Bonnie Butler: Welcome to Creating Accessible Content: A Conversation with Public Health Professionals. The hosting organizations are the Midwestern Public Health Training Center, the Iowa Prevention Research Center, and the Iowa Public Health Association. We want to thank Easterseals Iowa for their guidance on the content, and I encourage you to check out all of the accessibility information and trainings that are on their website.

I'm Bonnie Butler. I'm with the Midwestern Public Health Training Center at the University of Iowa College of Public Health. And I want to disclose that, while I am the presenter, I'm not an expert in accessibility, but our team did work with subject matter experts to create this presentation. If you have questions we can't answer today, we'll do our best to follow up with any answers or resources after the webinar.

First, I'm going to provide a quick overview of some of the accessibility topics. I'm going to summarize some of the slides to allow time for our panelists, but we'll share the slides afterwards as I mentioned.

So, I imagine this is the reason most of you have joined today. After a recent extension to the original deadline, all state and local government entities must meet Web Content Accessibility Guidelines or WCAG 2.1 Level AA standards by April 26th, 2027 for entities with a total population of 50,000 or more and by April 26th, 2028 for entities with a total population of less than 50,000.

What prompted this requirement? Accessibility isn't just a best practice. It's supported by federal laws such as the Americans with Disabilities Act or ADA, which requires reasonable accommodations to ensure equal access, and the Rehabilitation Act of 1973. Within that act, there's Section 504 which applies to organizations that receive federal funding and it prohibits discrimination based on disability. Section 508 is especially relevant to today's webinar because it focuses on digital accessibility. It requires websites, documents, and other digital materials to be accessible. 

So several standards help organizations meet those accessibility requirements. On the screen is an image highlighting the key points of the POUR principles: Perceivable, Operable, Understandable, and Robust, which we will look at in the next slide. These provide the foundation for understanding what makes content accessible. Web Content Accessibility Guidelines, WCAG, is the primary standard for digital accessibility and is the most commonly used accessibility standard. Section 508 and ADA requirements support implementation of these standards. So the POUR principles. Most accessibility guidance can be traced back to these four principles. P is for Perceivable. Can the users identify the content through one or more senses? If an image contains important information, users who cannot see it need an alternative way to access that information. O: Operable. Can users navigate and interact with the content? For example, some users navigate entirely with a keyboard rather than a mouse. Understandable: Can users understand both the content and how to navigate it? We should always use clear language and consistent formatting to avoid ac-- and avoid acronyms and jargon. And finally, R: Robust. Will the content work with different technologies, including assistive technologies, which we'll talk more about later? Good accessibility practices help ensure that content remains usable across all platforms and devices.

Accessibility Overview. So, language preferences may be something that you're already familiar with. They can vary across individuals and communities. Person-first language recognizes that a disability is only one aspect of a person's identity. Some communities, such as many deaf and disability advocates, prefer identity-first language because disability is viewed as an important part of their identity and culture. There's no single preference that applies to everyone. So, when possible, ask individuals how they prefer to be identified. And if their preference is unknown, the Department of Health and Human Services recommends using person-first language.

Accessibility is not a one-time task. It's an ongoing process of improving content and removing barriers because people access information in many different ways. Digital accessibility is about ensuring that everyone has an equal access to digital information by designing the content so that everyone can use it. For example, users may rely on screen readers, captions, keyboard navigation, or plain language. But accessibility isn't just about visual, hearing, or mobility disabilities. It also includes making information understandable. Using a 6th to 8th grade reading level can improve accessibility for many audience, including people with cognitive disabilities and those whose primary language is not English.

Assistive technology or AT is anything that helps a person perform a task more easily or independently. AT helps people access information, communicate, learn, and participate in daily life. For today's discussion, we're especially interested in assistive technologies that are used to access digital information because accessible content works better with AT and reaches a wider audience. When we create accessible content, we're helping ensure that assistive technologies can accurately communicate the information to the users. Examples include screen readers, screen magnifiers, speech-to-text software, captions, and alternative keyboards. Screen readers are assistive technologies that convert digital content into speech or braille. One important thing to understand is that screen readers don't read what we visually see on the screen. They rely on the underlying structure of a web page or document such as headings, alt text, descriptive links, and reading order. This is why proper formatting is so important. As we go through the rest of today's examples, keep screen readers in mind. Many accessibility practices are designed to help assistive technologies accurately interpret content.

