Additional support, adjustments and relevant resources should be made available to help overcome any challenges participants may experience with understanding information, retaining it, weighing it up or communicating a decision.

Adjustments can be split into four key areas.

Language looks at the informational content. Media looks at the different ways of presenting information. Context looks at the place, people, time and interactions. Relevance looks at the contributions of people with lived experience.

Language

When considering language in research communication, whether spoken, written, signed or conveyed through other means, it is important to think about the content and how it supports understanding.

Key aspects to focus on include vocabulary, ease of processing and the purpose of the communication.

Vocabulary should be grounded in plain English, using concrete words that relate to the real world, things people can see, hear, taste or touch.

Words should be familiar and commonly used in everyday life, and ideally ones that can be visualised based on personal experience.

If technical terms or abstract concepts are unavoidable, it is important to support understanding by providing a glossary of difficult words, using pictures and photographs, and meeting face to face to explain meanings through various media such as images, drawings, gestures or mime.

Ease of understanding can be improved by using short sentences and presenting information in bite-sized chunks.

In face-to-face communication, using pauses can help, while in written materials, white space can break up content to aid focus.

Supporting materials such as pictures, colours, flashcards and other visual tools can enhance engagement.

It is also important to use language, whether written, spoken or signed, that resonates with and is meaningful to the intended audience.

Purpose should guide how language is used to support understanding of the project, help individuals retain information, consider the implications of taking part and communicate an informed decision.

Using accessible language aligned with these goals ensures that individuals are better supported to engage with the research process meaningfully.

Media

When planning communication about a research study, it is important to carefully consider the choice of media to ensure accessibility and understanding.

A variety of media can be used to support participants, including written text, demonstration and film, sign and gesture, objects, pictures and symbols, and supported conversation.

Written text should be tailored to support reading ability using clear formatting and design choices.

This includes selecting a sans serif font such as Arial MT in no less than 12-point size and using appropriate font and background colours, such as pale blue for better readability.

Highlighted headings and subheadings, increased line spacing, use of white space and the strategic use of colour to emphasise keywords all contribute to a more accessible document.

Difficult or technical terms can be highlighted and linked to glossaries or further explanations.

Information should be broken into manageable chunks using bullet points or numbered lists. And the mode of presentation, whether on paper, a digital document with scrolling or a PowerPoint presentation, should be chosen based on what is most suitable for the intended audience.

Pictures and symbols can enhance engagement and support comprehension.

The type of image used should be guided by what is familiar and effective for the study population.

The purpose of introducing images, whether to aid understanding, facilitate interaction or support written information, should be clear.

Effective images have clear outlines, appropriate colour, borders to help focus attention, and are consistently positioned, for example, to the left of the corresponding text.

Consider whether colour or black and white, photos or line drawings are more effective, and how the images will be used, for example, in documents, flashcards or communication tools.

Demonstration and film can make the study more tangible.

This can be done in person through role play or demonstrations, or via pre-recorded media such as DVDs or web-based videos that participants can view at their own pace.

Sign and gesture play an important role in accessible communication.

Manual signing and natural gestures may be the preferred mode of communication for some individuals, and they can also be used to reinforce spoken language and improve understanding.

Objects related to the study can be powerful tools to anchor abstract concepts in reality.

Showing or using relevant items such as a video camera or audio recorder can help illustrate what participation involves, allowing the individual to explore and interact with key components of the study.

Supported conversation combines these methods to facilitate understanding.

This involves using tools like picture flashcards and objects during discussion, breaking information into chunks, pausing regularly to check comprehension, and checking back to confirm understanding.

By using multiple media thoughtfully and interactively, researchers can better support participants in understanding the study and making informed decisions about their involvement.

Context

The context in which study information is shared plays a vital role in supporting a person's understanding and engagement.

This includes careful consideration of both time and familiarity, which can significantly influence how information is received and processed.

Time should be used flexibly to accommodate the individual's needs and daily routine.

Appointments should fit within the person's existing schedule, and they should be given as much time as they need to review the study information at their own pace.

It is also important to offer repeated opportunities to revisit the information, allowing the individual to reflect and ask questions over time as needed.

Familiarity is another crucial factor.

Sharing study information in a familiar place and in the presence of known and trusted people can help the person feel more at ease and supported.

Familiar individuals can also assist communication by offering subtle prompts or clarifications that aid understanding.

However, researchers must also be mindful that the presence of a familiar person could sometimes inhibit or constrain the individual's natural expression.

Ultimately, it is the individual's choice whether and how a familiar person is involved, and this should be discussed and agreed upon when arranging how and when study information will be shared.

Relevance

Ensuring the relevance of study materials to the target population is essential, and this is best achieved by involving people with lived experience in their preparation.

This involvement can take the form of collaboration, where there are opportunities for joint development, feedback and response on certain aspects of the study, or co-production, where people with lived experience work in partnership with researchers throughout all stages or phases of the study.

Both collaboration and co-production emphasise the active participation of people with lived experience in designing and creating study materials.

While collaboration typically relates to input on some elements, co-production reflects a deeper level of involvement across the entire research process.

Participants in these processes may be invited to contribute to the study design and methods, review and comment on materials and procedures, devise recruitment materials, consider how information should be presented and provide endorsement of the final study materials.

Effective collaboration and co-production require deliberate planning, including the allocation of time and personnel to support working group activities.

It is important to provide repeated opportunities for participants to build relationships with each other and the research team.

Communication should be adapted to facilitate active involvement using different resources, such as audio files for repeated presentations or communication cards.

Additionally, there should be opportunities to recap study information and related tasks to ensure understanding and meaningful participation.