Interactive CDC Clear Communication Index

This is a simple interactive form of the CDC Clear Communication Index. The CDC says, "The CDC Clear Communication Index (Index) is a research-based tool to help you develop and assess public communication materials." If you're working on a fact sheet, pamphlet, PSA campaign, or anything remotely similar, you can use this to score and improve your material.

Before you begin

Identify your primary audience, their health literacy skills, your primary communication objective, and main message. You must know these 4 pieces of information to score the material accurately. If you don’t have this information, wait until you do to score the material.

Note about translated materials: If the audiences for the English and non-English versions are different, you should create and score the materials separately to account for audience differences.

Using the score sheet

The Index has a total of 20 items in 4 parts. These 20 items are presented as questions.

  • Questions 1-11 in Part A apply to all materials.
  • Questions 12-20 in Parts B, C, and D may not apply to all materials.
  • Choose one answer for each item you score.
  • Only score a point when all instances of an item in the material meet the criteria.

More detailed descriptions and examples of each item can be found in the User Guide.

1. Who is your primary audience?

Note: See Appendix B of the User Guide for a list of common public health audiences.

2. What do you know about the health literacy skills of your audience?

List as many relevant characteristics about your audience as you can. Try and include evidence about their literacy and numeracy skills; words, numbers, and health concepts they find familiar; their prior experience with the topic; and their ability to comprehend different information formats, such as graphs. If you don’t have any information at all, assume average to low health literacy skills.

3. What is your primary communication objective?

A communication objective is what you want your audience to think, feel, or do after they receive the message or material. Example 1: Increase the proportion of women between 18-25 years who intend to increase consumption of folic acid. Example 2: Increase the proportion of sexually active adults with favorable attitudes about taking an HIV test.

4. What is the main message statement in the material?

The main message statement is the one thing the audience must remember. The statement may be 1-3 short sentences. If you are reviewing an existing material with multiple messages, list all possible messages.

Part A: Core

The items in this section (1-11) apply to all materials.

Guideline Description Passes? Applies?
1. Does the material contain one main message statement? A main message is the one thing you want to communicate to a person or group that they must remember. A topic, such as heart disease or seasonal flu, isn’t a main message statement. If the material contains several messages and no main message, answer no. (User Guide page 5).

NOTE: If you answered No to Question 1, score 0 for Questions 2-4 and continue to Question 5.
2. Is the main message at the top, beginning, or front of the material? The main message must be in the first paragraph or section. A section is a block of text between headings. For a Web material, the first section must be fully visible without scrolling. (User Guide page 6)
3. Is the main message emphasized with visual cues? If the main message is emphasized with font, color, shapes, lines, arrows or headings, such as “What you need to know,” answer yes. (User Guide page 7)
4. Does the material contain at least one visual that conveys or supports the main message? For example, count photographs, line drawings, graphs and infographics as visuals. If the visual doesn’t have a caption or labels, answer no. If the visual has human figures who aren’t performing the recommended behaviors, answer no. (User Guide page 8)
5. Does the material include one or more calls to action for the primary audience? If the material includes a specific behavioral recommendation, a prompt to get more information, a request to share information with someone else, or a broad call for change, answer yes. If the call to action is for someone other than the primary audience, answer no. (User Guide page 10)
6. Do both the main message and the call to action use the active voice? If only the main message or only the call to action uses the active voice, answer no. If you answered no to #1 or #5, answer no. (User Guide page 11)
7. Does the material always use words the primary audience uses? If all specialized or unfamiliar terms are explained or described (not just defined) the first time they are used, answer yes. Acronyms and abbreviations must be spelled out and explained if unfamiliar to the audience. (User Guide page 12)
8. Does the material use bulleted or numbered lists? If the material contains a list with more than 7 items, and the list is not broken up into sub-lists, answer no. If the list is for additional information or references only or at the end of the material, answer no. (User Guide page 14)
9. Is the material organized in chunks with headings? This item applies to prose text and lists. If the chunks contain more than one idea each, answer no. If the headings don’t match the information chunks, answer no. (User Guide page 15)
10. Is the most important information the primary audience needs summarized in the first paragraph or section? The most important information must include the main message. A section is a block of text between headings. For a Web material, the first section must be fully visible without scrolling. (User Guide page 17)
11. Does the material explain what authoritative sources, such as subject matter experts and agency spokespersons, know and don’t know about the topic? If the material addresses both, answer yes. If the material addresses only one (what is known or not known), answer no. (User Guide page 18)

Part B: Behavioral Recommendations

Does the material include one or more behavioral recommendations for the primary audience? If yes, score items 12-14. If no, mark them N/A and skip to Part C.

Guideline Description Rating Applies?
12. Does the material include one or more behavioral recommendations for the primary audience? If no, STOP here and don’t score Part B. (User Guide page 19)
13. Does the material explain why the behavioral recommendation(s) is important to the primary audience? If you offer only numbers to explain the importance of the behavioral recommendation with no other relevant information for the audience, answer no. (User Guide page 20)
14. Does the behavioral recommendation(s) include specific directions about how to perform the behavior? This may include step-by-step directions or a simple description (for example: Look for cereal with 100% daily value of folic acid). If the material includes information about when and how to contact a medical provider or health official, answer yes. If the material mentions when and how often to perform a behavior, answer yes. (User Guide page 21)

Part C: Numbers

Does the material include one or more numbers related to the topic? If yes, score items 15-17. If no, mark them N/A and skip to Part D.

Guideline Description Rating Applies?
15. Does the material always present numbers the primary audience uses? Many audiences find numbers distracting or confusing. Make sure the numbers in the material are both familiar and necessary to support or explain the main message statement. If not, delete them. Whole numbers are used by most audiences. The types of numbers used will vary for each audience. (User Guide page 22)
16. Does the material always explain what the numbers mean? For example, “The amount of meat recommended as part of a healthy meal is 3 to 4 ounces – it will look about the same size as a deck of cards.” (User Guide page 23)
17. Does the audience have to conduct mathematical calculations? Adding, subtracting, multiplying, and dividing involve calculations. Calculating a common denominator for the purposes of comparison is a mathematical calculation. Use the same denominator, even for absolute risk (example: 1 out of 3), throughout the material so that audiences don’t have to calculate. (User Guide page 24).

NOTE: for this item, Yes is scored 0 and No is scored 1.

Part D: Risk

Does the material present information, including numbers, about risk? If yes, score items 18-20 (Items 19 and 20 have a “not applicable” (NA) option). If no, skip to Calculate Score.

Guideline Description Rating Applies?
18. Does the material explain the nature of the risk? If the material states the threat or harm and how and why people may be affected, answer yes. If the material has only the threat or harm but no explanation, answer no. For example, if the material states there are 1,000 new cases of a contagious disease in Springfield, does it also state that people in Springfield may be more likely to get the disease, why they may be more likely, and how serious the threat of the disease is? (User Guide page 26)
19. Does the material address both the risks and benefits of the recommended behaviors? This includes actual risks and benefits and those perceived by your audience. If the material addresses only risks or only benefits, answer no. If no behavioral recommendation is presented, answer not applicable (NA). (User Guide page 27)
20. If the material uses numeric probability to describe risk, is the probability also explained with words or a visual? Examples of probability information in a risk message are numbers (such as 1 in 5 or 20%). If the material presents numeric risk and also uses text to explain the probability, answer yes. If the material presents numeric risk and also uses a visual to explain the probability, answer yes. If the material only presents numeric risk, answer no. If the material does not include this type of probability information, answer not applicable (NA). (User Guide page 28)

Score: your score out of available points: %

View this tool's repository and source code here.