Skip to Main Content

North Carolina Health Literacy: Creating Patient Education Materials

This guide serves as the information hub for health literacy resources and efforts at University of North Carolina at Chapel Hill, as well as throughout the state of North Carolina.

Created by Health Science Librarians

Contact Us

Ask a Librarian
Email Terri Ottosen

On This Page

To write in plain language means to use the simplest, most straightforward way of expressing an idea. Doing so will ensure your audience understands it the first time they read or hear it. Materials are in plain language if your audience can:

  • Find what they are looking for
  • Understand what they find the first time they read or hear it
  • Use what they find to meet their needs

The following are resources and tools that can help you develop or assess patient materials so that they adhere to plain language principles.

Plain Language Tools

Program for Readability in Science & Medicine Toolkit Online Training

  • The goal of this FREE, hour-long course is to help research teams improve the readability of consent forms and other participant materials.
  • If you provide your email address when you register, you can exit the course, re-enter and go back to the page you were on last.
  • You will need speakers or headphones to hear the audio track.

Program for Readability in Science & Medicine Toolkit

The Program for Readability In Science & Medicine (PRISM) was inspired by health literacy concerns in health care and health research. PRISM’s goal is to bring readability awareness and plain language training and tools to researchers nationwide. Using plain language is a proven way to help make scientific and medical information easier for study participants, patients, and the public to understand.

Plain Language Medical Dictionary

The Plain Language Medical Dictionary widget is a project of the University of Michigan Taubman Health Sciences Library as part of the Michigan Health Literacy Awareness project.

Everyday Words for Public Health Communication

Everyday Words for Public Health Communication offers expert recommendations from CDC's Health Literacy Council and other agency communicators on how to reduce jargon and improve reader understanding. You can search for public health jargon or plain language words and find alternatives and example sentences.

Just Plain Clear Glossary

The Plain Language Action and Information Network (PLAIN) is a group of federal employees from different agencies and specialties who support the use of clear communication in government writing. Their guide, “Design for reading,” can help you use design elements to help users read and understand the information.

Clinical Research Glossary

The Clinical Research Glossary offers easy to understand clinical research definitions. All definitions are are developed by the Multi-regional Clinical Trials (MRCT) Center of Brigham and Women's Hospital, Harvard, and a team of patient advocates and other health professionals. This glossary is helpful to patients considering participating in clinical trials or those developing clinical trial participation materials.

Writing in Plain and Understandable Language

PEMAT (Patient Education Materials Assessment Tool) and User’s Guide

A systematic method to evaluate and compare the understandability and actionability of patient education materials. It is designed as a guide to help determine whether patients will be able to understand and act on information. Separate tools are available for use with print and audiovisual materials.

CDC Clear Communication Index

The CDC Clear Communication Index (Index) is a research-based tool to help you develop and assess public communication materials.

Making Data Talk: A Workbook 

This workbook was created by the National Cancer Institute to help you select and communicate quantitative data in ways lay audiences can understand.

Design for reading

Designing for reading is an important part of developing effective communications. Writing that is legible and well-organized is far easier to understand than more traditional styles. Even with regulations and the limits of publishing in the Code of Federal Regulations, you can use design elements to help users read and understand the information.

Before and After Examples from

The goal of the organization is to promote the use of plain language for all government communications. They believe that using plain language will save federal agencies time and money and provide better service to the American public.

Gateway to Health Communication & Social Marketing Practice (CDC)

This site provides resources to help build your health communication or social marketing campaigns and programs.

Clear & Simple - National Institutes of Health

This guide, Clear & Simple, is designed to assist health communicators in developing audience-appropriate information and communicating effectively with people with low-literacy skills. It outlines a process—five standard steps—for developing health information materials. Planning questions are included for each step.

Toolkit for Making Written Material Clear and Effective (Centers for Medicare & Medicaid Services)

The Toolkit for Making Written Material Clear and Effective is a health literacy resource from the Centers for Medicare and Medicaid Services (CMS). This 11-part Toolkit provides a detailed and comprehensive set of tools to help you make written material in printed formats easier for people to read, understand, and use.

