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Vol. LVIII, No. 11
June 2, 2006

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'Speak Plainly. Save Lives.'
NIH Honors 'Plain Language'

On the front page...

In its annual salute to the agency's communicators, NIH held the sixth Plain Language Awards ceremony on Apr. 19. Some awardees traveled across the country to receive the honors, which recognize NIH communication products that deliver messages clearly. Special guest recipients who attended the event included several representatives of the O'odham Nation and the communities of Gila River and Salt River in Arizona, and other American Indian communities. They collaborated with NIDDK staff to develop several award-winning communication products, including a video on slowing kidney disease and a calendar for people with diabetes.


"One of the challenges [in communication] is that there is no one-size-fits-all message," noted NIH director Dr. Elias Zerhouni, acknowledging those who contributed their expertise in cultural customs to help make the health education material more effective. "Every message has to be sensitive to its intended recipient. Culturally sensitive communication cannot be applied across the board. When you want to communicate, you can't just listen to yourself — you have to listen to the public you're trying to reach."

Guest speaker Burkey Belser, designer of the Nutrition Facts label, greets an attendee.  
NIH's Executive Secretariat, which hosts the Plain Language Initiative, and the plain language coordinating committee, received more than 175 nominations for material produced in 2005. Awards were given for outstanding, excellent and honorable mention.

Guest speaker Burkey Belser, designer of the Nutrition Facts label found on virtually all U.S. food and beverage products (and many millions more worldwide), discussed the Communication Index, a formula he developed to measure how well messages reach their targets.

His formula assigns a numerical value between one and 10 to each of four categories: difficulty of subject matter, difficulty of presentation, motivation of the reader and expertise of the reader. The difficulty values are multiplied and then divided by motivation times expertise to arrive at the CI. The higher the CI, the least likely the communication works. In fact, messages are deemed fully successful only at scores from 0.01 to 1.0. Between 1 and 10, communications enter a warning zone where they become more difficult to understand. After the 10-point mark, the audience tunes out completely.

Belser also acknowledged a gap between so-called "super-knowers" and "street-level knowers" that all communicators are ultimately trying to close. Super-knowers speak "in code." They often complain of having to simplify material it has taken them a lifetime to understand themselves. Street-level knowers speak in "stories based on cause and effect." They often worry that "This is too hard. I don't understand. Why can't this be simplified?"

NIH director Dr. Elias Zerhouni (standing, r) welcomes special guest recipients who attended the Plain Language Awards ceremony including several representatives of the O’odham Nation and the communities of Gila River and Salt River in Arizona.

Belser said, "If there's any take-away from this presentation, it's that motivation needs to be at the heart and soul of what we do. We have to consider the motivation of the reader. And we have to bank on the worst, particularly if it's about public policy."

Finally, showing slides of FDA's now nearly universally used Drug Facts label, which he also designed to make clearer, Belser addressed the consequences of not delivering important messages simply: "With poor communication, you may die," he said bluntly, with somewhat deadpan humor. "It's true, isn't it? You and your customers may die. Your citizens may die. You, your customers and your citizens may be seriously injured. With poor communication, your family and your pets may die.He or she may divorce you." If we don't communicate well, he concluded, then our health, work, families and social relationships all may suffer.

So, only half kidding, Belser came up with a bumper sticker that he wants everyone to have: "SPEAK PLAINLY. SAVE LIVES."

To find out more about the Plain Language Initiative and see a list of the current award-winning products, visit

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