Clear language. We need to use clear language. As we mentioned earlier, a good rule of thumb is to aim for a 6th to 8th grade reading level. This doesn't mean dumbing down the information. It just means communicating it clearly. Accessibility isn't only about technology. It's also about how we write. Even perfectly accessible websites can be difficult to use if the content is overly complex.Plain language helps nearly everyone, not just people with disabilities. Again, a 6th to 8th grade reading level is ideal. A few reading level tools are Hemingway Editor, Readability Formulas, and Microsoft Word Readability and Level Statistics. These tools are helpful, but they're not perfect. So technical terms, acronyms, and defined words can sometimes increase the reported reading level, even when the content is understandable. So use readability tools as a guide rather than as a strict rule. Consider both the reading level score and whether the content is clear for your intended audience.

Accessibility checkers are a quick way to identify common accessibility issues before you share your content. They're most effective when used throughout the creation process rather than only at the end. And this is really important for everybody in your organization who's creating any kind of content to know. It's going to take everybody knowing about these practices and being familiar with them to be effective. Accessibility checkers can help identify missing alt text, heading issues, reading order problems, and other common errors. Many Microsoft products include built-in accessibility checkers, which we'll look at later.  Other commonly-used accessibility checkers are Editoria11y, AccessiBe, and SiteImprove. Iowa HHS provides step-by-step instructions for working with Editoria11y Accessibility Checker on their website. So remember that these tools are helpful, but they should not replace human review. So, we'll look at ways to use these accessibility checkers.

Alternative text or alt text is a brief description of an image or other non-text content. Images can communicate a lot of information very quickly. We often say, "A picture is worth a thousand words," but if an image doesn't have alt text, a screen reader user may miss critically-important information entirely. However, not every image does require alt text. If an image is purely decorative or the information is already provided in the text, it can be marked as decorative. When sharing charts and graphs, don't just describe that a chart exists. Describe the information the chart is intended to communicate. So, also you want to consider the context when you're creating alt text.

Let's look at some examples for this image of a parking lot, and imagine that you're creating a post related to accessible parking. So, your first option for alt text could be, "Parking lot of a shopping center with cars and a shopping cart return." This example gives you a general description of the picture, but a better option would be option two: "Parking lot outside a shopping center. The cart return is positioned on and blocking the access aisle between two accessible parking spaces." This example creates a better understanding of the picture as it relates to the topic of accessibility.

Autogenerated alt text is available but it is limiting, so you want to be very careful when using it. So, while we might describe this image as "Woman with eyes wide open, eyebrows raised, and her mouth hanging partly open," which gives the user who can't see the image the same chance as a user who can see to decide what the image means, an autogenerated alt text might describe the image as, "Woman with surprised look on her face as a Labrador Retriever puppy pops out of a present box," which adds information that is not relevant or correct. So, always use caution when you're using autogenerated alt text.

Next, descriptive links. Descriptive links tell users where the link will take them or what action it performs. Descriptive links are especially helpful for screen reader users, people with cognitive disabilities, and users navigating by keyboard. They also allow screen reader users to generate a list of links on a page, but descriptive links improve usability for everyone since many users scan the links rather than reading an entire document or page. Remember to be descriptive and concise and to avoid vague text such as, "Click here," "Read more," or "Learn more," as the user has no idea where those links lead.

Let's compare these examples of descriptive links. First, "Click here to view the annual report," versus "View the 2025 Annual Report." The second option is best because the link destination is clear and specific. Example 2: "Click here to contact us" or "Contact us." The second option is actually best because the purpose of the link is immediately obvious. Example 3: "Read more," provides no context when a screen reader user navigates through a list of links, but "Learn about Emergency Preparedness" clearly tells users where the link goes, even if it's read out of context by the screen reader.

Reading order is extremely important. A document may appear organized visually, but assistive technologies don't interpret the page the same way that we do, so checking the reading order helps ensure users receive the information in the intended sequence. For example, we want a screen reader to announce the title first, then the main content, rather than jumping around the page. This is one of the most common PowerPoint accessibility issues because your slides can look perfectly organized visually while being read in a confusing order. When you include SmartArt and diagrams, the goal isn't to describe every shape, but to communicate the information the diagram is meant to convey. So, think about how you would explain the diagram to someone over the phone.

