Participatory design of mass health communication in three languages for seniors and people with disabilities on Medicaid

Am J Public Health. 2009 Dec;99(12):2188-95. doi: 10.2105/AJPH.2008.155648. Epub 2009 Oct 15.


Objectives: We used participatory design methods to develop and test guidebooks about health care choices intended for 600 000 English-, Spanish-, and Chinese-speaking seniors and people with disabilities receiving Medicaid in California.

Methods: Design and testing processes were conducted with consumers and professionals; they included 24 advisory group interviews, 36 usability tests, 18 focus groups (105 participants), 51 key informant interviews, guidebook readability and suitability testing, linguistic adaptation, and iterative revisions of 4 prototypes.

Results: Participatory design processes identified preferences of intended audiences for guidebook content, linguistic adaptation, and format; guidebook readability was scored at the sixth- to eighth-grade level and suitability at 95%. These findings informed the design of a separate efficacy study that showed high guidebook usage and satisfaction, and better gains in knowledge, confidence, and intended behaviors among intervention participants than among control participants.

Conclusions: Participatory design can be used effectively in mass communication to inform vulnerable audiences of health care choices. The techniques described can be adapted for a broad range of health communication interventions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged*
  • California
  • Communication*
  • Community Participation / methods*
  • Disabled Persons*
  • Focus Groups
  • Health Services Accessibility
  • Humans
  • Language
  • Mass Media*
  • Medicaid
  • Medicare Part C*
  • Program Development / methods*
  • United States