HEP4211 – Training Writing Health Messages
Lecture week 1: Introduction to ‘Writing Health Messages’
Basic principles for writing health messages
William McGuire’s Model of Persuasion:
It’s a misconception that health education has a large direct impact on behaviour, since
you ‘lose’ people in every step of this model of persuasion. Thereby, attenuating (=
reducing) the likelihood of effect on behaviour.
You need to optimize the content of your health message in every step; to make people
follow/go through every step and for your health message to be effective.
Attention
• Top-down → processes that are attended to the reader. He/she already has e
certain mindset, goals, expectations, prior knowledge, and motivation. If it
matched the mindset of the reader, they are more engaged with your literature.
o Health literacy = “It entails people’s knowledge, motivation and
competences to access, understand, appraise, and apply health
information in order to make judgements and take decisions in
everyday life concerning healthcare, disease prevention and health
promotion to maintain or improve quality of life during the life course”.
People with a lower health literacy are generally less likely to do
something with your health message than people with a higher health
literacy.
• Bottom-up → related to the characteristics of the material/message you want to
bring across; page-layout, visual support (like graphics, pictures, drawing,
colour), and reader guidance.
Both are related in the outcome of attention of the reader for your health message.
Optimal design for attention
• Attract attention to important information; visual differentiation (bottom-up),
make it visually different than other articles.
1
, • Keep readers attention; make the material visually appealing and stimulate
further reading, so make links explicit visually and in text (bottom-up).
• Make information structure evident/logical; meet de reader’s expectations on
text design (top-down), they expect a certain layout and aspects.
Important factors in design:
• Weak or no visual hierarchy provides no guidance for the used. Hierarchy
through proximity and white space creates balance and gives our eyes paths to
follow through the design.
• Important for a flyer or brochure: logical order/hierarchy, proximity, visual
differentiation, style/fonts, etc.
• Do not fear white space, since it creates contract and guides the reader’s eyes in
the intended direction.
• Think about the font you use. Generally, sans-serif is easier to understand for
people and they can read it faster.
o Rules of thumb: typeface sans-serif, lower-case, outline to the left, don’t
use more than two different fonts.
Improving a text → hierarchy, fonts, macro and micro typography, shape and colour.
Comprehension
Optimal design for comprehension
• Content: matches and builds on prior knowledge of your readers (the better your
information fits the prior knowledge of your target audience, the better you can
build forward on this. Building forwards on existing knowledge always works
better than starting from scratch).
• Text: optimal coherence on micro (local) and macro (global) level.
• Design: makes important concepts and links among concepts visible.
The proximity principle: related items must be grouped together visually, and items
unrelated to each other should be placed further apart.
2
, Line length: too narrow line length decreases comprehension, since people tend to rush
through the text and skip information. If it’s to wide, people have problems with going
to the next line (they might read the same line again, of skip the next line). The optimal
line length is between 40 and 60 characters (around 150% line-height).
The line spacing also depends on the type of font you use. The smaller a font, the larger
the line spacing must be for people to comprehend it.
Text coherence
• Macro level: headings, macro signals
o New topic = new heading. Make sure to explain new paragraphs.
• Micro level: argument overlap, ambiguous pronouns, descriptive elaborations,
sentence connectives, given-new order, explicit actor, explicit causality.
o If you connect sentences, make sure that it is very clear to what you are
referring (For instance: Two men are walking on the street. The man ….
→ not clear which man).
Readability tests → The Flesch Reading Ease Test gives readability scores of texts in
Word. A Close test involves actual respondents.
Further aids for comprehension can be graphic organisers, illustrations, or pictorials.
But be aware that you don’t overdo it, don’t make it a circus.
- Pictorials can be very helpful, together with a heading and as long as the
depiction is clear. A depiction is clear when people easily understand what the
pictorial represents, and what it means in the context it is in.
Numbering of paragraphs indicates a certain way to read it/order/level of importance.
If there’s no order in your text, just use bullet points instead of numbers.
Pretesting
This very important! Only asking 5 respondents from your target group to pre-test your
health message can reduce 80% of disadvantages/’mistakes’.
• Testing attention → e.g. What draws (primary) attention? What does the
respondent think the message is about? In which order does the respondent
read the message?
• Testing comprehension → e.g. Does the respondent understand what the
material is recommending and how and when to do it? Is anything unclear,
confusing, or hard to believe? What meaning does the respondent attach to key
words, symbols and abbreviations, and visuals?
Knowledge of methods that should be included in messages ≠ being able to write or
develop such messages.
Literature week 1: Writing Health Communication
Chapter 2 – Designing easy-to-read text
2.1 Choosing page sizes and orientations
Size of the page → determines the size of the overall visual display. The reader needs
to be able to scan, read, and focus on both gross and fine details in this display.