This slide shows a mock demonstration of checking reading order in PowerPoint. For accessibility purposes, I want to point out that there is no sound. So, first you would go to "Review" and "Check Accessibility." Then you would open the accessibility tab and select "Reading Order [Pane]." Review the sidebar showing the reading sequence. Use the up and down arrows to rearrange the items if needed. And mark non-essential elements as decorative so the screen reader can skip them.

Color contrast helps ensure that text and important visual elements stand out clearly. Even if your content is technically available, it isn't accessible if people can't read it. To meet the WCAG AA standard for normal text, that means a minimum contrast ratio of 4.5:1. But be sure that you're not relying on color alone. Some users may not perceive color differences, so color should support the information. Color should not be the only way the information is communicated. If you're unsure whether your colors meet accessibility standards, free tools such as WebAIM's Contrast Checker can help. Here's an example of what a color contrast checker looks like using the Iowa HHS logo, which is navy blue on a white background with white lettering. And there's also a screenshot of the color contrast and whether it meets the requirements.

Best Practices for Creating Digital Content. Accessibility isn't something you add at the end. It's easiest to build from the beginning. Many accessibility issues can be prevented simply by using Word's built-in tools rather than manually formatting the content.

So before sharing a document, use Word's Accessibility Checker to identify common mistakes. 

We'll spend the next few slides looking at some of these features in more detail. Accessible headings are very important. So simply making text bigger and bold does not create an accessible heading. You must apply Word's built-in heading styles because they create structure that screen readers can recognize and navigate. Many screen readers navigate documents by jumping from heading to heading. And if the headings aren't used correctly, it becomes much harder for them to find information.  So think of the headings like an outline and try not to skip levels. For example, going from Heading 1 directly to Heading 3.

Accessibility also matters when creating tables. Here's an example of a table using best practices and a poor example. So, screen readers don't see the entire table at once. They navigate through the table one cell at a time. You want to keep your tables simple. Complex tables with merged cells can be difficult for assisted technologies to interpret. You also want to use header rows. One of the most important steps is identifying a header row so that the users know what each column represents. And provide context. If a table contains important information, include a brief summary or caption to help users understand what they're looking at.

So, a document title is different from the file name. Screen readers use document titles to help users identify and navigate documents. Document titles may also appear in browser tabs and search results. Use clear, descriptive titles that tell users what the document contains. The file name might be something like, "Final Report _V3," but that's not very helpful to someone using a screen reader. Instead, give the document a clear title that describes its contents, such as, "Annual Report 2025" or "Emergency Preparedness Guide." This slide shows a mock demonstration of adding document titles in Word. For accessibility purposes, I want to point out that there's no sound. So to add document titles in Word, go to "File," then "Info," click "Properties," click on the "Title" field, add a descriptive title, and select "OK."

This slide shows a mock demonstration of Word headings. For accessibility purposes, again, I want to point out that there is no sound. So the Navigation Pane is one of the easiest ways to check your document for structure. Go to "View," then check [the] "Navigation Pane" box. Highlight the words you want to use as Heading 1.  Modify the font, font style, color, boldness, and other settings. And with the words still highlighted, go to "Home," then click "Styles." Right click over Heading 1 and select "Update Heading 1 to Match Selection." As headings are added, you'll see the structure show up in the Navigation Pane. If the outline looks logical in the Navigation Pane, it's usually a good sign that your headings are set up correctly.

This slide shows a mock demonstration of adding alt text in Word. Again, there's no sound on this slide. You want to right click on the image, select "View Alt Text," and add your description in the Alt Text box.

This slide shows a mock demonstration of adding descriptive links in Word. Again, there's no sound on the slide. To create a descriptive link in Word, you want to copy the web address. Highlight the words you want to use as the descriptive text. Click, "Insert," then click, "Link," click on the Address field, and paste the web address. Then select, "OK." If you use an image as a link, the alt text should describe both the image and the link's purpose or destination. Make sure the links are visually distinct from the surrounding text. And if you customize your hyperlink colors, verify that they maintain sufficient color contrast and remain easy to identify.

