This series is going to focus on the quote from Linda Hodgdon’s book, Visual Strategies for Improving Communication:
“Communication is 55% visual, 37 % vocal, and 7% verbal, or the actual message.”
This week, let’s look at the message, or 7% of communication.
Strunk and White’s book, the Elements of Style is an invaluable resources for this piece of communication. One of the key messages is to make your communication clear, concise, and direct. here are five things to consider when creating your message for print, scripts, storyboards, presentations, and conversations:
Use active tense.
An active tense creates a vigorous message that is compelling. The person receiving your message feels it is relevant to this moment. Avoid using passive statements such as “may be,” “can be,’ or “should be.”
Be direct.
Get to the point quickly. Say what you want right away. Avoid explaining the history of reasons for your message. Provide a reference the person you are communicating with can access if they are interested.
Be familiar.
Speak directly to your audience by using a personal tone. Everyone likes knowing you are interested in them. Using an a removed tone “one must consider…” is more difficult for your audience to understand.
Keep it short and simple.
It is easier to take in small amounts at regular intervals than a lot of information all at once. To do this it is essential to define your message clearly at the beginning.
Be positive.
Keep your tone positive. Focus on the actions you want them to take, rather than what not to do. A positive action statement is easier to act on and more powerful than a negative
The message, the words you choose to use – whether written or spoken – is only 7% of the message. it’s essential that the message is consistent with the rest of the recipe for communication : verbal and visual cues. Well-planned messages go along way toward understandability.
The essence of health literacy is looking at communication as a whole. The question is this: “Am I communicating effectively?”
A simple question, but very hard to answer.
In the next few weeks, I will share some methods for communicating clearly – particularly for those who have intellectual and developmental disabilities. The focus this week is defining communication.
In her book, Visual Tools for Improving Communication,´ Linda Hodgden states,
“Communication is 55% visual, 37 % vocal, and 7% verbal, or the actual message.”
Let’s look at this a bit more closely and define these categories.
Communication is 55% Visual.
The layout of the text.
The font used.
The photos or drawings.
The color coding.
Body movement.
Gestures.
Facial expressions.
Communication is 37% Vocal.
The speed of a person’s speech.
The volume of a person’s speech.
The intonation of a person’s speech (is it all the same, or does it change?)
Communication is 7% verbal:
The actual message or words.
Using visual tools in communication – regardless of disability – means being taking advantage of 55% of how your communication is received by the person with whom you are working.
In the next few weeks I will post tips for different aspects of communication: visual, vocal, verbal, and the entire communication package. It is an essential part of health literacy for people with intellectual disabilities.
Challenge for this week: Pay attention to your communication style. What visual, vocal, and verbal techniques do you use? Which are more affective?
Next week: Understanding your message – the 7% of communication.
Visual Strategies for Improving Communication by Linda Hodgdon, M.ed., CCC-SLP. Quirk Roberts Publishing, 1998. ISBN: 9780961678616
One of the key points of successful support for people wtih intellectual disability is the balance between what is important to the person you support and what is important for them. This is especially difficult for health care providers.
Let’s face it – the history of health care is very paternalistic in nature. We, the health care professional, know what you need to do to be healthy/live healthy/see well/hear well/play well. As we leave our training situations and begin to work with people in the community, we learn that what we know is just a small part of the game plan. If it’s not important to the people we provide services to, they are very unlikely to do anything we suggest.
There is a way of thinking that really helps when working through these issues, regardless of disability. It’s called person-centered thinking. It’s quite popular right now, but it’s been around a long time. The attached article offers some insights to the importance of u sing person-centered thinking when working with people with intellectual disabilities.
Issues around health literacy are everywhere. The challenge is especially tough for health care professionals working with people who have intellectual disabilities. Why? Because our messages must be tested for more than one audience:
People with Intellectual Disabilities
Those who support them (coaches, parents, siblings, direct support providers)
Our colleagues.
This is no small challenge. An article published March 27, highlights the need for people with out ID, but who are likely their supports. “Patient Bill of Rights Too Tough to Read.” (http://www.healthfinder.gov/news/newsstory.aspx?docID=624592.)
If the people who support those with intellectual disabilities cannot understand information, how will the people they support?
For Special Olympics, Healthy Athlete events, a document similar to the Patient Bill of Rights is our consent form. Is the process understandable?
We had a great World Games event in Boise, Idaho last month. The professionals who came to train from all around the world for the Health Athletes Program were stellar.
Most of my time was spent with the trainees in the Health Promotion area, though once we started the health screenings, my hand-held video camera and I went through each venue looking for examples of good health literacy skills as well as areas we could improve.
It will take me some time to look over these videos and edit them to show the skills we seek in a huge health screening. I think, however, the lasting education and skills happen closer to the athletes’ homes with the local programs, their teams, and coaches.
One of my roles at the games is to talk with our Healthy Athlete Clinical Director Trainees about health literacy. We share some tips and tricks regarding the importance of making things understandable. We talk about the use of person-first language as a practice used within Special Olympics. This time, we talked a lot about hwo the environment – the busy-ness and clutter – can affect the abiilty of a person with intellectual and developmental disabilities to understand what is happening. Not to mention the language and culture issues of a World Games event!