Consider how the text is going to be used, reader preferences and expectations, design
3
Lecture week 1: Introduction to ‘Writing Health Messages’
Basic principles for writing health messages
William McGuire’s Model of Persuasion:
It’s a misconception that health education has a large direct impact on behaviour, since
you ‘lose’ people in every step of this model of persuasion. Thereby, attenuating (=
reducing) the likelihood of effect on behaviour.
You need to optimize the content of your health message in every step; to make people
follow/go through every step and for your health message to be effective.
Attention
• Top-down → processes that are attended to the reader. He/she already has e
certain mindset, goals, expectations, prior knowledge, and motivation. If it
matched the mindset of the reader, they are more engaged with your literature.
o Health literacy = “It entails people’s knowledge, motivation and
competences to access, understand, appraise, and apply health
information in order to make judgements and take decisions in
everyday life concerning healthcare, disease prevention and health
promotion to maintain or improve quality of life during the life course”.
People with a lower health literacy are generally less likely to do
something with your health message than people with a higher health
literacy.
• Bottom-up → related to the characteristics of the material/message you want to
bring across; page-layout, visual support (like graphics, pictures, drawing,
colour), and reader guidance.
Both are related in the outcome of attention of the reader for your health message.
Optimal design for attention
• Attract attention to important information; visual differentiation (bottom-up),
make it visually different than other articles.
1
, • Keep readers attention; make the material visually appealing and stimulate
further reading, so make links explicit visually and in text (bottom-up).
• Make information structure evident/logical; meet de reader’s expectations on
text design (top-down), they expect a certain layout and aspects.
Important factors in design:
• Weak or no visual hierarchy provides no guidance for the used. Hierarchy
through proximity and white space creates balance and gives our eyes paths to
follow through the design.
• Important for a flyer or brochure: logical order/hierarchy, proximity, visual
differentiation, style/fonts, etc.
• Do not fear white space, since it creates contract and guides the reader’s eyes in
the intended direction.
• Think about the font you use. Generally, sans-serif is easier to understand for
people and they can read it faster.
o Rules of thumb: typeface sans-serif, lower-case, outline to the left, don’t
use more than two different fonts.
Improving a text → hierarchy, fonts, macro and micro typography, shape and colour.
Comprehension
Optimal design for comprehension
• Content: matches and builds on prior knowledge of your readers (the better your
information fits the prior knowledge of your target audience, the better you can
build forward on this. Building forwards on existing knowledge always works
better than starting from scratch).
• Text: optimal coherence on micro (local) and macro (global) level.
• Design: makes important concepts and links among concepts visible.
The proximity principle: related items must be grouped together visually, and items
unrelated to each other should be placed further apart.
2
, Line length: too narrow line length decreases comprehension, since people tend to rush
through the text and skip information. If it’s to wide, people have problems with going
to the next line (they might read the same line again, of skip the next line). The optimal
line length is between 40 and 60 characters (around 150% line-height).
The line spacing also depends on the type of font you use. The smaller a font, the larger
the line spacing must be for people to comprehend it.
Text coherence
• Macro level: headings, macro signals
o New topic = new heading. Make sure to explain new paragraphs.
• Micro level: argument overlap, ambiguous pronouns, descriptive elaborations,
sentence connectives, given-new order, explicit actor, explicit causality.
o If you connect sentences, make sure that it is very clear to what you are
referring (For instance: Two men are walking on the street. The man ….
→ not clear which man).
Readability tests → The Flesch Reading Ease Test gives readability scores of texts in
Word. A Close test involves actual respondents.
Further aids for comprehension can be graphic organisers, illustrations, or pictorials.
But be aware that you don’t overdo it, don’t make it a circus.
- Pictorials can be very helpful, together with a heading and as long as the
depiction is clear. A depiction is clear when people easily understand what the
pictorial represents, and what it means in the context it is in.
Numbering of paragraphs indicates a certain way to read it/order/level of importance.
If there’s no order in your text, just use bullet points instead of numbers.
Pretesting
This very important! Only asking 5 respondents from your target group to pre-test your
health message can reduce 80% of disadvantages/’mistakes’.
• Testing attention → e.g. What draws (primary) attention? What does the
respondent think the message is about? In which order does the respondent
read the message?
• Testing comprehension → e.g. Does the respondent understand what the
material is recommending and how and when to do it? Is anything unclear,
confusing, or hard to believe? What meaning does the respondent attach to key
words, symbols and abbreviations, and visuals?
Knowledge of methods that should be included in messages ≠ being able to write or
develop such messages.
Literature week 1: Writing Health Communication
Chapter 2 – Designing easy-to-read text
2.1 Choosing page sizes and orientations
Size of the page → determines the size of the overall visual display. The reader needs
to be able to scan, read, and focus on both gross and fine details in this display.
Consider how the text is going to be used, reader preferences and expectations, design
3
