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Make online health information useful for limited-literacy web visitors--Become a “plain English matchmaker”


I Introduction
II Different web visitors
III Techniques to help make the best match
IV Make sure your design is friend, not foe
V Iterative development: Ask early and ask often  
VI Tear down the wall of words
VII Resources

--submitted by Carolyn Wilby

I Introduction

Plain English writing can be described as a style of writing that represents the best match between your target readers’ characteristics and the characteristics of your written information. And it’s a match made in heaven because by writing in language familiar to your target readers, your information is not only easy to read, but it is also easy to understand and use.

Fortunately, the Golden Rule where plain English writing is concerned—write to your reader—is especially relevant where web writing is concerned. It is particularly important to take into consideration your web visitors’ characteristics because how they read online differs significantly depending on their literacy level.

II Different web visitors

There are ‘scanners and clickers’…
And then there are ‘plowers’…
Plus don’t overlook the ‘skippers and clickers’…

Higher-literacy web visitors tend to scan rather than read word by word, only spending about 25 seconds on each web page. This approach to online reading has earned higher-literacy web visitors the reputation as “scanners and clickers.”

By contrast, limited-literacy web visitors are often described as “plowers” because initially they focus on one word at a time, slowly making their way through the text. However, when the going gets tough and the information looks like it may be difficult to get through, they start to scan. But they don’t become true scanners because they find it difficult to understand text simply by scanning headings and subheadings, so they quickly turn into “skippers and clickers”:

  • “Skippers” – They start skipping over areas of information, often large sections of information …maybe even deciding to skip your entire website altogether.
  • “Clickers” – They start clicking on links instead of reading your website content.

They can plow it, skip it, and click it, but can they understand it?

In addition to having a solid understanding of how limited-literacy web visitors’ read by plowing, skipping, and clicking, it’s also important to keep in mind how they process what they find on the web. Limited-literacy web visitors may technically be able to read your information, but can they understand it? Will they be able to use the information you have provided?

For instance, limited-literacy web visitors tend to quickly max out with information overload so they have a limited working memory that makes it difficult to process multiple concepts at the same time. Research shows they are often more receptive to “just the basics.” As a result, it’s important to keep your health information brief and clear by asking yourself, “To take action, what do my limited-literacy web visitors need to know?” Make decisions about what health information to include based on the acid test of “need to know” rather than “nice to know” information. In addition, limited-literacy web visitors often prefer to print website pages rather than read on screen. They may also use printed material for reference or to share with family members. Is your website set up for easy printing?

III Techniques to help make the best match

Although your web visitors will certainly have a range of demographic and psychographic characteristics that are important to take into consideration, make sure that literacy level is one of them. If your target web visitors are limited-literacy readers consider incorporating the following techniques when developing new online health information or critiquing existing information:

  • Include as few elements as possible on your homepage by limiting the amount of text to mainly short descriptions.
  • Provide just “need to know” information about your health topic throughout your website by putting the most important information first and emphasizing specific guidance. For example, focus on behaviour change advice rather than providing in-depth background research and statistics.
  • Make your information as action-oriented as possible; don’t just tell your web visitors what to do, tell them how to do it. For example, break behaviours into specific steps so they seem manageable and encourage action by including interactive content like printable instructions, tip sheets, and checklists.
  • Create a positive tone. For example, rather than focus on describing behaviour change barriers and health risks, explain how to avoid risks and overcome barriers, and the benefits of adopting the desired health behaviour.
  • Write in plain English; language that is familiar to your web visitors. For example, some limited-literacy web visitors don’t understand the term “submit” so consider alternatives like “get started” or “go.” Create clear, stand-alone “chunks” of information that function independently from each other. Use the active voice, keeping paragraphs and sentences short and straightforward.
  • Provide your web visitors with additional clues regarding content meaning by using subheadings or “teaser” text underneath main headings.
  • Limit the number of links on each web page, making sure that any links lead to only relevant information like resources that supplement each web page’s text.
  • Ensure a simple navigation by using a linear approach; clickable page numbers at the top or bottom of each web page help your web visitors move from page to page without confusion. Also assist navigation by including “Home”, “Next”, and “Back” buttons.
  • Try to only include left-hand and centre navigation elements. Don’t include lengthy drop-down menus or any text that moves or changes like animations. Not only is static text easier to read, but limited-literacy web visitors often assume moving text is advertising and ignore it.
  • Indicate where your web visitors are in relation to the rest of the site by a clear menu and contrasting colours, but avoid breadcrumbs (a “breadcrumb trail” typically runs across the top of the screen showing where your web visitor currently is on your site, as well as primary pages that come before the current page).
  • Position all information so that your web visitors can read it without scrolling, known as positioning information “above the fold.” If necessary to continue text “below the fold,” include guidance to prompt your web visitors to scroll down for more information.
  • Rather than a search box, include a variety of ways for your web visitors to find information. For example, a listing of topics or an A-Z listing. If a search box is necessary, use a large text box with an action-statement like “click here” or “go” to signal to your web visitors that they need to enter search terms into the search box. Also allow for common misspellings and limit the number of search results displayed on a page, using clear titles in a large font and ample white space.
  • Include the option to print each page of your website.