Overall, our Clinical Director Trainees did a great job! They are dedicated, inspired, and able.
I do, however, wish I had the article I unearthed tonight. Well over a year ago I was interviewed by a writer for the Journal of the American Dietetic Association regarding working with people with disabiilties. My message – as always – is that the same best practices apply with a few modifications. I never saw a draft of the article before it was printed. Actually, if I hadn’t taken the time to read the cover (an afterthought), I would have thrown it away. But it turned out well. It’s a good tool for understanding the essence of respect when working in this field.
One of the reasons I enjoy the area that has been defined as “health literacy,” is because I’ve been doing it all along. When working with anyone – regardless of ability – in making changes for improved health it’s important communication is clear. In the health field, and personal counseling, the notion of “coaching” is quite popular right now. The main premise is to acknowledge as the professional, the best thing we can do is support people as they make decisions.
And I ask you, is this any different than what is best practice for working with people who have intellectual disabilities? To answer the question, I’ve uploaded the article, “We’re More Alike Than Different,” Which I’ve uploaded to the blog. The article is used with permission from the Behavioral Health Nutrition Practice Group of the American Dietetic Association (www.bhndpg.org).
More literature is being presented about using technology – cell phones, iPods, and so on – to send health messages. The following article discusses this technique:
Patient education on mobile devices: an e-health intervention for low health literate audiences
Journal of Information Science, Vol. 35, No. 1, 82-93 (2009)DOI: 10.1177/0165551508092258
Which led to a brief discussion for people with intellectual disabiltiies using cell phones and Ipods. We forget that for young adults, cell phones and iPod like players are seen as essential – the cell phone is replacing a land line. Many parents purchase cell phones wiht restrictions for their children with ID to keep track of where they are. They can be an important safety tool.
This led to a comment by Matt Holder, the Globarl Director for MedFest regarding use of text messages as a way to coach health promoting behaviors and options.
There are multiple tools available to schedule and send messages. The American Cancer Society uses an automated messaging tool to remind people who sign up for the program to get important health screenings.
Join in the discussion.
How can we use this technology to send understandable messaging to our athletes, parents, coaches, and direct support providers?
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Below are some automated messaging programs available on the Internet (free):
And a full text article about the topic for people without ID: Using Sequential Email Messages to Promote Health Behaviors: Evidence of Feasibility and Reach in a Worksite Sample http://www.jmir.org/2006/1/e3/
The Joint Commission released this announcement Friday, April 11, 2008. What are your thoughts regarding use for Athletes in Special Olympics, their families, direct support personnel, or coaches?
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The Joint Commission is launching a national campaign to help Americans prevent health care errors by promoting health literacy. Understanding Your Caregivers provides patients questions and answers that will help them better understand the care they receive. Among the topics are:
What can you do if you don’t understand what your caregiver is saying?
What can you do if they explain and you still don’t understand?
How do you understand all the instructions related to medicines, or even remember all of the medicines?
The campaign is part of their national patient safety Speak Up program which offers downloadable, easy-to-read brochures on issues such as preventing medication mistakes, avoiding wrong site surgery, and recovering after leaving the hospital.
For many, blogs are seen as a hobby, or a place for random thoughts. Blogs are also a great way to have an organized discussion and share information. That is the purpose of the Health Literacy for Healthy Athletes Blog.
For the purpose of the Healthy Athletes program, health literacy goes way beyond what is currently found in the literature and current tool kits. Those are typically designed for people without intellectual disabilities and target people with low reading skills. Special Olympics Athlestes, and people with intellectual disabilities, benefit in many ways from those programs. However, Healthy Athletes clearly seeks to do more.
Our goal is to create information that is easy to access, understand, and use to make changes in every day life. Our target audiences are:
People with intellectual disabilities.
Clinical Directors and volunteers in the Special Olympics Healthy Athletes Initiative.
Coaches in Special Olympics who coach individuals with intellectual disabilities.
People who support individuals with intellectual disabilities.
Famliies of individuals with intellectual disabilities.
Health care providers who include individuals with intellectual disabilities in their practice.
I believe if we use all the tools available to support people with intellectual disabilites, the tools exist to do a stellar job of improving health through health education in the Healthy Athletes Initiative using the framework of health literacy, the round table discussions about health literacy for people with intellectual disabilities, and the information from the athlete focus groups.
Now it’s time to put our heads together and make it happen! To do this, we must work together as a team (Together Everyone Achieves More).
Using this blog
Some folks may need a little help understanding how to use this Blog. I am here to help! Here is how the blog works:
An idea, topic, or question may be posted on this page
Chime in with your thoughts, ideas, comments by using the “Let’s Talk” tab or by clicking to comment below a post.
If you have resources you’d like to share related to health literacy, you can post them in a comment here or email them to me and I will put them in the Tools tab.
If using the blog takes too much time or is more than you want to learn, that’s Ok. Please give me a call or drop me an e-mail and join in the discussion that way.
I’m eager to hear from you.
Best regards,
Joan Guthrie Medlen, RD, LD
Clinical Director, Health Literacy
Special Olympics, Healthy Athletes.
Posted by Joan 
Posted by Joan 
Posted by Joan 