This is the last example. This slide shows a mock demonstration of adding tables in Word. And there's no sound on this slide either. Navigation can be added to tables by inserting designations to the headers and columns. Header rows tell users that this row is different, and repeating header rows at the top of each page helps users keep track of information that belongs together. Preventing a row from being split between pages makes a table easier to read and reduces confusion. To assign a header row, highlight the first row. Go to "Table Design." Check the box, "Header Row." Then, to adjust the table properties, go to "Table Layout," and click "Properties." On the "Row" tab, uncheck "Allow row to break across pages." Check "Repeat as header row at the top of each page." Then, select "OK." And I know we went through those very quickly, but we'll give you the slides. So, if you want to look at those more carefully, you certainly can.

So, that was a very high overview of accessibility, but we want to move on to our panel discussion. I'm going to give a brief introduction.

So, on the screen are pictures of our three panelists, starting with Colleen Powell, who is the Strategic Communications Bureau Chief at the Iowa Department of Public Safety. The Strategic Communications is a resource to 13 divisions and bureaus within the department. Colleen's area oversees web content, social channels, press releases, media relations, graphic design work, and open records requests.

Pictured in the center is Jessica Torres, a marketing professional who specializes in digital campaign management, website development and optimization, social media marketing, email marketing, lead generation, and digital advertising. Jessica joined the American Public Health Association in 2024 where she led the comprehensive redesign of the organization's website and managed the migration of the content management system.

In the right hand picture is Micah Knebel, a Health Communications Strategist at Black Hawk County Public Health. She has nearly 13 years of experience in public health with the past two years closely focused on communications. As a Health Communications Strategist, Micah works to ensure clear and accessible public health messaging for diverse audiences through the health department website, social media, news media, advertising, and community outreach.

So, we've put together some questions for our panelists, but, as I mentioned in the beginning, you also have the opportunity to suggest questions in the Q&A and we'll try to work those in as well.

So, the first question for our panelists is: Many local health departments are just beginning this work of digital accessibility. What are some of the first steps your organization took to improve digital accessibility and where would you recommend that others start?

Colleen Powell: Hi. Well, I just want to say thank you for all this information. I've been working in this for a little bit and, kind of like you mentioned, Bonnie, I'm by no means an expert, but catching on like many of you, and I found this presentation to be great and spot-on. You know, coming from a state agency, the state's done a really good job of helping us navigate auditing all of our digital assets, and so, as, you know, many of you are getting into this, you know, the first step is just looking at what you have and that includes, you know, your websites, obviously, all of your web content, and then, once you get into your websites, it's all of your digital assets that are associated, so any of the PDFs, any of your forms, any of the other resources you have that you put out to the communities that you serve, you know, taking a look at all of those. This also includes your what we would call like web applications, portals that you may offer up that go beyond the scope of what is internal but that you offer out to external. any mobile apps that you have, and also your, you know, your social media channels and and, you know, what does that look like and what does the content that you're putting out there consist of? And then, once you've got a good audit and you have that well organized as mentioned, you know, in the presentation, it's really prioritizing, you know: What gets used the most? What form do you have that your communities interact with the most? You know, your-- Which of your web pages get used the most? And you know, start there.

Micah Knebel: And-- Oh, go ahead.

Bonnie: Go ahead, Micah.

Micah: Well, I was just going to add so, for local public health at Black Hawk County, we've taken a countywide approach, so within our county we have two Communications people one myself for public health and then one for our county and then we also um have some others that are involved in websites and one of the first things we did was develop a core team of a couple of people that had significant roles within our communications knowing still that we had more staff that would also have impact. But one of the first things that we really tasked ourselves with was developing an accessibility plan. And in that plan, we really-- It's about intentionality as well as transparency on the work that we're doing. So, our accessibility plan that we've been working on goes over kind of just the basics of what accessibility is and how it impacts us as a county. Our goals as a county, a like an inventory of the platforms we use. We have multiple websites. We have multiple social media pages. Our training, how often are we going to be doing training, who goes through that training, a committee that oversees compliance, who responds to legal requests, like what our auditing standards are, and if we do get any requests in regards to things, who responds, how often do we respond, and then how do we regularly report out as a county? For us, doing that plan once again was really something to kind of make it very intentional and also keep us on track.

