Whether you are creating a nutrition handout or a slide presentation, beware of common writing and design errors that may send your materials straight to the recycle bin.

Mistake #1: Choosing a design template first.

Picking designs and colors is the fun part of creating education materials. Which is why this is a mistake I still find myself tempted to make. And while you may initially think that a snazzy design is what will draw attention, keep in mind that aesthetics are subject to personal taste. What one person finds appealing, another may find unremarkable, or worse yet, offensive.

Example

I recently came across a one-sheet, double-sided handout promoting pre-conception care for people with diabetes.

In this example, the design had a highly feminine design. Illustrations portrayed a generic family unit consisting of cis male, cis female, Caucasian parents.

By starting with the design, the educator projected their own views, perceptions, and tastes onto the piece rather than designing for the target audience. One of the first steps in creating effective communications is to identify your audience and learn about their perspectives and experiences. Only then can you write and design inclusive materials that will resonate with a wide range of readers.

Mistake #2: Using images for decoration.

In a handout or presentation slide, space is limited. Therefore, every word and every image counts. Pictures are often added to convey the theme of a piece, and/or to increase visual appeal. However, an image can do much more than that.

Take, for example, a slide about physical activity. There are many stock images that show symbols of exercise--a pair of walking shoes next to a set of hand weights, or an illustration of a person running. While these images make it clear what the image is about, they do not offer much else.

Imagery predates writing, a testimony to its influence. From cave drawings to children's books to film and video, the right pictures can:

• inform

• educate

• evoke emotion

• establish relatability

• model behavior

• build confidence

• increase inclusivity

Due to the wide range of learning styles, using pictures and illustrations with intention can help visual learners. For many people, multiple modes of learning are best, so a thoughtful juxtaposition of imagery and text can enhance its impact.

Again, knowing your audience will be required to select the right pictures. An illustration of a person running might not be relatable to readers who are currently sedentary, or have physical limitations, or are culturally resistant to formal exercise.

Instead, consider images that may appeal to self-efficacy, or perceptions of social norms, or other targets of behavior change. Use pictures to show who, what, and how.

As space is limited, proper pictures can help minimize the amount of text needed to convey a message. Used together, a whole story can be told on a single page.

Mistake #3: Writing to inform rather than to educate.

As health professionals, we are highly educated in sifting through the science of disease management. Many of us geek out over scientific illustrations of cell metabolism, statistically significant findings from well-designed studies, and evidence-based guidelines. When we present to peers, demonstrating this scientific savvy is well-received.

However, when designing for patients, sometimes we need a reminder to translate this information into messages that resonate. A key point to remember is to write in plain language--i.e., use every day terminology that the reader will recognize.

A general rule of thumb in writing health communications is to write at the fifth grade level to increase accessibility. If you are drafting your content in Microsoft Word, you can check the readability level in the Editor. However, readability tools have some limitations in health communications. While you should use everyday terminology, you should also define medical terms that the reader needs to know. For example, while you might use the term "high blood pressure" to simplify reading, also define "hypertension" early in the piece to further educate patients. While this will throw off the readability score, it may help them navigate the breadth of information they receive about their condition. As educators, our role is to communicate clearly as well as provide knowledge.

Not only should we target health literacy levels, but we should help develop them as well.

Also, highlight information that is important to the reader. As experts in our field, we may be tempted to include a comprehensive background about a topic. For example, health messages about diabetes often include the economic costs of treating the condition and its complications. While this information is important for informing policy, the $400+ billion dollars spent in the U.S. may not resonate with an individual. On the other hand, a discussion about a patient's personal costs may resonate more. For the individual, health costs are not limited to money, but also include physical, social, emotional, and other burdens. As mentioned earlier, learning about your audience is a key step before starting the writing and design.

The more your reader can relate to the information, the more likely they may apply it.

Learn more about writing for your audience at plainlanguage.gov.

Mistake #4: Omitting a call to action.

Before you can start writing or designing, be sure to determine the key objective of the piece. What should the reader do with this information?

Health literacy refers not only to the readers ability to understand the information, but also to their ability to use and apply that information. Whether it is a message to see their doctor for screening or a strategy for balanced meal planning, be sure your piece includes actionable steps that the reader can take to help them manage their health.

Whatever the objective, be sure to highlight that information so it is clear on the page.

Mistake #5: Burying the main points.

Perhaps you have written content that is easy-to-understand, informative, and motivating. And the images are relatable and actionable. But what have you done to insure that the reader takes the time to read the piece in the first place? While a snazzy layout or vibrant colors might get them to look, what will get them to stay?

Hold the piece at a distance. Or zoom out on your screen to see what information pops. Is the purpose of the handout clear? Can the reader see the key messages and the call to action at a glance? Or does it look like one large block of text?

The greatest writing is ineffective if the reader does not stop to read it. Therefore, be sure to highlight important messages that resonate to entice the user to read further. For example, a provocative headline, section subheads, boxes, or bold font can be used to help the reader skim the main points. If the messages are properly tailored, they will be motivated to read the details.

Mistake #6: Using copyrighted images from the internet.

While it is easy to copy and paste pictures from the internet, doing so can result in poor image quality at best and copyright infringement at worst.

Most images on the internet are copyright protected. The copyright owner will be the photographer or artist who created the image--not necessarily the owner of the website on which the picture appears. Therefore, when you see an image online, see if a photo credit is included, then find out if permission is required. A photo credit may not appear if the website owner purchased the license to use the image, such as from a stock photography website. Copyright licenses grant a range of rights. Some licenses require that the user pay royalties to the creator for each use, whereas royalty-free images can be used with minimal restrictions and without royalty fees.

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Upon purchasing a product from platemethodpics.com, you may:

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If a piece of artwork is covered under a Creative Commons (CC) license, the image may be free to use but with some conditions. For example, the copyright owner may require a credit or attribution, where their name appears near the artwork. Some CC licenses allow for modification to the art, while others prohibit any changes. There are some CC images that are in the public domain, where the creator waived their rights to the copyright and the user can use it for free without restrictions. Public domain images are available on sites like pixabay.com or pexels.com. Microsoft Bing also includes a "public domain" filter for image searches.

While the fair use doctrine allows for some uses without permission for educational purposes, there are limitations to this rule. When in doubt, reach out to the artist to inquire about permission and usage fees.

Taking images from the internet is a common practice. For small scale, one-off projects, this usage may slip under the radar. However, if you are repeatedly distributing or presenting your design to a large audience, you may put yourself or your company at risk for legal action. For more information about copyright law, visit copyright.gov.

The six mistakes described above are often made at the beginning of a project. Now that you know what to avoid, be sure to share this information with your interns, peers, and other colleagues involved in your health education program. Also share the checklist for creating effective health communications.