nccmt spotlight webinar: clear communication index

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Funded by the Public Health Agency of Canada | Affiliated with McMaster UniversityProduction of this presentation has been made possible through a financial contribution from the Public Health Agency of Canada. The

views expressed here do not necessarily reflect the views of the Public Health Agency of Canada..

Clear Communication Index

Presenters:

Lourdes M. Martinez, PhD

Sarah Gilman, MPH

February 1, 2017 1:00 – 2:30 PM ET

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Housekeeping

Use Chat to post comments and/or

questions during the webinar

• ‘Send’ questions to All (not

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Connection issues

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wireless),

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• 1-866-229-3239

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After Today

The PowerPoint presentation (in English and French)

and English audio recording will be made available.

These resources are available at:

PowerPoint: http://www.slideshare.net/NCCMT/

Audio Recording:

https://www.youtube.com/user/nccmt/videos

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How many people are watching

today’s session with you?

Poll Question #1

A. Just me

B. 1-3

C. 4-5

D. 6-10

E. >10

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Your profession? Put a √ on your answer (or RSVP via email)

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Epidemiologist Management (director,

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professionals (nurse,

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Clear Communication Index

http://www.nccmt.ca/resources/search/247

Episode 31

6

NCC

Infectious

DiseasesWinnipeg, MB

NCC

Methods

and ToolsHamilton, ON

NCC Healthy

Public PolicyMontreal, QC

NCC

Determinants

of HealthAntigonish, NS

NCC

Aboriginal

HealthPrince George, BC

NCC

Environmental

HealthVancouver, BC

7

Registry of Methods and Tools

Online Learning

Opportunities

WorkshopsMultimedia

Public Health+

Networking and

Outreach

NCCMT Products and Services

8

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Poll Question #2

How familiar are you with the

method or tool we are discussing

today?

A. I am not familiar with the method or tool

B. I have heard of the method or tool

C. I have used the method or tool

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Presenter

Lourdes M. Martinez, PhD

Health Communications

Specialist, Centers for

Disease Control and

Prevention

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Presenter

Sarah Gilman, MPH

Director, National Resource

Center for Lupus, Lupus

Foundation of America

CDC’s Clear Communication Index

Lourdes M. Martinez, Ph.D.

February 2017

Office of the Director

Office of the Associate Director for Communication

Overview

Background on creation

Need for creation

How the tool was developed

Who was involved in development

Describe the tool and how to use it

CDC examples using the tool

Why Do We Need to Focus on Clarity?

Clarity is foundational for communication effectiveness

Communication science and related disciplines should

inform practice

Implement the Plain Writing Act

How Was the Index Developed?

CDC staff and contract team

CDC: Cynthia Baur and Chris Prue

Contractors: RTI International and CommunicateHealth Inc.

Multi-step process

Questions and items based in scientific literature, staff

and consumer testing

Expert Panel Areas of Expertise

Social cognition, persuasion, and cognitive and

informational processing

Adult literacy and education

Social psychology, message framing, role of emotion

Social networks, media, and marketing

Scientific literacy measurement, science communication

Cross-cultural communication

Health literacy

Visual communication & design

Numeracy, risk communication, medical communication

Linguistics, language in health communication messages

Developing the Index

Review of existing health literacy guidelines to identify items

(n=205)

Input from expert panel on items and evidence

Search and review of evidence to support items

(n=43)

Create draft index

(n=36)

Expert panel reviews and rates items and evidence

Use of findings: We developed numerous drafts of the index, last one

with 23 items.

Testing the Index at CDC

• Pilot tested draft index (study team)

• 7 materials scored by two people each

• Expert panel review

• Cognitive interviews with CDC communicators

• 8 staff (6 health communication specialists, 1 Public Health

Analyst and 1 Associate Director for Communication Sciences

• Given user guide and scoring sheet

• Scored a material that they worked on and a preselected material

• “Think aloud” technique with observer and note taker

• User testing (including inter-rater reliability study)

• 67 staff invited to participate

• Sent user guide, score sheet, 3 materials, and a web link to

survey

• 28 staff responded within 2 week time frame

Testing the Index at CDC

Focus groups with the 8 members of the dyads (matched

pairs)

Communication staff and subject matter expert pairs recruited

from four national centers

• Environmental Health

• Infectious Diseases

• Immunization and Respiratory Diseases

• Chronic Diseases

Given user guide and score sheet to use on a project of their

choosing and 2 weeks to try it out

Refining the Index

Initial index had 22 items – current has 20 items

Eliminated 1 item that seemed to not apply to CDC work

Combined two items into one (describing nature of risk)

Initial user guide

Didn’t have definition of risk – there are many different meanings

of risk in public health so this was added to new guide

Initial score sheet

Required users to do math

Now there is a fillable form that calculates the score

Widget available

Initial trainings were 4 hour workshops

Trainings now are 1 ½ hours long and tailored for programs

Pre-recorded webinars for CDC staff

Testing the Index with Consumers (n=870)

More consumers could

Identify the main message

Find information of interest to them

Use the information to decide

when they viewed materials designed using the Index

versus CDC’s usual practices

Source: The CDC Clear Communication Index is a new evidence-based tool to prepare and review health information. (2014). Health

Promotion Practice, 15(5):629-37. doi: 10.1177/1524839914538969l. https://www.ncbi.nlm.nih.gov/pubmed/24951489

CLEAR COMMUNICATION INDEX: 4 QUESTIONS AND 20 ITEMS

How can you use the Index?

