Successful health communication is not just about delivering the information but how it is framed and presented to the intended audience. In the last article, I introduced Audience Design in Clinical Outcome Assessments. In this article, I want to widen the focus to look at how Audience Design can be a useful concept in the creation and development of health information in general.

In healthcare contexts, poor communication or miscommunication can have serious consequences. It can lead to patients misunderstanding basic instructions about their medicines or study participants misinterpreting informed consent forms. All health-related texts, be this for a health promotion campaign, a patient information leaflet, a clinical trial consent form or COA, must be designed to be clear, usable and actionable.

Audience Design in Health Communication

Audience Design is the process of tailoring communication based on the characteristics of the intended audience. In the context of health communication, the developer of the information ought to be asking questions during the creation process, such as:

·       How familiar is the audience with medical terminology? Are they clinically trained and would have no problem understanding jargon? Are they laypeople and would they require simplified language?

·       What is the formality level? Should the communication be formal and professional or conversational, direct and engaging?

·       What are the audience’s cultural backgrounds? To what extent would this affect how they interpret medical information?

·       What about health literacy? Can the audience easily understand and act upon the information provided?

·       What about the emotional tone? Should the language be reassuring, urgent, neutral or motivational?

These and many other factors need to be aligned with the intended communication to ensure engagement, create understanding and help bring about better health outcomes.

Each kind of health communication involves different audience requirements. We shall focus on health promotion, Patient Information Leaflets (PILs) and Informed Consent in clinical studies.

Audience Design in Health Promotion Campaigns

The aim of health promotion campaigns is usually to influence behaviour and encourage positive health practices. This would involve smoking cessation, take-up of vaccination drives, hand hygiene. However, the same message cannot be effective universally across all demographics. A smoking cessation campaign must employ a different tone and format to target teenagers, which will be very different to a campaign targeting older smokers. The creator of the health message would need to research how different groups of people seek and access information. Based on this, the health promotion specialist might consider the following:

Teen Audiences:

·       Prefer content that is engaging and social-media-friendly

·       Do not like overly formal or medicalised language

·       Seek information that involves testimonials from peers and storytelling that they can relate to.

This might lead the health promotion specialist to design a TikTok campaign that uses influencers to share personal stories about stopping smoking.

Whereas for older audiences, it might be different:

·       Depending on age and degree of visual acuity, they may prefer clear, large-font printed materials

·       They may want simple, step-by-step guidance on how to give up smoking.

This may lead the health promotion specialist to design a brochure to be distributed in pharmacies with visual aids to explain nicotine replacement therapies.

The Audience Design principle at play here is that health campaigns must be customised to the communication styles and media preferences of different target groups. Research it before you write it. Do not assume anything.

Audience Design in Patient Information Leaflets (PILs)

In a previous company I co-founded decades ago that specialised in User Testing of Patient Information Leaflets, we implemented a step at the beginning of the process called the ‘Audience Design Step’. This was based on the concept of Audience Design in sociolinguistics and was not meant to be proprietary in any way. The principle of it was to adhere to the spirit of Audience Design when designing a leaflet that could be understood across different literacy levels. Research demonstrated at the time – just as it continues to show now – that many PILs were (are) written at a reading level that is too high for the lay patient. This could lead to improper medication use, including harm to the user.

So, when applying Audience Design to PILs, for laypeople, the writer would want to:

·       Use plain language (e.g. ‘stomach pain’ instead of ‘gastric discomfort’)

·       Use a layout that is friendly, with plenty of spacing and bullet points

·       Write in simple, short, uncomplicated sentences.

And for PILs for medical professionals:

·       Can use technical terminology

·       Can focus on mechanisms of action, contraindications, and so on

·       May include detailed clinical trial data.

The Audience Design principle for PILs is that they must be adapted for diverse health literacy levels, while balancing usefulness and accessibility with medical accuracy.

Audience Design in Clinical Trial Consent Forms

Clinical trial consent forms must communicate complex medical and legal information to laypeople. This means that they also must be written in a style that ensures that anyone reading it will be able to understand fully what they are agreeing to.

There are two Audience Design pitfalls with consent forms. The first is that they can be too complex, such as:

This study involves a randomised, double-blind, placebo-controlled methodology to assess the pharmacodynamics of investigational compound X.

This is far too difficult for a lay audience to understand. On the other hand, it could be too simplified, where key information is lost, such as:

You may get the real drug or the fake one. You won’t know which.

This oversimplifies the trial structure and misses essential details.

A ‘halfway-house’ between the two could be:

In this study, you will either get the new medication or a placebo (a pill with no drug in it). Whichever one you will receive will be random, like flipping a coin.

The writer of a consent form (or the writing team) could think about Audience Design in the following ways:

For Lay Participants:

·       Use plain language with clear explanations of medication

For Researchers and Ethics Committees:

·       The content is simple and ensures readability while maintaining technical accuracy and integrity.

 The Audience Design principle at play here is that, by striking a balance between legal precision and lay comprehension, informed decision-making can be achieved.

Recommendations

Best practices for applying Audience Design in health communication are as follows:

·       Segment Audiences: Define specific demographic groups, such as age, literacy level and cultural background

·       Use Plain Language: Do not use jargon when communicating with patients and the general public

·       Perform User Testing for readability and comprehension, using an iterative, formative approach

·       Adapt for cultural and linguistic differences to fit cultural expectations and language norms.

Final Thoughts

In health communication, one size does not fit all. Audience Design is an important concept to ensure that health messages, patient information and patient-facing clinical study materials are appropriately tailored to their intended audiences. By aligning communication and style with audience needs, health communication interventions can enhance comprehension, improve engagement and contribute to better health outcomes.

Thank you for reading,

Mark Gibson

Leeds, United Kingdom, March 2025