Jessica Torres: And so we had overhauled the APHA website a little bit over a year ago. So this was one of the things that we were thinking about from the get-go. If you're doing a website redesign, that's a really good opportunity to think about how to bake accessibility into your um website templates, your page design, any widgets or modules that you might use. We have a lot of different content editors. It's not just one person updating the website. We have folks internal, external who make changes to various pages. And so when you're tasked with multiple users, that could be a challenge because, you know, you might adhere to all of the, you know, best practices, but if everybody else in the organization doesn't, even if one person isn't, that can really impact um maintaining your um AA certification. So one way to get around that was when we did the redesign, we made sure that all of the templates and the modules best, you know, fit those guidances. So folks can't just like select any color when they're, you know, designing a web page. They have a a select set of pre-approved um color schemes that meet the color contrast requirements. You know, alt text is required for images. You can't upload documents without ARIA labels for things, you know, so, there's a lot of things that kind of take the guesswork out of it and make it easier for folks to just jump in and it prompts them at every step of the way so that once you actually get to publishing the web page you're able to maintain that AA certification.

Bonnie: That's all excellent information. And I would just back up what Jessica was saying. All of the people I talked to when putting this webinar together talked about how much easier it is to have everyone involved from the very beginning, making sure everything's accessible right from the start because it's much more difficult and expensive to have somebody go back and try to make things accessible. Okay, so many health departments have limited staff and resources. I don't think I know anybody in public health who says we have way more staff and resources than we need. So how did your organization balance accessibility requirements with competing priorities and day-to-day responsibilities?

Colleen: Well, and I think everybody's kind of hit on this. It, you know, this really starts with an organizational, you know, your organization and your leadership buying in. It's not just one committee, you know, beating the drum of accessibility. We got to make sure that you have lots of support because, you know, there may be resources you need, training, this may-- you know you have to-- may have to commit some dollars to it, so I think you know looking at it even if it you know I think as the Communications Bureau we're all like freaking out you know like, "Oh my god. How are we ever going to do this? We're a very small team. There's only three of us here." But you know it's looking even just beyond our team and getting, you know, buy-in building-wide and organization-wide that really helps.

Micah: I was just going to add to that. Yeah, that education piece and realizing it's not going to be one or a couple of roles, like nobody's going to be able to be the fix all. For us, as we were pushing out trainings, like where we prioritized the initial trainings was not just those that necessarily updated our social media or our websites but even like managers and our departments of understanding here is what accessibility is, this is how the impact is, here's what the value is. So that way, even when we're planning conversations of content that we're going to be building, we have more staff that are aware of it and can be thinking through that right from the get-go.

Bonnie: Very good. Anything else on that question? Okay, you can always come back also. If you think of something that refers back to one of our earlier questions, please jump in because all of your experience is really valuable. What were some of the biggest challenges you encountered when implementing accessibility practices and how did you address them? Some of you have already covered that a little bit, but if we could touch on that again, that would be great.

Micah: One-- I mean, we've touched on this already like as you mentioned, but you know the time thing obviously is a big thing that I think that a lot of people think about is it's-- it takes time to think about things and I think, one, everyone should be-- recognize that you've already taken time to watch webinars like this, watch this webinar, other webinars to get an understanding of it, so that's already huge. But you know also accepting that this isn't a once once you know it you're done very much the conversations we've had is we need to treat accessibility like we do cybersecurity. There isn't a, "Hey, we hit this threshold, we're good to go moving forward." There's going to be changes. There's going to be different things that we're going to be doing and we need to continue to learn and accept that that's a part of that process. And once again, the department buy-in helps support that. But the-- I guess the other challenge that we've had as a department has been with digital documents just because we have so many people that are creating our documents. And so for us-- I mean, early on some of the external stuff that I was seeing was a lot about PDF remediation. Going out, buying software, and thinking, oh, you know, "I need to be able to invest money into this so that way we're remediating all of the PDF documents we have." For us, we really stepped back from that and did an inventory of how are we communicating in our various digital documents. What do we have more control of? Essentially, are we getting things sent externally where some individuals are not held to the same standards as we are? Are-- Do we have software that's creating things in a certain way that we're needing to troubleshoot? How do we do that? Really, is the way that we're putting out information even make sense to go out in the way that we're doing it? For instance, are we doing annual reports that really instead of having a long um PDF document, does it make sense for us to just make a website that we update annually? So really taking that inventory and really talking with our various departments on it has been huge. We're still working on it. But also one of the things that we've been working on as a tool is having kind of a workflow document that is recommendations based on types of information we're trying to do. So like if it's a text-heavy information, maybe it is a Word document. If it's really a data-heavy support thing, maybe it's an Excel workbook or a Word table. If it's mixed content, maybe it is a PDF, and that's where we have to look more at the-- that tagging structure, things of that nature. But regardless of all of this, there's still that also that education component of how do we build that content accessibly from the beginning? And so the other piece that as we've been doing this, especially since it touches so many staff, is doing more hands-on training and basic training of how do we actually create accessible documents from the beginning so we're not at the end of it, we get something and we're having to fix it later.

