Speaker: Cynthia Baur, Ph.D. — Endowed Chair and Director, Horowitz Center for Health Literacy, University of Maryland
Health literacy includes more than reading and speaking about health. It also includes how people find information and use that information. Cynthia Baur explains the COVID-19 response through a plain language lens.
Plain language is clear communication, through which your audience can understand the message the first time they read or hear it. The COVID-19 pandemic caused a lot of miscommunication and misinformation. People would often grasp onto the first piece of information they heard, but that doesn’t necessarily mean that the information was correct or clearly communicated.
Sometimes, the problem could simply be the terms that are used. However, there are other essential elements that need to be made explicit for clear communication:
- Emphasising the main message,
- Showing clear action steps, and
- Explaining numbers and risks.
Ideally, agencies would highlight these key elements in all emergency communications.
Plain Language Standard
Let’s look at an example: Does the phrase, “low risk” pass the principal plain language standard?
They are both single-syllable words, so they would score well on a readability scale. They are common words. This is often what people look for to describe something as plain language.
Remember, though, that the principal standard is that the audience can understand the message the first time they read or hear it. Although the word “risk” is short, risk itself is a complicated issue, even outside the pandemic. Think about heart disease, cancer, diabetes, or other medical issues. Risk means harm or danger, but the exact nature of low or high differs for each person. The phrase “low risk” may be familiar, but its exact meaning is ambiguous. We need more information and context for it to make sense.
Another problem during the COVID-19 response was relying on digital channels to distribute information. Information was shared and re-shared on social media platforms. When additional information was provided, such as corrective statements, clarification, and explanations, it was not being shared at the same rate or popularity. As a result, a lot of incomplete and outdated information was being shared on social media platforms.
Communicating Changes and Ambiguity
Another linguistic challenge during the COVID-19 response was related to changing recommendations. Communication during uncertain times is key, but there are limits to what communication can do. It can make the uncertain even more abstract or ambiguous. For example, middle-aged and young adults were confused about the nature of risk for themselves. They could grasp the health risks that the virus posed for older adults and immunocompromised folks, but they were not provided with enough information on risks within their own age bracket. Furthermore, the term, “older adults” wasn’t defined clearly, which led to additional confusion.
“There's still more we DON’T know than what we do know about immunity to the new coronavirus. Humility remains very much in order.”—former CDC Director Dr. Thomas Frieden, Sept 15, 2020
Many people believe that clarity will bring about a level of certainty to a message. Yet in emergency response situations, clarity does not always bring about certainty. How do we use plain language techniques when the situation is uncertain? In these cases, when the situation itself is variable and changeable, sometimes writers hit the wall of what language can do. We have to strike a balance of what we can offer as clear communicators in uncertain times.
During the COVID-19 pandemic, several unfamiliar acronyms have been used, which has resulted in further confusion and lack of understanding. One such acronym is the Emergency Use Authorization (EUA). The Food and Drug Administration (FDA) uses this acronym to show that they need to respond to an emergency as an exception to the usual process. However, audience research shows that people do not trust or accept the EUA acronym in messaging. People think it means that the process is being rushed. Plain language would have helped clearly communicate the purpose to the public, so there would have been less confusion and mistrust.
Plain language is a necessary—but not the only—requirement in complex communication situations. By itself, plain language could not have completely alleviated the communication issues during the COVID-19 response. However, had more plain language explanations been provided earlier, the public might have a firmer foundation for shifting science, which could have resulted in more clarity and understanding overall.
Additional information and resources include:
- Plain Language Community of Practice
- 2021 Federal Plain Language Summit
- Plain Language Writing Act (PDF, 125 kb, 3 pages)
- CDC COVID-19 Home Page
- The CDC Clear Communication Index
- Clear Communication Index User Guide (PDF, 1.1 MB, 36 pages)
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