• Design and develop new communication products

• Assess existing communication products

• Foster discussion before and during review processes

https://www.cdc.gov/ccindex/pdf/full-index-score-sheet.pdf

What is the Clear Communication Index

(Index)? • 4 questions and 20 items based in communication and

related sciences that staff can use to develop, assess

and score communication products

• Assesses materials in these 7 areas

– Main Message and Call to Action

– Language

– Information Design

– State of the Science

– Behavioral Recommendations

– Numbers

– Risk

4 Questions Before Scoring

Who is your primary audience?

What do you know about the health literacy skills of your

audience?

What is your primary communication objective?

What is the main message of the material?

Calculate the Score for the Material

Step 1: Add up the total points that the material earned

(this is the numerator).

Step 2: Add up the total possible points that the material

could have earned (this is the denominator).

Step 3: Divide the numerator by the denominator and

multiply by 100 to get the total score.

______ / ______ X 100 = ______

How to Interpret Your Score

If the total score is 90 or above:

Excellent! You have addressed many items that make

materials easier to understand and use.

If the total score is 89 or less:

Note which items scored 0 points. Use the descriptions and

examples in the User Guide to revise and improve the

material. Then apply the Index again to check your work.

You can use the Index as many times as you need to revise

the material to get a score of 90 or above.

EXAMPLES

Thimerosal - Original Main

message

?

Thimerosal - Revised

Language of

primary audience

One main message &

located at the top of the first

page Visual

supports main

message

Active

Voice

Most important

information

summarized on

the first page

Language of Primary Audience

Original

Revised

Heart Disease - OriginalAre these numbers

the audience uses?

Is a lay explanation about what these

numbers mean provided?

Heart Disease - Original

Numbers

audience

uses?

Lay explanation of

what numbers

mean? Is this

relevant to the

users?

Heart Disease - Revised

Lay explanation of

what numbers

mean presented

in numbers used

by audience.

Numeric probability

of risk explained with

both text and

numbers

Heart Disease - Revised

Explains what

the risk means

to the user

Lmartinez@cdc.gov

Visit our websites for more resources:

www.cdc.gov/ccindex

www.cdc.gov/healthliteracy

Office of the Associate Director for Communication

Lupus Foundation of AmericaUser Story

Sarah Gilman, MPH

Director, National Resource Center on Lupus

February 1, 2017

1. The Foundation

2. Clear Communications Index

a. Timeline - How we learned to use the CCI

b. Writing Guidelines and how we use CCI

c. Recommendations for using the tool

Overview

We are dedicated to improving the quality of

life for all people affected by lupus through

programs of research, education and

advocacy.

We serve adults and children with lupus,

caregivers, loved ones and health care

providers.

Our Mission

Lupus Foundation of America

Website = 8 million visits per year

Social media posts receive hundreds of

interactions from followers

Health educators regularly refer constituents to

our online content as a source of education

Our content is a key education tool:

1. A digital home for the lupus community.

2. A living source of health information,

empowerment and support for anyone with

questions about lupus.

3. Dynamic, broadly focused content that

draws people in and encourages higher

levels of interaction and stronger

relationships.

Funded by CDC-PULSE Grant

National Resource Center on Lupus

Education & Research + Marketing &

Communications

2 writers

Graphic designer

Digital marketing manager

Communications director

Marketing director & content director oversee

the team jointly

The Content Team

January 2014

- Health Literacy Campaign

October 2016

- CCI Training for LFA Content Team

- 2 hour training with actual-use samples

October 2016-Present

- Regular use of the CCI in education content

Our timeline

Writing Guidelines

Writers keep tool handy in desktop shortcut

or physically at their desks

Expectation for writers and editors:

- Every piece in production will be measured against

the tool

- Every piece under review will be measured against

the tool

At minimum:

- 4 preliminary questions

- Section A

Recommendations

Learn about health literacy + plain language

Take CCI training or self-teach

Get organizational buy-in

Designate an owner that can enforce CCI

use

Require all writers and editors to keep it

handy

Require, at minimum, first 4 questions and

part A

Plan for (at least) yearly refreshers and new

staff trainings

Success is in the long-game

Thank You

Sarah Gilman

gilman@lupus.org

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Your Comments/Questions

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and/or questions

• ‘Send’ questions to All (not

privately to ‘Host’)

Chat

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Poll Question #3

Could this method or tool be useful

in practice?

A. Very useful

B. Somewhat useful

C. Not at all useful

D. Don’t know

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Your Feedback is Important

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Poll Question #4

What are your next steps? (Check all

that apply)

A. Access the method/tool referenced in the presentation

B. Read the NCCMT summary about the method/tool described today

C. Consider using the method/tool in practiceD. Tell a colleague about the method/tool

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Join us for our next webinar

NCCMT Spotlight on Methods & Tools: MetaQAT

Date: Tuesday, March 21, 2017

Time: 1:00 – 2:30pm EST

Interested in a tool to appraise all types of public health

evidence? Do you appraise public health evidence? Are

you interested in a single tool that can appraise many

different types of evidence and study designs? Join us

for a webinar to learn about the MetaQAT.

Register at: https://health-evidence.webex.com/health-

evidence/onstage/g.php?MTID=e096a1f507835d52365f5c9c3a6f397be

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Funded by the Public Health Agency of Canada | Affiliated with McMaster UniversityProduction of this presentation has been made possible through a financial contribution from the Public Health Agency of Canada. The

views expressed here do not necessarily reflect the views of the Public Health Agency of Canada..

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