passive Voice
Is often longer:
The application must be completed by the
applicant and received by the grants office by
June 1st. 17 words
Active Voice
Cuts the number of words:
We must receive your completed application by
June 1st. 9 words
Use pronouns to speak to the
audience
• Research shows that people relate better to
information that talks directly to them by using
pronouns.
• Using general nouns such as “beneficiary” or
“purchaser” requires the audience to “translate”
before they can be sure you are talking to them.
How to use pronouns
 Refer to your organization as “we”
 Refer to the reader as “you” in the text
and as “I” in questions
 Make sure you define “we” and “you”
Without pronouns
To establish eligibility for a voucher, an
applicant must show that the applicant has
a low income and that the present care of
the applicant is inadequate. 27 words
With Pronouns
To establish your eligibility for a voucher,
you must show you have a low income
and your present care is inadequate. 21
words
Do not use these “pronouns”!
He/she
His/her
S/he
Let’s use pronouns and active
voice
• Applications can be submitted any
day of the week, including
weekends and holidays.
• They will be opened the next
business day.
• If your application is acceptable,
you will be notified, usually within
48 hours.
• You can submit your application any
day.
• We will open them the next business
day.
• If we accept your application, we will
notify you, usually within 48 hours.
Using lists and tables
• Lists can be a very powerful way to
convey information.
• Make sure that all the items in a list are
constructed in a parallel way – each item should
start with the same part of speech.
• Try not to mix “and” and “or” in one list, it can
be confusing.
Here’s a CMS example
Medicaid: Apply if you are aged (65 years old or
older), blind, or disabled and have low income
and few resources. Apply if you are terminally ill
and want to receive hospice services. Apply if
you are aged, blind, or disabled; live in a nursing
home; and have low income and limited
resources. Apply if you are aged, blind, or
disabled and need nursing home care, but can
stay at home with special community care
services. Apply if you are eligible for Medicare
and have low income and limited resources.
And in list form
You may apply for Medicaid if you are:
• Terminally ill and want hospice services;
• Eligible for Medicare and have low income
and limited resources; or
• 65 years old or older, blind, or disabled and
have low income and few resources and
– You live in a nursing home; or
– You need nursing home care but can stay
at home with special community care
services.
And one more
During this same period, prescriptions for HRT
declined rapidly, following highly-publicized
reports from the Women’s Health Initiative (WHI)
study that showed an increased risk of breast
cancer, heart disease, stroke, blood clots, and
urinary incontinence among postmenopausal
women who were using hormone replacement
therapy that included both estrogen and
progestin. (50 words in one sentence)
And as a list
During this time, prescriptions for HRT declined
rapidly. The Women’s Health Initiative (WHI)
publicized studies showing increased health risks
among postmenopausal women who were using
both estrogen and progestin . Risks included:
•breast cancer
•heart disease
•stroke
•blood clots
•urinary incontinence (41 words in 3 sentences)
Use common words
• Avoid uncommon words, bureaucratic words,
foreign words, and jargon.
• Even highly educated people read faster
and with better comprehension if you stick
with common words.
• Big words do not make you look smarter!
Common words
Instruct
Tell
Receive, Obtain
Get
Parameter
Limit
Assistance
Help
Regarding
About
Retain
Keep
Avoid abbreviations
jargon
legal terms
Latinisms
Abbreviations
• Readers complain more about
abbreviations and acronyms than about any
other feature of bureaucratic writing.
• Using abbreviations turns your material into a
research project for readers.
• If your abbreviation has another, more
common meaning, your audience will forget your
special meaning and remember the more
common one.
How can you fix abbreviations?
• Don’t use more than two, and at most
three, abbreviations in each written
document.
• Instead, use “nicknames” such as “unit” instead
of WPU for Witness protection unit, or “case
review” instead of PQCR for Peer Quality Case
Review.
Jargon
Bureaucratic writing is often full of
jargon
metabolic demands
circulation system
hypertension
expiry date
Bureaucratic and legalistic
words
•
•
•
•
•
•
Herein
Hereafter
Hereby
Pursuant to
In accordance with
Shall (use “must” instead)
Latin terms
• “i.e.” and “e.g.” are major problems.
• Many people do not know what these mean.
• Many who do know the meanings don’t
remember which is which.
• Other Latin terms to avoid – “via” “per”
Keep sentences short
In most material, sentences should
average 20 words or fewer, with no
sentence longer than 40 words.
On the web, limit the average to 15 words,
with no sentence longer than 30 words.
Consider this sentence
If this continues, over time some recurring
infections may have to be treated with
different and stronger antibiotics and the
very real possibility that eventually no
antibiotic will be effective in killing the
bacteria. (34 words in 1 sentence)
All you need is this
If this continues, some recurring infections may
have to be treated with stronger antibiotics.
