Avoiding the ambiguity minefield in healthcare communications: Three strategies for success

Steve Seiferheld
VP, Market Research
HRA, part of The Agency Network at MJH Life Sciences

In any healthcare context, the audience must interpret communications as the producers of the content intended. Humans are vastly different. How we interpret what we hear and see is idiosyncratic by nature. In this spirit, healthcare communications—a critically important discipline—must avoid ambiguity. Able copywriters, public health professionals, and market researchers take great care to avoid terminology that can be interpreted inconsistently across segments of the population.

Here are three strategies proven to help maximize clarity and avoid ambiguity.

1. Replace ambiguous words with “concrete language.”

Ambiguous words make it dangerously easy for people to have different interpretations of what they just saw or heard. Replacing these words with concrete language, or “tangible qualities or characteristics, things we know through our senses,” provides greater consistency of interpretation.¹ Consider some examples of ambiguous versus concrete verbiage.

2. Utilize imagery to clarify text.

Digital ads, images, schematics, or animatronics add great value to communications. For example, some medications come in a self-injectable format. Patients might be instructed to “grasp or pinch a sizable area of the skin at the injection site.” What defines “sizable?” One person might think of it as an inch of skin, while a second might imagine it as four inches. Including a visual of the self-injection process eliminates the need for interpretation of “sizable,” a rather ambiguous concept itself.

Another use of imagery might involve the application of a topical cream or ointment. A well-known brand of a moisturizing agent tells users to “apply as needed” and “apply ointment liberally.” Imagery can provide examples of what might define “as needed” (eg, dry, flaking skin or an open sore) and “apply ointment liberally” (eg, showing ointment on a finger, or comparing a dollop to a coin for context).

3. Pretest your materials

Pretesting materials provides the best safeguard against releasing ambiguous questions, copy, or instructions to the audience of interest. When possible, pretesting should include an array of people with different demographic and psychographic characteristics. Examples might include age, gender, health literacy, and history of conditions.

When conducting market research, a specific pretesting technique called cognitive interviewing (or cognitive testing) provides excellent insights into how subjects interpret questions and statements. The testing of questionnaires focuses on “cognitive processes that respondents use to answer survey questions.” In this scenario, an interviewer probes a respondent on what specific words and phrases mean to them. Ultimately, the process evaluates whether a respondent can formulate an answer and match it to at least one option associated with a survey question.²

Cognitive testing lets us assess ambiguity by having a respondent verbalize their interpretation of words. For example, imagine the question: “How many times have you spoken with your lawyer over the past year?” In the process of cognitive testing, one might discover that a respondent has multiple lawyers for different purposes. Further, the respondent might interpret “spoken” to mean only live conversation and omit text messaging or email. Also, a respondent might speak to a lawyer on professional and personal terms, not knowing which to reflect in an answer. Having the respondent walk through their cognitive interpretation of the question informs the researcher of a suspected ambiguity.

Ambiguous language regularly arises in everyday vernacular, lulling us into a dynamic that is dangerous for healthcare communications because they are vital to our well-being. This is no trivial matter. We must strip healthcare communications of ambiguity and replace it with precise language, so the target audience all see and hear the same thing—a healthy practice if ever there was one.

References:

1. Concrete and Specific Language - Idaho State University. Accessed September 13, 2022.
2. Willis, Gordon B. Cognitive Interviewing, A “How To” Guide. Presented at the American Statistical Association, 1999.