Principles of Plain Language

Principles of Plain Language Dr. Annetta L. Cheek, Chair Center for Plain Language Presented at the University of Maryland Horowitz Center for Health Literacy 3-10-09

What is Plain Language? Material is in plain language if readers can • Find what they need • Understand what they find • Use it to fulfill their needs And they should be able to do this the first time they read or hear it!

Think about your audience! • You must understand your audience’s knowledge of and familiarity with a topic. • What is plain language for one audience may not be plain language for another audience.

Why do we recommend plain language? • There is lots of evidence showing that plain language benefits the writer and the reader. • Readers save time and are more likely to get the information or benefit they are seeking. • Writers save money, because readers make fewer mistakes, respond more quickly, ask fewer questions, comply more fully with requirements.

We’ll look at just a couple examples

Veterans Benefits Administration • One office, in Jackson, MS, decided to rewrite one standard benefits letter into plain language. • Significantly fewer calls from customers. • More veterans applied for benefits.

Fewer calls from customers

Another VBA example • Every several years the Veterans Benefits Administration sends a letter to all veterans, asking them for an up-to-date beneficiary. • If a veteran dies and the beneficiary listed in his VA file isn’t valid, the VA must find a valid beneficiary. • It costs the VA several thousand dollars to do the research to find a valid beneficiary.

Higher response rate, lower costs Estimated savings $8 mil every mailing cycle

Federal Communications Commission • Revised regulations about radio operations on pleasure boats to improve their clarity. • A Washington-based firm studied the ability of users to find answers to questions in the old and new versions. • The test groups included both new and experienced users.

Less time for users to solve a problem (in minutes)

Overview of Plain Language Techniques None of the techniques we’ll discuss define plain language – rather, they are ways to achieve plain language Together, these techniques help you be clear and concise.

Use: Logical organization Informative headings Active voice Pronouns Lists and tables Common words

Avoid: • Abbreviations, jargon, legal terms, Latin Long sentences • Unnecessary words, redundancy • Information the audience doesn’t need

A general principle – Less is more! Plain language usually – but not always – helps you be more concise.

Organize logically for the reader There are several standard ways to organize: Chronological Most important first General first, special and exceptions last If you find material more than once, suspect poor organization

Headings There are three types of headings Questions – Why should we use headings? Statements – Headings help guide readers Topics - Headings

The most useful headings • Are question headings, because people generally come to our documents with questions. • But don’t make up the questions – use question headings only if you know the audience’s questions.

Use active voice • The best sentences are like the ones you first learned in school. • Subject, verb, predicate – Who, does what, to what or whom. We charged the incorrect amount.

Avoid passive voice • Passive voice is one of the major problems of bureaucratic writing. • Passive voice is harder to understand. • Passive voice can confuse the audience because it’s not clear who does what.

What is passive voice? The actor follows the verb. Some form of the verb “to be” is combined with the past participle of another verb. The frog was swallowed by Fred.

Can disguise who does what: A frog was swallowed. Passive Voice Active Voice Makes it clear who does what: Fred swallowed a frog.

Is often longer: The application must be completed by the applicant and received by the grants office by June 1st. 17 words Passive Voice Active Voice Cuts the number of words: We must receive your completed application by June 1st. 9 words

Use pronouns to speak to the audience • Research shows that people relate better to information that talks directly to them by using pronouns. • Using general nouns such as “beneficiary” or “purchaser” requires the audience to “translate” before they can be sure you are talking to them.

How to use pronouns • Refer to your organization as “we” • Refer to the reader as “you” in the text and as “I” in questions • Make sure you define “we” and “you”

Without pronouns To establish eligibility for a voucher, an applicant must show that the applicant has a low income and that the present care of the applicant is inadequate. 27 words

With Pronouns To establish your eligibility for a voucher, you must show you have a low income and your present care is inadequate. 21 words

Do not use these “pronouns”! He/she His/her S/he

Let’s use pronouns and active voice • Applications can be submitted any day of the week, including weekends and holidays. • They will be opened the next business day. • If your application is acceptable, you will be notified, usually within 48 hours.

You can submit your application any day. • We will open them the next business day. • If we accept your application, we will notify you, usually within 48 hours.

