Patient education videos: plain language and captioning for accessibility

Some days a single toggle changes everything. I still remember watching a short diabetes explainer without captions on the train—muffled audio, medical jargon, and a distracted mind. I turned on captions later at home, trimmed the jargon in my own notes, and the message finally clicked. That tiny moment keeps nudging me: if a video is worth making, it’s worth making understandable and accessible. Today I’m writing down the practical ways I’m weaving plain language and captions into patient education videos, along with what I’ve learned from credible guidance and real-world trial and error.

The moment clarity beats production value

I used to fuss over animations and background music before double-checking whether the message landed. These days, I flip the order. I focus on the few sentences the listener must walk away with, then build the visuals to serve those lines. When I do this, something quiet and powerful happens: people watch longer, they replay the hard parts, and they share the link with a family member. In health communication, clarity outruns polish.

• Start every script with one-sentence purpose: “By the end, you’ll know how to check your inhaler technique.”
• Swap specialized terms for everyday equivalents, and explain any essential medical words once in plain English. A helpful primer on plain language lives at the CDC Plain Language page.
• Plan for accessibility from the outset—player controls, captions, and transcripts are easier to get right when baked in. The federal Section 508 site has a step-by-step on synchronized media and caption-friendly planning here and here.

Plain words that land closer to real life

When I get stuck, I imagine explaining the topic to a friend on a walk. If the sentence feels heavy in my mouth, it’s probably heavy on screen. I also borrow checklists from research-based tools (like the CDC’s Clear Communication Index) to test whether my script does the basics well: state the main message upfront, use active voice, and organize information so the next step is obvious. You can skim the Index overview here.

• Lead with the need. “If your child has a fever, these are the three things to check.”
• Chunk the path. Break instructions into 3–5 short steps. Pair each step with a simple visual.
• Show and tell. Demonstrate the action while the caption states the step in everyday words.
• Cut the hedge words. Swap “in order to,” “utilize,” and “commence” for “to,” “use,” and “start.”

Captions, transcripts, and audio descriptions are not extras

Captions are how many people actually “hear” your video. They support Deaf and hard-of-hearing viewers, folks in noisy places (or quiet ones like night feeds), second-language learners, and anyone who would rather read than listen. Accessibility standards frame this clearly: provide captions for prerecorded video, provide captions for live video when feasible, and add audio description or an alternative for essential visuals that aren’t conveyed by sound. The Web Content Accessibility Guidelines (WCAG) spell out these expectations—see the WCAG 2.2 overview here and the “Captions (Prerecorded)” explainer here.

• Write real captions. Include spoken words, speakers’ names (when needed), and meaningful sounds (“[inhaler clicks],” “[alarm beeps]”).
• Don’t rely on auto-captions alone. Machine captions miss medical terms and accents; always review and correct.
• Add a transcript. Besides accessibility, transcripts help with search and note-taking and allow quick scanning before committing to watch.
• Think about audio description early. If critical content is visual (like a rash pattern or injection angle), narrate it in the main audio or plan a described version.

For U.S. public-sector teams (and many contractors), accessible design isn’t just considerate—it’s required. Section 508 points to technical standards for accessible ICT, and recent policy updates underscore the expectation that web and mobile content meet recognized accessibility benchmarks. If you work for a state or local government, the Department of Justice finalized an ADA Title II rule in 2024 that sets specific web and app accessibility requirements—details are summarized here. I’m not a lawyer, but the practical takeaway is straightforward: plan for captions and accessible players from day one.

A simple, repeatable script-to-caption workflow

My workflow only has four moving parts now, and it’s been kinder to my schedule:

• Draft the spine. One-page script with the main message, three key points, and the “do next” line.
• Storyframe the visuals. For each sentence, note the supporting shot or graphic, and the on-screen text (kept short).
• Export and caption. Record, then generate captions (.srt or .vtt). Edit for accuracy, speaker labels, and non-speech cues.
• Player and QA. Use a player with keyboard controls and visible caption toggle. Do a quick WCAG-oriented check before publishing.

Two things help me stay honest with quality: a short viewer test (ask one colleague and one patient advisor to watch with captions on) and a lightweight scoring pass using the CDC Index (it nudges me to put the action step in plain view). I keep links to the Index and the federal 508 “synchronized media” guidance on my template so I don’t have to hunt them down mid-edit.

Micro-choices that add up fast

Not every improvement requires a new budget. These are tiny habits that move the needle on comprehension and engagement:

• Design for reading speed. Keep each caption segment short enough to read comfortably. Split long sentences across multiple caption frames.
• Avoid text baked into the video. On-screen labels as live text are easier to read and translate; otherwise, viewers are stuck with whatever’s rendered.
• Use contrast and quiet backgrounds. Busy footage competes with captions; a simple backdrop helps the message breathe.
• Name acronyms once. “Chronic obstructive pulmonary disease (COPD)” the first time, then use “COPD.”
• Keep numbers friendly. Round when clinically safe and show the “so what” (e.g., “Check your blood pressure at the same time each day”).
• Segment by decisions. Organize videos around choices patients actually face (“pill vs. inhaler,” “clinic visit vs. telehealth follow-up”).

