Part 1: Create accessible and readable text documents with these tips

by Lana MacEachern on 2022-05-09T08:30:00-03:00 in Health literacy, Organization of Information | Comments

In health care, we frequently create text documents to communicate important information to our colleagues, patients and clients, and the public. But how well do our messages get across, given that our audience may include people with:

  • reading disabilities,
  • low literacy,
  • visual impairments, and
  • a first language other than English?

In this two-part post, we’ll suggest a few things you can do to make your text documents more readable and accessible. To start, we’ll focus on font choice, text alignment, and general plain language considerations.


Choose a sans serif font with a minimum size of 12 points for body text. To emphasize words or phrases, make the font bold rather than using italics or underlining. 

  • Italicized words are more difficult to read.
  • Underlining overlaps the bottom parts of some letters, which can also make words more difficult to read.
  • Screen-reader software may mistake underlined words for hyperlinks.

Text Alignment

It’s tempting to centre headings on the page and use justified alignment to make a block of text look neat and tidy, but this can decrease readability. Text should always be left-aligned. 

  • When text is centred or right-aligned, people with reading difficulties may have a hard time telling where each sentence or line begins.
  • Justified text is spaced so that the beginning and end of each line lines up with the left and right margins respectively. This can result in large gaps between words, which can cause problems for people using magnifying devices. 

Plain Language

Plain language is words and sentence structure that are simple, clear, and direct. Break up long, complicated sentences and paragraphs into smaller parts. 

Avoid convoluted words when a simpler word says the same thing. If you can’t avoid using a medical term, explain the term in brackets.

Instead of: Use:


acquire get
alternatively or
consequently so
concerning about
utilize use
nausea nausea (upset stomach)

Avoid unnecessary filler words that don’t add to the idea you’re expressing.    

Instead of: Use:
has been shown to be is
the provision of care providing care
needs to be considered consider
be knowledgeable about know
in order for for
your attention is drawn to please see

Did you know? “Approximately half of all Canadians experience some challenges understanding the health information and teaching provided to them (Guo, 2012).” Nova Scotia Health’s patient education pamphlets are written at a Grade 6 reading level so more people can read and understand them. Microsoft Word can check the readability (grade level) of your document using the Flesch-Kincaid Grade Level test. 

We hope these tips enhance the documents you create for health-care audiences across a range of tools, whether handouts or presentations. You will find more information in the list of additional resources below. In Part 2 of this article, we’ll provide some tips on using bullets and ordered lists, tables, and links.

In the meantime, if you have any questions or would like more resources to help you develop your skills around creating and sharing information that is accessible and easy to understand, don’t hesitate to reach out to us at AskLibrary@nshealth.ca or book a consultation to speak one-on-one with a library team member.

Additional Resources

AbilityNet. (2022). Creating accessible documents. https://abilitynet.org.uk/factsheets/creating-accessible-documents-0 

Microsoft. (2022). Make your Word documents accessible for people with disabilities. https://support.microsoft.com/en-us/office/make-your-word-documents-accessible-to-people-with-disabilities-d9bf3683-87ac-47ea-b91a-78dcacb3c66d?ui=en-us&rs=en-us&ad=us#bkmk_avoid_tables_win  

Ryerson University. (n.d.). How to create accessible documents. https://www.ryerson.ca/accessibility/guides-resources/accessible-documents/ 

York University Centre for Staff Development & Technical Learning [YUCSDTL]. (2021). Designing accessible word documents. https://csdtl.info.yorku.ca/files/2021/04/Designing-Accessible-Documents-Course-Handout-Revised-April-2021.pdf?x31038 



Guo, D. (2012). The impact of low health literacy on Health. UBC Medical Journal, 3(2), 39-41.https://ubcmj.med.ubc.ca/past-issues/ubcmj-volume-3-issue-2/the-impact-of-low-literacy-on-health


Lana MacEachern

Library Technician
Aberdeen Hospital, Northern Zone

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