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U.S. Department of Health and Health Services
Office of Disease Prevention and Health Promotion
Health Literacy Online: A Guide to Writing and Designing Easy-to-Use Health Web Sites
A Brief Introduction to User-Centered Design


How do I know whether my Web site meets the needs of users with limited literacy skills?


By involving users with limited literacy skills throughout all stages of Web site development. This is called user-centered design.

User-centered design is accomplished through an iterative process. The iterative process can be summed up in three words: Test. Revise. Repeat.

Imagine spending money and time designing a Web site from start to finish, only to discover that your users are unhappy with the site or unable to find what they are looking for (or both).

Instead, involve users as codesigners. Have users try out your Web site early on, and continue to test different sections of your site as you develop them. Fine-tune as you go to avoid a major overhaul. This is iterative design.22

The key to iterative design is to continually apply what you learn from users to improve your site.8

Summary of Iterative Design and Testing Methods

Common iterative design methods are briefly described here. At the end of each chapter, we suggest specific methods and tips you can use to test and improve your Web site.

Individual Interviews

Individual interviews involve talking to users one on one, either in person or over the phone. Unlike a usability test, you aren't watching the participant work. You are finding out background information about their information preferences, habits, and experiences.8,23

Focus Groups

Focus groups are similar to individual interviews, except that you are interviewing several participants (typically 5 to 10) at once. A moderator facilitates the focus group and uses a script to lead the discussion. Focus groups are used to learn about users' beliefs, attitudes, or reactions to a design or prototype.8

Task Analysis

Conduct a task analysis to find out what users are trying to accomplish on your Web site and how they currently accomplish those tasks.8,13,23,24 What steps do they take? What tools do they use? A task analysis can be done through observation or interviews.

A task analysis can help you "unpack" the requirements or demands put on users to accomplish a task on your site. Often we make false assumptions about Web users' knowledge or skills. For example, we may assume users know what BMI (body mass index) stands for or that users will correctly interpret the meaning of an icon or symbol.

Personas and Scenarios

A persona is a made-up individual who embodies the characteristics of the real users you may have interviewed and the data you gathered. When creating a persona, include demographics, values, access to technology, and quotes.7,8,13,25–27

It helps to give your persona a name and a picture. Keep your personas in mind as you design your site. Ask yourself: Would Susan use this? How would Joe approach this task?

Once you've developed personas for your site users, you are ready to develop scenarios. Scenarios are short stories that describe the goals and tasks of your users.7,8,24 They can help paint a realistic picture of how personas use your Web site.

Card Sorting

Card sorting can help you group or organize information on your Web site. Many people use card sorting to help with information architecture. The topics and information featured on your site are listed on index cards. Participants are asked to sort or organize the cards into categories that make sense to them. You also can use card sorting to prioritize information by importance.23


A prototype is a mockup of your Web site, similar to a rough draft. Start with a paper prototype or wireframe. (A wireframe is an illustration of the layout of a Web page.) Each piece of paper represents a page of your Web site. Users tell you which information or link they would click on, and you show them the new piece of paper (or "screen").8,22,24,28,29

As you get further along in the development process, consider building a clickable prototype. This HTML (hypertext markup language) "shell" lets users click through several screens of content.

Usability Testing

In usability testing, a moderator observes a user performing tasks on your Web site. Have participants "think out loud" as they use the site to help you understand their approach and process. Note where users have problems or get lost.22,30,31

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