IV Make sure your design is friend, not foe

Even if you incorporate all of the above techniques into your website writing and navigation, your information may still go unread—or be difficult to understand—if its design scares away your limited-literacy web visitors. If your design takes away from your content rather than adding to it, your limited-literacy web visitors may immediately turn into “skippers and clickers” and be gone before you know it. Here are some techniques to help make sure your design complements your website information to help engage your limited-literacy web visitors:

  • Assess your font style. There has been a lot of debate about whether serif fonts (like CG Times) or sans serif fonts (like Arial) are easier to read online. Many decide to use sans serif fonts because these font styles have become more common online so web visitors may be more comfortable with them.  
  • Use at least a 12-point font. A small font size is especially difficult for limited-literacy web visitors (and older adults). Consider allowing web visitors to adjust the text size on each web page.
  • Avoid clutter. Clean-looking web pages are easier to read and less distracting so they are less likely to overwhelm limited-literacy web visitors. For example, use white space to break information into manageable “chunks.”
  • Use images to complement your words by providing additional clues to their meaning, helping your limited-literacy web visitors find, understand, and use your information.
  • Avoid dark backgrounds or backgrounds with patterns or images; black text on a white or very light background is the easiest to read.
  • Make all buttons large and in a contrasting colour to the background and surrounding text, and make sure that it is obvious that buttons are clickable.

V Iterative development: Ask early and ask often  

Whether referred to as field testing, usability testing, or just good old fashioned feedback – it’s a development stage that is often neglected. If done at all, asking the target group for feedback is often left to the final development stages, or worse, as an afterthought post-project. By contrast, the ideal is to ask early and ask often. Try to involve your target limited-literacy web visitors whenever possible – from concept stage right through developing each section of your site. Incorporate feedback as you go. This is how iterative development works—a cyclical process of creating, testing, and refining throughout the entire development process.

VI Tear down the wall of words

By becoming a “plain English matchmaker” essentially you tear down the wall of words – the all too common full screen of text that turns off limited-literacy web visitors. Websites plagued by the wall of words both intimidate and overwhelm limited-literacy web visitors – quickly turning them into “scanners and clickers” and almost immediately into “exiters.” Central to the above techniques is plain English writing, it will help keep your limited-literacy web visitors right where you want them – on your website easily reading, finding, and using your information. It’s well worth the effort as research shows that it’s not limited literacy that’s the problem, it’s poorly designed websites; limited-literacy web visitors are successful online when websites are developed well. To help you get into the habit of writing more clearly, download the free “Wordy and Redundant Phrase Buster” report by inputting the Promo Code: joy at

VII Resources

Clear Language at Work website includes tips, resources and more at

Lower-Literacy Users: Writing for a Broad Consumer Audience; How Users Read on the Web F-Shaped Pattern For Reading Web Content; How Long Do Users Stay on Web Pages? A range of helpful articles at Alterbox: Jacobson Nielsen’s newsletter on web usability:

Health Literacy Online: A guide to writing and designing easy-to-use health websites:

Letting Go of the Words: Writing Web, Content That Works:

Making the Web friendlier for lower-literacy users:

Reading and Navigational Strategies of Web Users with Lower Literacy Skills:

Why design for people with reading difficulty and low literacy:

Your guide for developing useable and useful web sites: