Helen: Welcome to Health Literacy Out Loud. I’m Helen Osborne, president of Health Literacy Consulting, founder of Health Literacy Month, and your host of Health Literacy Out Loud.

In these podcasts, you get to listen in on my conversations with some truly remarkable people. You will hear what health literacy is, why it matters, and ways we all can help improve health understanding.

Today I’m talking with Dr. Karen Jacobs, who is an occupational therapist and a certified ergonomist. Her list of professional accomplishments is long and prestigious. It includes being a professor and program director at Boston University, editing and authoring numerous books and journals, and serving as the president of the American Occupational Therapy Association.

A primary focus of Dr. Jacobs’s research is about ergonomics, specifically how using notebook computers, iPads, backpacks and other technology affects students of all ages. Ergonomics matters to professionals too.

Welcome, Karen.

Karen: Hi. Thank you.

Helen: You and I are both occupational therapists. We have known each other for many years, but obviously our work has taken us in different directions. Do tell. What is ergonomics?

Karen: Ergonomics is a word that we see on diapers, tennis rackets and gardening tools. The public probably has seen the word but may not know what it means. I’m happy you asked me to define it.

It is looking at the workplace, tools, equipment and environment, and helping to design those items so that they fit the person rather than someone going into a workplace and using it the way it’s set up.

Helen: Is this tailored to the individual?

Karen: It can be to individuals and to populations of people. There are different aspects of ergonomics. There’s rehab and healthcare ergonomics, but what we’ll talk about is just ergonomics in general.

Helen: I am curious about this. Quite a while ago I did a podcast on universal design so that our environment fits everybody. Is that the same?

Karen: It has some of the features of that, but it’s really looking at ergonomics for one in some regard where we’re making sure that it fits the individual person as well.

We are looking at ergonomics for a larger population as well. We see products that have been designed for various different populations. It could be cooking items.

Helen: I know the whole wall where I go get my kitchen gizmos is just filled with big foam-type handles on tools and things. Is that ergonomics?

Karen: It depends. There’s no Good Housekeeping seal of approval when someone puts the word “ergonomic” on a product. That’s really important for your listeners to remember. Just because a product says ergonomics, it doesn’t necessarily mean that there’s someone who has checked that it is.

What I tell people to do is when you’re looking for a product, say it’s a chair or one of those cooking items we’re talking about, try it to see if it works for you. See how you feel. Try to work in comfort. That’s the key. There are a lot of products that say ergonomics on them, but they may not be a good match for you.

Helen: I know you and I know this, but I just want to make this relevant for everybody who’s listening in on this conversation. This isn’t about health literacy, per se, and how we communicate. It’s really about us as communicators taking care of ourselves. Is that why ergonomics matters?

Karen: It is very important. I think health communicators are a group of people who really need to apply what they are sharing with other people to themselves. I’m going to share some strategies to help them stay healthy. Many health communicators use technology.

Helen: We all do, Karen.

Karen: You and I in particular love our technology.

Helen: Are we talking about our computers or mobile devices? What kind of gizmos are we talking about?

Karen: We’re talking about our computers, mobile devices, like our smartphones, and tablets. That might be an iPad. We’re talking about all the technology that we use. A lot of times when we’re using this kind of technology, we’re in static postures. That’s not great.

Helen: What does “static postures” mean?

Karen: It’s just staying in one place and not moving very much.

Helen: When I write, sometimes I’m so involved in what I’m writing I don’t even blink. I forget about moving.

Karen: Absolutely. I’m glad you asked me to define static, because I know our health communicators are probably saying, “She’s not using the language to make it clear.” Thank you so much.

Helen: I’m going to get you on that.

Karen: One of the first things that I tell people when they’re using any kind of technology is to work in comfort and vary your postures often. What I mean by postures is how you’re sitting and holding the mobile phone, iPad, tablet or computer.

You need to change your postures. I like to have people move every 20 minutes or so. I actually call it the 20-20-20 rule when we’re on a computer. I’ll share that with you. Take a rest break every 20 minutes for 20 seconds and look about 20 feet away from the monitor.

That’s something that I tell people to do when they’re using their tablets, like an iPad, or when they’re sitting in front of a computer. That break is really important to refresh.

What do I mean by that? Sitting back in your chair is not the break I’m talking about. Get up out of your chair, walk around, pet the dog, and get a glass of water.

Helen: Karen, I tried this. I actually have a lot of aches and pains all over. I think we all do the more we do this work. I was writing my book. It was very intense, focused work. A physical therapist told me what you’re telling me. “Stop and take a break.” My concentration was so enmeshed in what I was writing that I found it disruptive.

Karen: I’m sure people will say that. People who are on the computer feel like, “I have to respond right away. I have to stay in the zone.” You’ll stay more productive taking these breaks. You’ll feel refreshed as well.

I tell people when they’re writing to have a little tape recorder there. Record that last thing you have to get down before taking your break.

Many of our smartphones have these little recorders built in. If you don’t have one, they’re very inexpensive to purchase. I keep that. That’s a way that I take my break from the computer but not lose my train of thought.

The other thing is many people can’t take a break because they lose track of time. Another strategy that I tell people to do is to put a little timer on your phone that beeps every 20 minutes so that you take a break.

Maybe you don’t have a smartphone, but you have a computer that you’re working on. There is free software out there that will pop up to say, “Take a break.”

In fact, there’s one that I helped design for children that anybody can use. It’s called Stretch Break for Kids. We’re all kids. We’re children of all ages.

Helen: Is this a website or an app?

Karen: It’s actually a software program that you can download at my blog, which is http: //Blogs.BU.edu/kjacobs/. You can go onto my blog and download it free of charge.

I want to tell a little bit more about Stretch Break for Kids. It’s easy to put on your computer. It will pop up every 20 minutes. You can set it for a different time. If you say, “Oh my god! I want to take a break but 20 minutes is just not realistic,” you can set it for 30 or 45.

It will pop up and go through some easy-to-do stretches. It also has ergonomic tips. The stretches are with some nice, relaxing yoga music, so it takes you away.

I do want to note that anybody who has any kind of problems should probably consult with a doctor before installing or starting an exercise program, but Stretch Break for Kids is great.

On my blog, I also have a lot of free tip sheets. People can download them. It tells you how to set up your notebook computer. It talks about lighting. I have one on luggage and purses because that’s all about ergonomics too.

Helen: I was just wondering about that. I know you’ve done a lot on backpacks.

Karen: Yes, we have that as well.

Helen: It’s all the things that we carry too. I know I run around airports a lot. Even though I’ve downsized some of my devices, sometimes I still have to take my bigger laptop with me. That starts to weigh me down.

Karen: It’s heavy. A backpack may be good for you, but you might be using some kind of a wheeled luggage case to go around the airport. I actually love having my computer and carry-on in a suitcase that fits in the overhead compartment that has wheels that go around in a circle. That would be 360 degrees.

That’s really important because when we’re walking in the airport, we know that it can be a long distance that we have to walk. This wheeled suitcase has a handle. I can have it in front of me, behind me and beside me. It’s really helpful with walking as well.

Helen: That’s really helpful.

Karen: It’s an ergonomic strategy that we just applied.

I want to mention the purse. You went by that very quickly. I haven’t noticed how heavy your purse is.

Helen: I don’t like wearing purses at all. That’s probably why I skipped over that whole issue. Tell us about pocketbooks. A lot of people use them.

Karen: Pocketbooks can be extremely heavy. What I tell people to do is go in your purse and take out what you don’t need. Do you really need keys for everything, or could you just have the two keys that you need daily and keep that other set somewhere else and retrieve it when you need it?

Do you really need to have that much makeup in your purse? Do you really need to have all those cards in your wallet that weigh it down, or all the change in your purse?

You can lighten up your purse. A lot of times people will say, “My shoulders hurt me.” When we talk about what it is, it’s that purse on one shoulder that’s really weighing you down. That’s another application of ergonomics.

Helen: It’s interesting, Karen. As I’m listening to you, I can hear the individuality in there. For me, writing, concentrating and focusing on what I’m doing is most important. To have to be interrupted every 20 minutes is really not what I want to be doing, even though you tell me it’s the right thing to do.

I carry a tiny pocketbook, so that’s not an issue for me, but somebody else might say, “I need all that makeup. I need everything that’s in there.” I can see the individuality in there.

What happens when someone is in a workplace setting where they don’t have a lot of flexibility?

Karen: We all have flexibility in the sense of how we behave with our technology, but we can set up our computer workstations so that we are comfortable and change our postures often. Perhaps what we could do is talk about some strategies for setting up your computer workstation.

Helen: I’m sure listeners want to hear that, and so do I.

Karen: That’s really important. The strategies I’m going to give are ones that you can use for your desktop and notebook computers.

Let me start with the notebook computer. Notebook computers were not designed for everyday use.

Helen: By notebook, do you mean a laptop or more like an iPad?

Karen: I call a laptop a notebook because laptop makes you think, “It’s going to sit in my lap.” That’s not necessarily where your portable computer should be. The desktop computer is one that’s sitting on your desk. You wouldn’t pack it up and take it home with you. The notebook computer or laptop is one that’s more portable.

If you picture yourself sitting in front of your notebook computer, you’re going to see that most of the time you’re looking down at the screen.

I’m going to guess that your listeners are probably rubbing their shoulders right now saying, “She’s right. My back and shoulders are hurting me. Maybe it’s because I’m looking down at the monitor.”

One of the first things I tell people to do with their desktop and notebook computers is to raise the screen so that it’s at eye level. With a notebook computer, that can be problematic because when I raise it up, it puts the keyboard at a very strange position.

We need to make our computer into what we call a CPU and get a keyboard that we use instead of the keyboard that’s on our notebook computer.