Jessica: And I would add that a lot of times within organizations change is partially technical but it's also partially cultural, right? You have to get buy-in from people. Leadership support helps, of course. But one thing that could be helpful is to actually show people the stakes for folks who have accessibility needs. So like you know showing them what a screen reader actually does with an untagged improperly formatted PDF or what somebody actually experiences when they're trying to access a web page that's poorly built. There's a free browser extension that I like called WAVE and it'll actually show you like how things are or aren't working on your page. And so, using those tools and actually seeing-- getting the experience as a person who's trying to, um, access pieces of content on your site can really help with that culture shift.

Bonnie: That sounds like a great resource. And Micah, I liked what you said about kind of rethinking how you're presenting things to people. So, you're not just trying to make your documents accessible or your web content accessible, you're really thinking about how to reach them best. I think that's kind of-- that's a a good thing for us all to remember. Go further upstream and think about how to make it more simple for people. Okay. So, for organizations that may not have dedicated communications or accessibility staff, what are some quick wins or high impact changes that they can make right away?

Colleen: I think for us, you know, dealing with, you know, the-- some of the stuff that you covered, Bonnie, with alt text, I mean, that's kind of-- that's-- and what you have, whether it's in your PDFs or on your website, what you have embedded as an image, I think some of us don't even realize, you know, we snip all the time because it's easy and bring things in. So that-- that's a good one. Obviously the links and, you know, using good descriptive verbiage in your links. That's an easy one to tackle. Looking at your tables, you know, where you have tables. I mean, I think some of it is just even looking at our own work and some bad habits that we have. I mean, how many of us have wanted two columns and inserted a table because-- and then pulled the lines out? Well, now we got our two columns, but we're, you know, we're not even thinking, "Oh gosh, if someone's got an assisted device, they're reading this as a table instead of how we're looking at it." So, even just understanding some of our own bad habits, and, you know, working to improve those and and having, you know, open conversation with people. So, there's some real easy places to start. And just talking about it, you know, as both Jessica and Micah have brought up, you know, bringing everybody in on the conversation and having that education, showing people, as Jessica talked about, what it looks like when something is poorly tagged. You know, that's at least a place to start. A couple of things that we kind of did initially, too, was we did-- we just looked at our website and realized, is there stuff on there that we can archive? And we did find things. So really just looking at what you currently have on your website and seeing does it really need to be there because that's less stuff you need to go through as you're trying to do your cleanup on your website.

The other thing, too, we've been fortunate that we've been able to work with an accessibility vendor that's done our education and kind of looked at some of our documents, but one of the things we also did was create an accessibility statement for our county that our legal team approved. So, in that accessibility statement, it talks about the county's commitment to accessibility, the standards we're following, our current status, where we're at with accessibility, and then contact for-- just a contact for feedback or if someone runs into issues on our website, who to reach out to. And going back to the-- same as that plan, it's really about transparency for anyone that is interacting with our-- like, our website. So, that way, if you do run into issues while we're trying to avoid those, there's someone who to, uh-- a direct person to be able to reach out to as well as showing the intent of the work that we're doing.

Bonnie: I think that's a great idea and we talked a lot about that when we were planning this webinar. You can have the best intentions, you can do a ton of homework, but you may miss something and things change. So, having a opportunity for people to give feedback is a great idea. And there are a lot of great conversations happening in the chat, also; adding some resources. I hope we can share those after we're done because I know that's not always accessible to everybody. But I hope that people who are able to are able to keep up with the chat in case we can't get to everything because there are some great resources being shared. Are there any specific tools, templates, checklists, or resources that your organization has found particularly helpful for creating accessible content?

