Jeanne McGee, McGee & Evers Consulting, Inc., Vancouver, WA  Handout for a presentation Session  on multicultural audiences  10th National CAHPS User Group Meeting, Baltimore, MD  March 2006  To be “clear and effective” written material has to do all of the following things:  1. It must attract readers' attention Members of your intended audience will make snap judgments about your written material,  based on a quick glance. They may be in a hurry or distracted or uncomfortable with  reading. Since you have only a few moments to convince them to read it, their first  impressions are crucial: the topic and purpose should be clear; it should look appealing;  it should look like it’s worth reading; it should look like it’s going to be easy to read.  2. It must hold their attention  To encourage people to keep reading, the material must seem worth the effort  and it must be easy to follow. You don’t want readers to give up because what  initially caught their eye proved to be hard to read, distracting, confusing, or  of no interest. To keep holding their attention, the material needs to seem  personally relevant and be at the right level of detail for them.  3. It must make readers feel respected and understood  The material needs to be culturally appropriate, making readers feel that it was  written for them. The information needs to fit with the readers’ cultural  knowledge, traditions, beliefs, and values. It needs to respond to their interests  and experiences, and anticipate the kinds of questions or concerns they may have.  It needs a friendly and supportive tone that puts readers at ease, making them  receptive to the information.  4. It must help them understand  Comprehension is crucial. You want your readers to be able to skim and pick  up the main points, without stumbling over words they don’t know or being  distracted by the design. It needs to be easy for them to find and understand  information of personal interest.  5. It must help move them to take action  When you produce written material, it’s for a reason – there is something  you want your readers to do. Ultimately, what makes written material  clear and effective is that people can read and use the information to do  something that seems feasible and of value to them.  Source: Making Written Material Clear and Effective, Part 1: A Guide to Writing, Design, and Translation,  written by Jeanne McGee for the Centers for Medicare & Medicaid Services. Draft manuscript March  2006; do not cite or quote or use in any way without written permission from Jeanne McGee.  Recommended Web sites Provider’s Guide to Quality and Culture  http://erc.msh.org (to reach the site, follow the link on this page)  An outstanding resource for understanding and addressing the  needs of culturally diverse populations. Includes audio clips,  excerpts from publications, and a number of populationspecific  profiles. Topics include cultural competence, patientprovider  communication, and health disparities. Extensive list of  references and links.  DiversityRx  http://www.diversityrx.org  Great source of information about best practices, training courses,  model programs, legal issues, and policy issues. It has a glossary  and a section on demographics and statistics.  Cultural Diversity in Healthcare  http://ggalanti.com  Interesting and helpful website with cultural profiles, case studies,  links to other websites, as well as recommended books, articles,  and other information.  Tips for taking a reader-centered approach  -Be clear about the audience and goals for your written material.  -Do research to learn about your intended readers and the issues.  -Be aware of ways in which you differ from your intended readers and  keep reminding yourself that you are writing for them, not yourself.  -Create “low barrier” material by adopting the perspective of your readers  and fixing anything that might keep them from noticing, understanding,  and using the material.  -Orient your writing and design toward the subset of your readers who  are less attentive, less knowledgeable, and less skilled at reading.  -Recognize that “educating” your readers by giving them information you  think they need will not automatically capture their interest or move   them to action.  -Get insights into what your readers want and need to know by observing  the settings and manner in which the written material will be used.  -Get help directly from your intended readers on what to say and how  to say it.  -Write as if you were talking with your readers.  -To find out how well your materials are working, test them by getting  reactions directly from your readers.  Source: Making Written Material Clear and Effective, Part 1: A Guide to  Writing, Design, and Translation, written by Jeanne McGee for the Centers  for Medicare & Medicaid Services. Draft manuscript March 2006; do not cite  or quote or use in any way without written permission from Jeanne McGee.  Coming in 2006 from the Centers for Medicare & Medicaid Services (CMS):  Making written material clear and effective  This new twovolume set of books by Jeanne McGee:  -Gives indepth guidance on how to make written material easier for people  to understand and use.  -Uses a readercentered approach to address issues of health literacy, cultural  and linguistic  appropriateness, and the needs of audiences that include less  skilled readers and older adults.  -Stresses the impact of graphic design and the crucial importance of testing  material directly with the intended readers.  -Is written in a friendly, nontechnical style for people who have little or no  formal training in plain language writing, document design, or research methods.  -Explains how to use a readercentered approach to address issues of health literacy,  culture, and reading skills of your audience.  -Offers detailed guidelines for clear and effective writing, document design, and  language translation.  -Explains how to apply the guidelines, using many examples that include a beforeandafter  makeover on how to revise a brochure.  -Gives step-by-step guidance on how to use interviews and focus groups to get feedback  directly from readers and use it to improve written material.  -Covers a number of methods, including cognitive interviewing and usability testing.  -Discusses practical arrangements, including how to select and recruit participants.  Chapters in this book are listed on page 6 Chapters in this book are listed on page 7 Update of a 1999 CMS guide  The new set of books is the updated and expanded second edition of the 1999 CMS  guide shown below (Writing and Designing Print Materials for Beneficiaries: A Guide for  State Medicaid Agencies):  When will the new set of books be available?  -Release date. CMS plans to release this new set of books in 2006. Though the  date for release has not been set, it will likely be in the Fall.  -Printing and distribution. Plans for printing and distribution are still in  progress and they include some form of website distribution. Most likely, book  chapters will be available in PDF format to download and print from a website.  -Notification list. To add your name to the list of people to be notified when  the new set of books is released, please send an email to one of the CMS project  officers or to the author (see contact information on the right).  What has changed in the new edition?  This new edition will help CMS employees, CMS partners, beneficiary advocates,  other HHS agencies, state agencies, contractors, and other health agencies  communicate more effectively with the audiences they serve:  -It’s more inclusive. The new edition expands the scope of the original guide  to include Medicare and the State Children’s Health Insurance Programs (SCHIP)  as well as Medicaid.  -It adds new topics, including things to know if your material is for older adults,  and using websites to distribute written material. It expands on some topics.  For example, the original guide’s chapter on methods of testing material with  readers has been expanded into a separate volume. Other topics covered in greater  detail include language translation, use of visuals, page layout, and other  aspects of graphic design.  CMS project officers:  Centers for Medicare & Medicaid Services (CMS)  7500 Security Boulevard, Baltimore, MD 21244  Kate Heinrich: 410 7863284  kate.heinrich@cms.hhs.gov  Barbara Allen: 410 7866716  barbara.allen@cms.hhs.gov  Author of the books:  The original guide and the new two volume second edition were written for CMS by:  Jeanne McGee: 360 5744744  jmcgee@pacifier.com  McGee & Evers Consulting, Inc.  1924 NW 111th Street  Vancouver WA 98685  Making Written Materials Clear And Effective, Part 1: A Guide for Writing, Design and Translation Background 1. This Guide and how it can help you  2. Is written material appropriate for your  audience and purpose?  A readercentered approach to developing and testing written material  3. What are “Basic Level” literacy skills?  4. Using a reader-centered approach to develop and test written material 5. Tips for making written materialculturally appropriate 6. Things to know if your written material is for older adults  Introducing the Guidelines for Writing, Design, and Translation  7. What are the Guidelines for Writing, Design, and Translation, and how  can you use them?  8. Guidelines for websites  Guidelines for clear and effective writing  9. Guidelines for content of your written material 10. Guidelines for organizing the content (sequencing, grouping, and labeling) 11. Guidelines for writing style  12. Using formulas to measure the reading grade level of written materials 13. Guidelines for engaging, motivating,and supporting your readers Guidelines for clear and effective document design  14. Tips for learning about design and working with design professionals 15. Guidelines for overall design and page layout 16. Guidelines for fonts, size of print, and contrast 17. Guidelines for headings, bulleted lists, and emphasizing blocks of text  18. Guidelines for use of color  19. Guidelines for use of photographs,illustrations, and clip art 20. Guidelines for tables, charts, and diagrams  21. Guidelines for forms and questionnaires  A ”before and after”example of revising written material  22. Using this book’s guidelines to revise a brochure  Guidelines for translation of written material  23. Guidelines for culturally and linguistically appropriate translation  Tips for saving time and money  24. Tips for developing written material in efficient and costeffective  ways  Bibliography and list of resources  25. References and resources cited in this guide Making Written Materials Clear And Effective, Part 2: Methods for Testing Materials With Readers Background 1. About this book and how it can help you  2. Why get feedback directly from your intended readers?  3. Will it take a lot of time and money?  Planning your project  4. Questions to guide your planning  5. How much and what type of testing will you do?  6. Choosing a location for your feedback sessions Selecting and recruiting participants  7. Strategies for selecting and recruiting participants  8. Tips for recruiting people on site for immediate participation in  an interview  9. Tips for recruiting people to participate later on at a scheduled  time and place  Three basic methods of collecting feedback from readers  10. Encouraging readers to “think aloud”  11. Asking questions  12. Observing behavior and giving the reader tasks to perform Designing a session to get the feedback you need  13. Basic steps for designing a feedback session 14. Creating a written guide for conducting the session  15. Tips for assessing appeal and cultural appropriateness 16. Tips for finding out how well the layout and organization are working  for readers  17. Tips for assessing comprehension  18. Tips for determining how well the content meets readers’ interests  and needs  19. Tips for assessing usability  Conducting feedback sessions with readers  20. Tips for note taking, taping, and transcription 21. Conducting the session  22. Tips for interviewing technique and troubleshooting Using the results from your feedback sessions  23. Using feedback from readers to improve written material  Bibliography and list of resources  24. Resources and references cited in this book  Draft list of chapters as of March 2006 – subject to change before publication