Using Inclusive Language in Health Care Materials

American Cancer Society Inclusive Language Guide

This document from the American Cancer Society provides language guidelines about subjects related to health equity including social determinants of health, shifting to person-centered language, race, ethnicity, and national origin, sexual orientation, gender identity, and disability status. It includes introductions to each topic as well as terminology to avoid and suggested replacements, real-life examples, and references for further reading.

APA Inclusive Language Guidelines

This glossary of terms compiled by the American Psychological Association cover topics of equity and power, person-first and identity-first language, identity-related terms, culturally appropriative and pejorative language, violent language, and language that doesn't say what we mean.

OHSU Inclusive Language Guide

This guide from Oregon Health & Science University Center for Diversity and Inclusion provides instruction on understanding and using inclusive language in writing, teaching, and conversation.

CDC Health Equity Guiding Principles for Inclusive Communication

This guide from the CDC covers best practices for inclusive public health communication including using a health equity lens, key principles, preferred terms, developing inclusive communications, inclusive images, and resources and references.

UNC Health Sciences Library LGBTQIA Guide

This guide from the UNC Health Sciences Library includes "support resources for patients, information about LGBTQIA+ health disparities, tools for doing research on LGBTQIA+ health, and educational resources for health professionals."

UNC Health Sciences Library Latinx Guide

This guide from the UNC Health Sciences Library "contains health resources for Hispanic and Latino/Latina/Latinx individuals and their healthcare providers. Topics include:

  • Cultural Humility and Cultural Competence
  • Patient-Provider Communication
  • Health Conditions
  • Latino/Latina/Latinx Health Research
  • Latino/Latina/Latinx Health Search Terminology
  • Professional Associations serving Latino/Latina/Latinx Communities"

Assessing the Readability of Materials

Assessing and Developing Health Materials (Harvard School of Public Health)

This site brings together health literacy studies’ information including information on vocabulary and sentence structure, the reading process, as well as layout and design elements for health materials. Links on the page also include an overview, research findings, strategies and tools, and policies, reports, and initiatives.

SAM Suitability Assessment of Materials

Available in Doak & Doak (1996), Chapter 4, p.49 SAM, the Suitability Assessment of Materials instrument offers a systematic method to objectively assess the suitability of health information materials for a particular audience in a short time. It guides you to rate materials on factors that affect readability and comprehension. SAM rates materials in six areas: content, literacy demand, graphics, layout and type, learning stimulation & motivation, and cultural appropriateness.

Assess, select, and Create Easy-to-Understand Materials

From the AHRQ Health Literacy Universal Precautions Toolkit: Tool 11
This tool from the Agency for Healthcare Research and Quality provides an overview and specific actions for practices to be able to assess, select, and create easy-to-understand materials including training staff, working with your patients to evaluate forms and other written materials, and tracking your progress in ensuring your practice is communicating clearly with patients and their families.

Readability Calculators

Readability calculators take a sample of your writing and calculate the number of sentences, words, syllables, and characters. They are helpful when deciding if your writing is at the appropriate level for your intended audience. Below are a selection of commonly used readability calculators when assessing health literacy levels.

The Flesch Grade Level Readability Formula

The formula is used in business, industry and government as well as education, to score materials from the upper elementary level through the secondary grades and beyond. The formula takes into consideration (1) the total number of words, and (2) the number syllables, and (3) the total number of sentences. It is one of the most popular and heavily tested formulas.

Fry Graph Reading Formula

Calculates reading difficulty level by the average number of sentences and syllables per hundred words. These averages are plotted onto a specific graph; the intersection of the average number of sentences and the average number of syllables determines the reading level of the content.

SMOG – Simple Measure of Gobbledygook

Measures readability that estimates the years of education needed to understand a piece of writing.

Terri Ottosen, MLIS, AHIP

Profile Photo
Terri Ottosen