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Center for Health Literacy Promotion Blog

Promoting Health Literacy with Beginnings Guides Part 10: Layout

In this Part 10 of our series using the SAM - Suitability Assessment of Materials - to evaluate Beginnings Guides, we address layout, the architecture of the page. Like the architecture of a building, layout makes a page inviting or intimidating, easy or physically demanding to navigate, memorable or nondescript.  SAM names eight factors that substantially influence the suitability of health education materials by making the process of reading painless or not. We will take them in order. But first, I will add one essential item that SAM leaves out and that all page design should respect
Reading gravity rules layout
Reading demands physical skill, concentration and time, all of which may be in short supply. The information architect must ensure that none of the reader’s effort and time are wasted, or worse, sacrificed to design.
We read from the top left corner of the page and work our way across and down; left to right and back again to the bottom right corner.  Page design should facilitate this efficient pattern and avoid disturbing reading rhythm.  In testing, on average 67 percent of readers showed good comprehension of information that complied with reading gravity compared to 32 percent of readers of the same information on pages that required them to work against reading gravity. Learn more and see an illustration here.
Reading gravity explains many of the suitability factors for layout.
Position illustrations adjacent to related text.
SAM says photos or other graphics should be placed adjacent to the text that they explain. Ideally the text is to the left of the graphic (so you read it, then see the explanatory graphic)  and a caption is immediately below the graphic. Otherwise, the illustration becomes a distraction and interrupts reading.
Make it easy to predict the flow of information
That means the content follows a logical sequence and is presented consistently. For example, Beginnings Pregnancy Guide content is sequenced by gestational age and the usual progress of pregnancy. Each of the six booklets uses the same section heads and text addresses similar subjects in consistent order (e.g. Your Baby’s Growth and Development). Warning Signs are always located on the back cover; they change by stage of pregnancy; no searching is required.
Use visual cues to direct attention to key content
For example, Beginnings Guides highlight key messages by displaying them in bold type in a box with 10% cyan( light blue) screen. Research suggests the light screen attracts the eye without interfering with comprehension. A cell phone icon alerts the reader to a condition that warrants a call to the doctor.
Keep the page clean
Simple design works best for readers. A cluttered page looks hard to read, and most likely is.  Testers may say the over-designed page is more attractive, but their comprehension will suffer.
Keep color in a supporting role
Color attracts the eye. Use it to lead the reader to key content. Or to lure the eye up to the “fallow corner” at the upper right. Check to make sure the color does not pull the eye against reading gravity like it does below.
Keep lines short - 30 to 50 characters and spaces
Remember the reading eye moves from left to right and back again. At the end of the line, the eye returns to its starting place and drops down to the next line.
Unless something is in the way. Then it has to search for what is next, and be lost to the distraction.
Keep high contrast between type and paper.
When contrast is low, reading is difficult. For comprehension, black type on white paper is far and away the best. More on colored type.
SAM says use non-gloss (matte) finish. Glossy paper carries a reflection which can be distracting. However, other testing showed no difference in comprehension. A coated stock repels fingerprints and is more durable.
Beginnings Guides get a Superior rating for complying with all these factors most of the time. Look through the Pregnancy Guide.  SAM requires at least 5 to be present. Material with fewer than three factors present or that just looks uninviting or hard to read is Inadequate.
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