How Polly Combats Low Health Literacy With Humor and Technology

HowA challenge for public health educators and behavior change experts is helping people who have low levels of health literacy. These people may have difficulty with written communication, understanding medication instructions, or how to care for a chronic condition. Low health literacy is incredibly common, with some groups estimating that as many as 88% of American adults struggle with some aspect of health literacy.

An app called Polly (developed at Carnegie Mellon) has a clever solution for helping people with low health literacy learn health tips or other useful information in a fun and friendly way. It’s a game, and it’s been used in countries like India, Guinea, and Pakistan to reach populations without reliable access to information. The way it works is that you can speak into the app and choose a voice distortion (such as making your voice deeper or higher), then send your message to a friend’s mobile number. The friend can listen to your funny message, then hears information about public health interventions or job listings.

There are three ways this app overcomes barriers related to low health literacy:

  1. It uses the audio channel, so reading skills are not required. Although health literacy and general literacy are not the same thing, they often overlap. If someone’s health literacy issues stem directly from difficulty reading, then reducing the need to read can help improve comprehension of health information.
  2. It leverages social relationships to spread messages. Word of mouth is a powerful tool. People are more receptive to information that comes from a trusted source.  Researchers like Nicholas Christakis and colleagues have shown that social influence travels quickly and meaningfully through multiple degrees of connection. Polly takes advantage of this mechanism to spread education.
  3. It creates a sense of relevance by yoking the helpful message to a relevant one. We want to hear the distorted message from our friend, which was uniquely created for us, is probably interesting and entertaining, and reminds us of a positive relationship. Not only is the recipient likely in a good mood and receptive to information by the time the educational piece comes up, but the sense that the message is personal can help relate the information to oneself: This is a tip I should try.

Finally, it’s worth noting that mobile remains a powerful way to reach people in some areas of the world where Internet accessibility remains spotty. The fact that Polly is a phone-based program no doubt enhances its reach in the developing world.