Helen: Do you mean just get a separate keyboard?

Karen: Yes. The way for us to make the computer fit us rather than us going into awkward postures to use the computer will require these external accessories. These are just add-ons to what we would use with our computer. They’re not expensive.

Helen: That’s really helpful to you know. There’s a colleague of mine who uses her laptop all the time, and she is always rubbing her neck. In fact, she looks very hunched over. I’m really concerned about her. I know more and more people are using these lighter weight devices, like laptops. I can see this is a growing problem.

Karen: It is, and it’s a problem that can be solved. That’s the good news. They are such simple steps. I have all these tips on my blog, but I want to continue with what people need to do.

Having that keyboard is not enough. You need to have some kind of input device besides the keyboard. A mouse is a good one. Now we have a keyboard and a mouse. We’ve raised our notebook computer.

You could raise your notebook computer on anything, like some old yellow pages or books that you don’t need, or you could buy a notebook riser. I actually have a very lightweight notebook riser that I keep in my backpack with a small keyboard and a mouse. All of that is very portable. It is not weighing down my computer because I’ve selected items that are lightweight.

Helen: Furthermore, you use the wheelie when you’re carrying it.

Karen: I do. I like wheeled backpacks. I have a backpack that goes on my back, but I’m very careful to pack it correctly so that it doesn’t provide me with any discomfort.

Helen: I use a regular old bag and put it on one shoulder. What do you think of that?

Karen: You said you don’t use a purse, but if that’s heavy you’re going to have the same results as carrying a heavy purse.

Helen: I just use it for travel.

Karen: I would suggest alternating shoulders and tearing down what you have in there. Get rid of anything you don’t need.

There are a couple more things I want to talk about with the computer. We’ve raised the screen so that it’s approximately at eye level. If we have a notebook computer, we have an external keyboard and mouse.

How far away you keep your computer monitor is important. I always tell people to make sure that it’s directly in front of you and about an arm’s length away with a closed fist. Make sure whenever you’re working on a computer that you’re perpendicular, or 90 degrees, to a window so that you’re avoiding glare on the screen.

Glare makes us go into awkward postures. You mentioned your friend who sits in this awkward forward posture. We call that turtling.

Helen: That’s what she looks like.

Karen: We want her to not be a turtle because that’s not a comfortable way of accomplishing the job that she’s trying to do.

Throughout the day, changing your posture is really important. We always tell people to sit up straight in your chair, or actually lean back a little bit in your chair. That’s a more comfortable way of working.

Sometimes if you really want to make sure that the work environment fits you, you may want to consider getting a sit-stand desk. What I mean by that is you can have the desk go up so that you can stand and work, or you can have the desk at a regular height that we typically have so that you can sit.

That’s what I encourage people to use when they’re on computers for a lot of time during the day.

Helen: Most of us are. Thank you, Karen. This is a wealth of great ideas. I would imagine you have no shortage of work out there as our society has more devices and all kinds of ways of doing this.

I’m just curious. For all the work you do in ergonomics and occupational therapy, what about this keeps you up at night and worries you?

Karen: What worries me is that people are not paying attention to what their bodies are telling them. Your friend is a perfect example. You might have seen her rubbing her shoulders, but she still stayed in that awkward position.

Helen: Even after I told her. I said, “Suzanne, that looks like that hurts. I worry about you.” She sat up for a moment, and then went right back to doing it.

Karen: I think what we have to do is listen to our bodies. When your body tells you that you’re uncomfortable, change your position and what you’re doing.

That’s really important because we can be the masters of our own fate of staying healthy if we practice some of these very easy ergonomic strategies. If unfortunately you already have discomfort or pain, or it has led to a disability, you can contact an occupational therapist to help you.

Helen: You got that in, Karen.

From one occupational therapist to another, thank you so much for bringing this to our attention and making it clear why we who communicate health information also need to take care of our own health and bodies.

I just want to thank you for this, Karen. When we’re done, I’m going to take off my headset and microphone, turn off the computer and do a good stretch.

Karen: Absolutely. I’m going to do the same. Helen, thank you for having me on your podcast today. It was a pleasure.

Helen: It was a delight. Thank you, Karen.

I learned a lot from Karen Jacobs, and I hope that you did too, but health literacy isn’t always easy. For help clearly communicating your health message, please visit my health literacy consulting website at www.HealthLiteracy.com. While you are there, feel free to sign up for the free monthly e-newsletter, “What’s New in Health Literacy Consulting?”

New Health Literacy Out Loud podcasts come out every few weeks. Subscribe for free to hear them all. You can find us on iTunes, on the mobile app Stitcher Radio, and on the Health Literacy Out Loud website, www.HealthLiteracyOutLoud.com.

Did you like this podcast? Did you learn something new? Will you put into place some of what you heard from Karen Jacobs? I sure hope so. If so, tell your colleagues and friends. Together, let’s let the whole world know why health literacy matters. Until next time, I’m Helen Osborne.