Short frameworks I use to cut through the noise

I find simple, repeatable patterns more helpful than long style guides. These two cover most of my needs:

• Message–Action–Why. Start with the message (“Use your spacer every time”), show the action, explain why it matters in one plain sentence.
• Show–Say–Support. Show the behavior, say the step in plain words via captions, support with a quick tip or caution (“If you hear a whistle, your breathing is too fast”).

When I want to sanity-check a draft beyond my own taste, I glance at an official playbook. The CDC’s Clear Communication Index is research-based and practical; it asks if the main message is obvious, if numbers are explained, and if the call to action is doable. You can explore the user guide here.

Building for different brains and senses

Accessibility is broader than hearing. WCAG 2.2 adds criteria that help with attention, memory load, and touch targets. I don’t memorize the entire standard; I anchor on a few questions during editing:

• Can I operate the player without a mouse? Keyboard access and visible focus indicators matter.
• Is the tap target big enough on mobile? Fiddly buttons are frustrating for everyone, not just folks with motor differences.
• Is timing adjustable? Give viewers control to pause, rewind, and replay tricky steps.
• Are headings and labels clear? Labels like “Start” and “Next step” beat clever phrasing when health decisions are at stake.

If you’re new to the standards world, this gentle overview of what changed in WCAG 2.2 is a helpful doorway from WAI.

A tiny usability lab you can run tomorrow

Nothing beats watching someone use your video. I keep it simple—two to three people, one short video, 15 minutes. I ask them to turn captions on, explain the main point back to me, and show me which part they would replay. My notes focus on friction: where they paused, which terms tripped them up, and whether they knew what to do next.

• Invite one person with lived experience of the condition if possible.
• Try one run with audio muted (caption-only) and one with audio on. Both should make sense.
• Capture the exact phrases they use—that’s your plain language draft for the next edit.

Quick resources I keep on my bookmark bar

• CDC Plain Language
• CDC Clear Communication Index
• Section 508 Synchronized Media
• WCAG 2.2 Guidelines
• DOJ ADA Title II Web/App Rule (2024)

Signals that tell me to slow down and double-check

I’ve learned to pause when any of these show up:

• Jargon creep. If a sentence needs a glossary, I rewrite it.
• Auto-captions untouched. If no human has reviewed the captions, I fix that before publishing.
• Missing alternative. If key info is only visual, I add narration or description.
• Player friction. If I can’t tab to the play/pause and caption toggle, I escalate a fix.
• Legal questions. If the video is for a public entity or a regulated program, I ask our accessibility lead or legal team to review alignment with current rules.

My compact pre-publish checklist

• Main message appears in the first 20–30 seconds in plain language.
• Captions reviewed for accuracy, speaker labels, and meaningful sounds.
• Transcript posted alongside the video in an accessible format.
• Player supports keyboard access and a visible caption toggle.
• Numbers and terms are explained with everyday words.
• Final pass using a research-based checklist like the CDC Index.

What I’m keeping and what I’m letting go

I’m keeping the discipline of “message first,” the habit of writing captions as part of the script, and the humility of user-testing with two or three real people. I’m letting go of ornate narration, clever-but-unclear metaphors, and the idea that accessibility is a later add-on. If you’re starting fresh, borrow the official guides wisely: use CDC’s plain language tips to draft, WCAG to check your player and media alternatives, and Section 508 resources to plan captions and transcripts without drama.

FAQ

1) Are auto-captions good enough?
Auto-captions are a starting point, not a finish line. Always review and correct medical terms, speaker labels, and non-speech cues. For planning guidance and good practices, see the federal synchronized media tips here.

2) What’s the difference between subtitles and captions?
Subtitles usually reflect speech for people who can hear the audio; captions include speech and meaningful sounds, and often identify speakers—this is what improves accessibility. The WCAG “Captions (Prerecorded)” explainer has a concise overview here.

3) Do I need audio descriptions for every video?
Not always. If critical information is purely visual and not in the audio, add description (either built into the narration or as an alternate track). WCAG and organizational policy (e.g., Section 508) can help you decide what’s appropriate.

4) How can I write in plain language without oversimplifying?
Keep the facts, simplify the words. Lead with the action the viewer can take, use everyday terms, and define essential medical words once. The CDC’s plain language resources include practical examples you can adapt here.

5) We’re a small team—what’s the lowest-effort improvement we can ship this week?
Post a reviewed caption file and a clean transcript for your top video, and add a brief on-screen summary slide with the “do next” step. Then schedule a 15-minute caption-only user test with two people and refine.

Sources & References

• CDC — Plain Language
• CDC — Clear Communication Index
• W3C — WCAG 2.2
• HHS — Section 508 Synchronized Media
• DOJ — ADA Title II Web/App Rule (2024)

This blog is a personal journal and for general information only. It is not a substitute for professional medical advice, diagnosis, or treatment, and it does not create a doctor–patient relationship. Always seek the advice of a licensed clinician for questions about your health. If you may be experiencing an emergency, call your local emergency number immediately (e.g., 911 [US], 119).