Micah: For us, what I will say is, you know, we are building into our systems ex-- our own internal checklists. So, while we have things outlined in a plan, we're not going to go back to a plan every single time for whenever we're creating content. So really re-emphasizing like our social media checklist. So, as we're building out what content we're doing, like did we add alt text? Do-- Did we do captioning? Things of that nature. Having those in a quick, easy to access reminder has been an important part of how we've been moving forward.

Jessica: Yeah, I think it's helpful to have a checklist built into your workflows when developing the content before you even get to the publishing stage. You know, if the-- The best thing you could do is, like I mentioned, to have templates that do it for you so that the major, you know, guidances are met: having alt text as a required field, having descriptive links or having an ARIA label for links - that's also required - you know, developing all of your color schemes for your site with color contrast, ensuring that you use headers, ensuring that you use plain language where where possible - all of these things being sort of part of the process from the beginning can really help you. And then if you are at a point where you're not yet-- like, you haven't done a redesign or you're not planning on doing a redesign, having that checklist moving forward can be helpful because it's important to know that even though everybody's kind of focused on this right now because of this upcoming requirement, I would warn against treating this like a one-time cleanup. You know, deciding how accessible content is developed is important, not just fixing what's broken.

Bonnie: I don't think we can hammer that point home enough. I think that's very important that it needs to be a complete change in how we think about doing things. Okay. We've covered some of these things in general, but I'm going to still ask the questions just in case there are other more specific things you can share. So, many public health professionals regularly create documents, presentations, and PDFs. What accessibility practices have been most useful or realistic for your team to implement?

Colleen: I, well, and it's-- as you said, Bonnie, it's been mentioned, but using the templates, using the styles that are already built into some of those applications. I mean that's an easy place to start.

Jessica: Yeah. and swip-- swapping bold text. Like a lot of our content, our legacy content when we completed the website redesign used bold text instead of proper like header tags. Just fixing that we noticed not only has it made our site more accessible but it-- it's not just accessible to read-- screen readers but also to search engines and other tools, even GenAI, um, in identifying the site hierarchy and important content to to pull through, so, I would say, you know, headers are a huge part of that.

Colleen: Yeah, just going off that-- what you said, Jessica, I don't think we realized how often we put things in italics or we put things in red to try to bring attention to a specific line, um, and, you know, those are obvious places to start.

Bonnie: Good tips. How do you ensure accessibility becomes part of your workflow rather than a one-time project?

Micah: Yeah, so, as I mentioned, for us, really, we've been outlining that in our accessibility plan and making it a county priority. So looking at how often are we doing our regular reviews of our website? Also, are-- you know, things like, are we going to continue to contract with a vendor? What are those roles going to do versus the parts that we are in charge of? Who-- What are the specific positions that are in charge of various tasks education-wise? How often are we doing education with which staff? That really-- Having that in our plan helps us really be clear on what um what we're doing and how we move forward.

Jessica: And I would add, you know, what we do is, once a year or so, we do, uh, we have a developing-- a developer that looks at our website and, um, ensures that we've maintained that AA certification over time. Like I mentioned, we have 20-something content editors and so, while everybody tries to adhere to the guidance and, you know, maintain that over time, it, you know-- degradation does happen over the course of the year and so, even if you were meeting that requirement at launch, a year later, you know, you-- there might be things that you could fix. And so I would say, if possible, having a budget to do that is definitely nice to have and to ensure that you're not missing anything and that allows you to kind of maintain that certification moving forward.

Colleen: Well, and just quick speaking of that, you know, building it into your procurement process, you know, something I know that this, you know, working-- being a state agency that that's kind of there, but, at whatever level you are, if you're working with a vendor and they're producing a product for you, whether those are, you know, annual reports or website content or applica-- you know, digital apps, just making sure that's part of the scope of work and understanding of who is maintaining that, you know, compliance and what that looks like. thinking about that on the front end.

Bonnie: Great. So, you all are kind of farther in the process than some people who are on the webinar might be. So, looking back, is there anything you wish you'd known when your organization first began focusing on accessibility?

Micah: I would say and we've talked about this, but really that culture of accessibility and starting that early on. One of the things that we did is not only-- Public health, we were a little bit further along with it. It had been a conversation that we had been talking about for a very, very, very long time. But even just doing education with our Board of Supervisors was a piece that we found to be important and like I said with other members of our leadership team because, as we work through processes where sometimes we have control and we don't, it's easier to be able to have those longer conversations and really talk through things and maybe change up things that we have been doing when we have that buy-in.

