Linked below is a resource produced by NYC Opportunity (NYC Mayor’s Office for Economic Opportunity) that includes tools and tactics for civic service design regarding COVID-19 public health efforts that can also be applied to the broader design realm. Use these tips to amp up concreteness to more effectively catch your target user’s attention and make them more likely to perform the key behavior.
You can use the following audit checklist to evaluate your digital tools, such as a website, mobile app, social media content, and digital print media. This checklist centralizes recommendations derived from Health Literacy Online, ETR's Health Equity Framework, and design thinking.

1. Learn about your users and their goals

  • Who are your users?
  • What are your users' challenges and fears regarding COVID-19 and the vaccine?
  • What are their motivations on your website? Why are they here?
  • What are they trying to do on your digital tool? i.e. goals and user's definition of success.
  • What are the individual factors that impact your users' attitudes and behaviors towards searching and accepting COVID-19 vaccine information? How do continually learn from our constituents and establish them as the experts? e.g. a built environment such as access to the internet, mobile phone, and a computer.
    • How might we lead with transparency in our work?
    • How might we share research insights and data transparently?
    • How might we intentionally recruit diverse teams?
  • What are your users' physiological pathways? How can we accommodate or challenge structures that exclude individuals from participating in public spaces? e.g. cognitive and comprehension disabilities and conditions such as Dementia, Alzheimers, and Parkinson's Disease.
    • How might we design for a commitment to recovery?
    • How might we address imbalanced power dynamics?
    • How might we support a person’s sense of physical and psychological safety?
  • What networks and relationships do people value the most to feel safe, protected, and empowered to take action on healthy behaviors? e.g. a trust messenger/ health translator from their communities, family, friends, schools, religious institutes (church, temple, mosque).
    • How might we amplify the voices of hyperlocal communities?
    • How might we design processes to empower people and foster a sense of agency in people?
  • What are the systems of power that prevent or accelerate their access to accurate and transparent COVID-19 information? e.g. undocumented immigrants, lack of insurance, rural community access to healthcare.
    • How might we shift the balance of power?
    • How might we ensure that we center our collaborators over our funders?
    • How might we ethically involve people in the co-design and research process?

2. Write actionable content

  • Did you put the most important information first at the top of the page, above the fold?
  • What is the health behavior that you want your users to do? e.g. check vaccination eligibility, or learn more about vaccine side effects.
  • Did you set realistic and positive expectations? e.g. include the benefits of taking action to set a prevention plan against COVID-19 for your family.
  • Did you provide specific action steps for your users to do immediately? Instead of telling users what to do, tell them how to do it.
  • Did you write in plain language? Use familiar language and an active voice. e.g. "When you get the COVID-19 vaccine, the nurse will give you an immunization card with your vaccine dose 1 brand name, date, and location of vaccine administration."
  • Did you check your content for accuracy? Include the date when the content was last reviewed and the reviewer's name and contact information to give your content more credibility with your users.
CDC COVID-19 Frequently Asked Questions (FAQ) page

3. Display content clearly on the page

  • Did you limit paragraph size? Use bullets and shortlists.
  • Did you use meaningful headings?
  • Did you use a familiar font with at least 12-point type for print media and 16-point type for a website and mobile view?
  • Did you use white space and reduced clutter?
  • Did you keep content? In the center of the screen and above the fold?
  • Did you label links clearly?
  • Did you use images that facilitate learning and reduce negative emotions? e.g. avoid vaccine imagery that could deter people with needle phobias.
  • Did you use bold colors with contrast? e.g. avoid dark backgrounds.
  • Did you make your site and documents accessible to people with disabilities? Learn more about 508 compliance.

4. Organize content and simplify navigation

  • Did you create a simple and engaging homepage? Users with limited literacy skills have difficulty processing multiple concepts at the same time, so include as few elements as possible on the homepage.
  • Did you use labels that reflect words your users know? To help different users find what they need, repeat topics under multiple categories. For example, based on card sorting, content on vaccination eligibility in our vaccine website template appears under three categories: Homepage, Find Vaccines, Phases.
  • Did you enable easy access to home and menu pages?
  • Did you ensure that the "Back" buttons work?
  • Did you use linear information paths? This is especially important in completing vaccine eligibility forms and registering for a vaccination appointment.
  • Did you include simple search and browse options? Include language translation options for multilingual users.

5. Engage users with interactive content

  • Did you include printer-friendly tools and resources? e.g. provide a link to printable pages. We learned users with limited literacy skills prefer to print pages from a website, rather than read text on a computer screen. Also, they may want to share health information with family members or friends who don't have access to a computer or post it on their fridge.
  • Did you simplify screen-based controls and enlarge buttons? e.g. design buttons that are easy to find and click. Some users with limited literacy skills do not understand the term "Submit". So use an alternative like "Go" or "Get Started".
  • Did you include interactive content that users can tailor, but not too much? Users want personalized health information, but they don't want to enter a lot of personal data.
San Francisco Vaccine Notification Webpage
  • Did you incorporate audio and visual features to build trust in the community? Evidence-based research shows that audio and video can enhance comprehension and retention of online information. Using a role-modeling strategy, such as video testimonials or flyers, is key when engaging the Hispanic community, where adult immunization rates are already much lower than among whites.
  • Did you include social media for increased engagement and social proof?

6. Evaluate, measure, and revise your digital tool

  • If budget allows, did you recruit users with limited literacy and limited health literacy skills from various backgrounds and conduct usability testing? This option may not be practical for health content developers, so, instead, you can use a proxy for health literacy. Usability will help test comprehension in multiple ways, such as having users think out loud as they complete tasks and having them describe what they've read in their own words.
  • Did you integrate analytics to track users' flow in your digital tools and gauge their behaviors?
  • Did you recruit diverse moderators and/or researchers for testing? Whenever possible, use moderators who share similar cultural experiences and values when working with people with limited literacy skills and those of diverse demographics.
  • Did you create plain-language testing documents? e.g. screeners, consent forms, and moderator guides. As a general rule, limit the number of tasks and questions when conducting usability testing with users with limited literacy skills.