Eventually some infections may resist all
antibiotics. (21 words in 2 sentences)
But this is even better for a
general audience
Eventually, we will have to use even
stronger antibiotics to kill some
infections. Some may resist all
antibiotics. (18 words in 2 sentences)
.
One more example
The National Cancer Institute's Cooperative
Planning Grant for Cancer Disparities (CDRP)
Research Partnership Program issued by the
Radiation Research Program is an effort to
strengthen the national cancer program by
developing models to reduce significant negative
consequences of cancer disparities seen in
certain U.S. populations. (45 words)
Do you need more than this?
The Cooperative Planning Grant for Cancer
Disparities (CDRP) Research Partnership
strengthens the national cancer program by
developing models to reduce negative
consequences of cancer disparities. (25
words)
Omit excess words
• Generally, “less is more.”
• Challenge every word you write. Do you
really need it?
• Bureaucratic writing contains many
unnecessary words.
• Eliminating excess words is a skill you’ll
work on your entire writing career.
A couple examples
The Office of Cancer Survivorship was
established in 1996 by the National
Cancer Institute in recognition of the large
number of individuals now surviving
cancer for long periods of time.
The National Cancer Institute created
the Office of Cancer Survivorship to
recognize many individuals now
survive cancer for long periods.
Or even better:
The Office of Cancer Survivorship
recognizes the many individuals now
survive cancer for long periods.
Another example
• We are faced with the challenge of making
sure that all divisions of the organization
were aligned with the strategic direction
and goals of the new structure.
• We need all divisions to accept the new
goals and structure.
And one last example
Prevalence can also be expressed as a
percentage and it can also be calculated
for a specific amount of time prior to
January 1, 2004 such as diagnosed
within 5 years of January 1, 2004. (35
words)
Prevalence can also be expressed as a
percentage and calculated for a specific
period before January 1, 2004, such as
“diagnosed within 5 years of January 1,
2004.” (28 words)
Don’t tell the audience what
they don’t need to know
Dietary supplements are not over-the-counter
medicines. This can be very confusing. The part
of the Food and Drug Administration that
controls dietary supplements is the same part
that controls foods sold in the United States.
News flash!
Readers don’t care that the part of the Food
and Drug Administration that controls dietary
supplements is the same part that controls
foods sold in the United States.
In general, they don’t care what federal
agency is doing something. They don’t care
when an organization was created. They
don’t care what law a program is based on.
They don’t care what the official name of the
program is.
Here’s a question sent to FEMA:
I just found out that the products I have been
using to clean my home are toxic! Have I
damaged my health by using these
products?
Do you think this is what the person
needed as a response?
•Answer: First of all, what is meant by toxicity? Somewhere on
the order of 70,000 different chemicals have been identified as
toxic. A chemical produces a toxic effect at concentrations that
alter the normal state of the organism. For many chemicals, there
is a dose at which there are no toxic effects, there is a dose at
which the effects are reversible, and there is a dose at which the
effects may have permanent consequences. An example of some
toxic chemicals that many of us are exposed to regularly are
caffeine, tobacco, and alcohol. At doses normally consumed by
the average person, the "high" effect felt by the individual
response can be quite different. One person may be able to drink
5 cups of coffee with out visible effects, while another person
might get the shakes after 2 cups of coffee. This is an example of
how the dose and response varies from one person to the next.
At some point, each of these chemicals can have a much more
serious effect on the individual. At extremely high doses . . .
The Ministry of Health has developed Version 16 of the
New Zealand Influenza Pandemic Action Plan (NZIPAP),
which is the result of 18 months of intensive work around
pandemic planning by the Ministry of Health, district health
boards and central government agencies. The NZIPAP
recognises that Ma¯ori, Pacific peoples, and people from
lower socioeconomic groups, who have poorer health
outcomes than the rest of the New Zealand population,
may be similarly disadvantaged in the event of a
pandemic. Therefore, work is currently underway to
ensure that the specific needs of ethnically diverse Pacific
communities are recognised and addressed, in the event
of a pandemic. This work is being led by a
multidisciplinary Pacific expert group, including primary
care and public health clinicians, academics and
community representatives. (126 words)
The Ministry of Health has developed a plan to
respond to an outbreak of pandemic flu. This
plan recognizes that the segments of New
Zealand’s population, such as the Maori and
Pacific peoples, that currently have poorer
health may be especially at risk in a pandemic.
The plan will ensure that if a pandemic does
occur, we can take care of the health needs of
these peoples. (67 words)
Summary
Plain language:
• focuses on the reader, not the writer.
• saves the writer time and money because
readers call or write back less often with
questions.
• gives better customer service.
• gets better results.
Questions?
Resources
www.plainlanguage.gov
www.centerforplainlanguage.org
www.health.gov/communicaton/lit
eracy/
How to reach us
Dr. Annetta Cheek
[email protected]
Joanne Locke
[email protected]