) has identified patterns of behavior and effective practices related to how lower literacy users interact with health-related Internet sites. However, prior research has not addressed how such users react to the unique challenges represented by interactive medical forms on health sites, such as interactive health quizzes, questionnaires, and registration forms. The goal of this four-month study was twofold: 1) to identify reading, writing, and navigational strategies of users with lower literacy skills when interacting with web-based forms in a medical context; 2) to develop design principles for making such web-based medical forms usable and accessible for lower-literacy adults. Eyetracking was used to gather data about how users interacted with a variety of web-based forms. Analysis of sessions with 26 low-literacy users (REALM score < 60) identified a variety of challenges users faced in completing forms. Based on these observations, proposed principles of effective form design were developed. Revised prototype forms were designed in accordance with these principles and iteratively tested with 14 users to verify improved usability. BACKGROUND

Electronic voting interfaces present particular challenges for voters with low literacy. Research has found that individuals with low literacy typically encounter problems in electronic interfaces related to their tendencies to read every word, act on every word, interpret words literally, skip text, become distracted, and stop reading too soon. Based on a growing body of research about the experiences of low-literacy voters in electronic interfaces, this paper presents eleven principles to address these challenges. It also translates those principles into specific best practice recommendations related to language, navigation, visual design, and interaction in electronic voting interfaces.

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