Dailey, S. (2005). NIHSeniorHealth.gov: Empowering
older adults with health information. Journal on Active Aging, 4(2),
6162. Retrieved from
[PDF File - 403 KB]
This background piece heralds the award-winning work of
the National Institute on Aging and the National Library of Medicine on the NIH
SeniorHealth Web site (http://NIHSeniorHealth.gov). The article
describes the purpose of the Web site and provides an overview of some of the
Echt, K. V. (2002). Designing Web-based health
information for older adults: Visual considerations and design directives. In
R. W. Morrell (Ed.), Older adults, health information, and the World Wide
Web (pp. 6188). Mahwah, NJ: Lawrence Erlbaum Associates.
Echt summarizes the research behind Web-based interface
design and explains the special considerations necessary to design Web-based
health information for older adults. This chapter includes clear guidelines for
layout, organization, navigation, and graphics.
Freimuth, V. S., & Mettger, W. (1990). Is
there a hard-to-reach audience? Public Health Reports, 105(3),
This article dispels myths, deconstructs assumptions about
"hard-to-reach" audiences, and offers alternative perspectives to highlight the
strengths of different audience segments, encouraging innovative approaches to
Kaphingst, K. A., Zanfini, C. J., & Emmons, K.
M. (2006). Accessibility of Web sites containing colorectal cancer information
to adults with limited literacy (United States). Cancer Causes and Control,
Kaphingst and colleagues found that many colorectal cancer
Web sites were too difficult for the average American adult and much too
difficult for adults with limited literacy to use. Common problems with the
sites included the following: lack of review of key ideas; insufficient use of
illustrations for key messages; crowded layout and long line lengths; small
type size; lack of cues to highlight key content; and lack of interactive
Kodagoda, N., & Wong, W. (n.d.). Why design
for people with reading difficulty and low literacy. Retrieved from
[PDF File - 121 KB]
This document summarizes previous research conducted by
the authors on users with low literacy and the Web. The authors explain the
benefits of semantic Web technology and offer design guidelines for users with
Lefebvre, R. C., Tada, Y., Hilfiker, S., &
Baur, C. (in press). The assessment of user engagement with ehealth content:
The eHealth Engagement Scale. Journal of Computer-Mediated
This article describes the psychometric testing and
evaluation of the eHealth Engagement Scale, which was adapted from commercial
advertising research. Internal reliability of each of the two multi-item
subscales of the eHealth Engagement Scale was 0.878 for "Involving" and 0.805
for "Credible." The eHealth Engagement Scale may prove to be an important
mediator of user retention of information, intentions to change, and ultimately
efforts to undertake and achieve behavior change.
Morrell, R. W., Dailey, S. R., & Rousseau, G.
K. (2003). Commentary: Applying research: The NIH Senior Health Project (pp.
134161). In N. Charness & K. W. Schaie (Eds.), Impact of
technology on successful aging (pp.134161). New York, NY: Springer
This chapter offers a detailed outline of the special
considerations, design principles, and methodology implemented in the NIH
Senior Health Project. Not only do the authors explain the unique needs of
aging populations, including their usability testing procedures and results,
but also they clearly lay out detailed guidelines for Web content development
for aging populations.
Neuhauser, L. (2001). Participatory design for
better interactive health communication: A statewide model in the U.S.A.
Electronic Journal of Communication/La Revue Electronique de Communication,
11(3,4). Retrieved from
This article provides an example of how participatory
design was used by hundreds of parents and people with disabilities to create a
health Web site for 33 million residents of the State of California.
Nielsen, J. (2005). Low literacy users. Jakob
Nielsen's Alertbox. Retrieved from
This Web site provides an overview of the user population
with lower literacy as well as practical tips for improving the usability of
Summers, K., & Summers, M. (2004). Making the
Web friendlier for lower-literacy users. Intercom, June, 1921.
[PDF File - 378 KB]
The authors describe some of the online behaviors of
limited literacy users. These behaviors, such as avoiding search functions or
reading every word, often contradict developers' most basic assumptions. It's
important to address these issues in developing online prevention content.
Summers, K., & Summers, M. (2005). Reading and
navigational strategies of Web users with lower literacy skills. Retrieved from
[PDF File - 76 KB]
This research article summarizes results from a study that
sought to understand the differences between the reading and navigational
strategies of users with low literacy skills and those with medium to high
literacy skills. The authors offer strategies and design principles to make
Web-based medical content usable and accessible for lower literacy adults.
Zarcadoolas, C., Blanco, M., Boyer, J. F., &
Pleasant, A. (2002). Unweaving the Web: An exploratory study of low-literate
adults' navigation skills on the World Wide Web. Journal of Health
Communication, 7(4), 309324.
Based on an ethnographic study of a group of low-literate
adults, the authors identify specific navigational and content issues that
present barriers for this population. They discuss preliminary assumptions that
can be used to inform the development of Web tools for low-literate adults and
directions for future applied research.
Zarcadoolas, C., Pleasant, A. F., & Greer, D.
S. (2006). Health literacy and the Internet. In Advancing health literacy
(pp. 117140). San Francisco: Jossey-Bass.
This book chapter brings together the research from two
worlds: health literacy and the Internet. The authors explain the strengths and
weaknesses of using the Internet to communicate health information. In addition
to reviewing key research findings, the authors outline specific challenges,
opportunities, and ethical issues. This chapter contains applied exercises and
an abbreviated glossary of commonly used Internet jargon.
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