Using lists and tables • Lists can be a very powerful way to convey information. • Make sure that all the items in a list are constructed in a parallel way – each item should start with the same part of speech. • Try not to mix “and” and “or” in one list, it can be confusing.

Here’s a CMS example Medicaid: Apply if you are aged (65 years old or older), blind, or disabled and have low income and few resources. Apply if you are terminally ill and want to receive hospice services. Apply if you are aged, blind, or disabled; live in a nursing home; and have low income and limited resources. Apply if you are aged, blind, or disabled and need nursing home care, but can stay at home with special community care services. Apply if you are eligible for Medicare and have low income and limited resources.

And in list form You may apply for Medicaid if you are: • Terminally ill and want hospice services; • Eligible for Medicare and have low income and limited resources; or • 65 years old or older, blind, or disabled and have low income and few resources and • You live in a nursing home; or • You need nursing home care but can stay at home with special community care services.

And one more During this same period, prescriptions for HRT declined rapidly, following highly-publicized reports from the Women’s Health Initiative (WHI) study that showed an increased risk of breast cancer, heart disease, stroke, blood clots, and urinary incontinence among postmenopausal women who were using hormone replacement therapy that included both estrogen and progestin. (50 words in one sentence)

And as a list • During this time, prescriptions for HRT declined rapidly. The Women’s Health Initiative (WHI) publicized studies showing increased health risks among postmenopausal women who were using both estrogen and progestin . Risks included: • breast cancer • heart disease • stroke • blood clots • urinary incontinence (41 words in 3 sentences)

Use common words • Avoid uncommon words, bureaucratic words, foreign words, and jargon. • Even highly educated people read faster and with better comprehension if you stick with common words. • Big words do not make you look smarter!

Instruct Tell Common words Receive, Obtain Get Parameter Limit Assistance Help Regarding About Retain Keep

Avoid abbreviations jargon legal terms Latinisms

Abbreviations • Readers complain more about abbreviations and acronyms than about any other feature of bureaucratic writing. • Using abbreviations turns your material into a research project for readers. • If your abbreviation has another, more common meaning, your audience will forget your special meaning and remember the more common one.

How can you fix abbreviations? • Don’t use more than two, and at most three, abbreviations in each written document. • Instead, use “nicknames” such as “unit” instead of WPU for Witness protection unit, or“case review” instead of PQCR for Peer Quality Case Review.

Jargon Bureaucratic writing is often full of jargon metabolic demands circulation system hypertension expiry date

Bureaucratic and legalistic words • Herein • Hereafter • Hereby • Pursuant to • In accordance with • Shall (use “must” instead)

Latin terms • “i.e.” and “e.g.” are major problems. • Many people do not know what these mean. • Many who do know the meanings don’t remember which is which. • Other Latin terms to avoid – “via” “per”

Keep sentences short In most material, sentences should average 20 words or fewer, with no sentence longer than 40 words. On the web, limit the average to 15 words, with no sentence longer than 30 words.

Consider this sentence If this continues, over time some recurring infections may have to be treated with different and stronger antibiotics and the very real possibility that eventually no antibiotic will be effective in killing the bacteria. (34 words in 1 sentence)

All you need is this If this continues, some recurring infections may have to be treated with stronger antibiotics. Eventually some infections may resist all antibiotics. (21 words in 2 sentences)

But this is even better for a general audience Eventually, we will have to use even stronger antibiotics to kill some infections. Some may resist all antibiotics. (18 words in 2 sentences) .

One more example The National Cancer Institute's Cooperative Planning Grant for Cancer Disparities (CDRP) Research Partnership Program issued by the Radiation Research Program is an effort to strengthen the national cancer program by developing models to reduce significant negative consequences of cancer disparities seen in certain U.S. populations.(45 words)

Do you need more than this? The Cooperative Planning Grant for Cancer Disparities (CDRP) Research Partnership strengthens the national cancer program by developing models to reduce negative consequences of cancer disparities.(25 words)

Omit excess words • Generally, “less is more.” • Challenge every word you write. Do you really need it? • Bureaucratic writing contains many unnecessary words. • Eliminating excess words is a skill you’ll work on your entire writing career.

Principles of Plain Language