Bonnie: Anyone have anything to add to that?

Colleen: Well, and also just, you know, don't freak out, right? (Laughs) I think this rolled out and I know, you know, for me, coming from someone who really didn't have these levels of expertise and, you know, walking into a position - I don't know where everybody on this you know webinar is at in their careers and the, you know, the organizations they work for - but just, you know, taking a deep breath, taking it one step at a time. We're all going through it, and lean into those other agencies, right, that can be resources for you, whether that's HHS or your county level or whatever, you know, whatever you have the state, you know, lean into people who are doing it. You don't have to reinvent the wheel, so, don't hesitate to send someone an email, say, "Hey, you've got some great stuff going on. Can I, you know, borrow some of that?"

Bonnie: So, if participants leave today remembering just one thing about creating accessible content, what would you want that takeaway to be? And I'll just say mine would be what you said: Don't freak out. (Laughs)

Micah: I would say, you know, from a public health perspective, we already know that we're trying to reach people where they're at so they can get to their optimal health and accessibility is an important part of making us better communicators and having people actually access the good information we're trying to share.

Jessica: I would add: Don't be intimidated about the size of what it would take to fix it. If you wait until you have a dedicated staff or a full budget or a complete strategy to get started, you know, that's a mistake and it's going to end up being costlier than if you just get started today. Try to fix the highest level things. Work on your homepage. Look at Google Analytics. Find your top, you know, 10 most visited web pages and focus on fixing some of the issues there. If your website uses templates or content types throughout your site at all, if you fix it on the widget or the page type or the module level, it will be fixed throughout the site. And so that could be really helpful.

Colleen: And I-- And I just, you know, from our perspective, it's, you know, I think some of you are already further ahead than, you know, even we are in that it's-- it-- this-- we're not just doing this because it's a law, right? Because we, you know, there could potentially be lawsuits. We're doing this to better serve our communities and in the long run, this is a, you know, very good thing. So, you know, having that attitude, it's not just about whether or not, you know, this is going to get pushed back come next April or there'll be an extension or there'll be more time. It's this-- These are good policies.

Bonnie: I agree. And I also agree with the comment about when you go to some of these trainings or participate in some of these trainings that show an example of what people are dealing with when they have an accessibility issue and are trying to navigate, it really was an eye opener for me, as well. It really helped me to sort of keep that in mind as I was um developing things later. And it's just a small piece of accessibility. And there's so much more to learn. Do you have any final thoughts or advice today?

Jessica: I would say just keep in mind, you know, there are five top things to focus on. Fix your alt text. Use descriptive language or ARIA labels when developing links. Fix your color contrast. Use headers and focus on plain language. Sometimes that means developing multiple versions of the same document. We have a couple of examples on our site where we have something that's more focused-- aimed at professionals versus aimed at the general public. Thinking about your audience and tailoring your content to be accessible from a plain language perspective is something that is important not to forget, as well.

Bonnie: So, we're running out of time, but I'm going to try to throw one question in there that I know we've talked about on our team. Are there any reliable graphics tools with accessibility checkers? And specifically, we've talked about Canva and about how it says it's accessible, but really it does have some accessibility issues. Do any of our panelists have experience with that? And if not, that's okay. I thought it was worth throwing out there just in case.

Micah: Yeah. What I will say, well, we have used Canva, but there are some other resources, including the ones that you've linked, that we've done some double-checking as well. Even like looking at ChatGPT or Copilot for doing alt text, it's good as starting points, but using additional resources as well and having a better understanding of things is important.

Bonnie: Terrific. Well, I feel like we could talk for another half hour, but we want to respect everyone's time. And we do have some final slides. So, quickly, to wrap up the webinar, this slide has a list of resources and links to help you continue to build your skills and knowledge about creating accessible content. There's Web Content Accessibility Guidelines 2.0 Checklist, Easterseals Iowa Online Training Options, WebAIM: Contrast Checker, Minnesota Accessibility Resources, Section508.gov: Create Accessible Content and Social Media Content Creation.

Thank you so much to our panelists. It was so helpful and thanks to everyone who joined and we hope to see you next time.