Formatting public health material for accessibility and inclusivity
Microsoft Word Document Layout and Formatting
The section 508 of the United States Rehabilitation Act of 1973 requires federal agencies to make
their electronic and information technology accessible to people with disabilities. The following
information is designed to assist in modifying documents to ensure Section 508 compliance.
Useful Tools
The Styles pane (Home> Styles section> Click on small icon in bottom right hand corner)
A Style is a set of formatting attributes that can be applied to text to change its appearance in one
simple step. Heading and paragraph styles help to make the document easier to read, and they add
structure to the document. A person who uses a screen reader or relies on the visual cue of section
headings can more easily navigate a document structured with Styles.
The Reveal Formatting pane is useful for examining the characteristics that have been applied to a
piece of text. This includes fonts, styles, language settings, bullet and numbering styles, etc. To open
the Reveal Formatting pane, first open the Styles pane (see above). Then in the Style pane, select
"Style Inspector" (bottom of the Style pane). In the pop up window, select "Reveal Formatting"
(bottom of the pop up window). Close the pop-up window. At the bottom of the Reveal Formatting
pane, check the box next to “Distinguish style source.”
Layout and Formatting Checklist
Styles
Description
Styles pane is used to format text
and create Headings, rather than
simply using bold or increasing
font size to distinguish headings.
Headings are kept short.
Hierarchal / logical structure is
used with consecutive headings.
Styles pane is used to create
Bulleted or Numbered Lists,
rather than by tabbing and using
dashes or other characters.
Styles pane is used to locate the
text in the desired place on the
page, rather than by using text
Additional Instructions
TO TEST: Select the heading in the text. Check
the Reveal Formatting pane (shift f1). In the
Paragraph section, “Paragraph Style Heading #”
will appear if a Style is applied.
TO FIX: Select the text. Styles pane> right click
on the desired Style (e.g., “Heading 1”)> Modify>
adjust the text as desired.
TO FIX: Use fewer than 20 words.
TO TEST: File> Options> Advanced> Display>
“Style area pane width and outline views”> set to
2". Then View> Draft. If styles are used correctly,
they will be displayed hierarchically in the right
hand panel.
TO FIX: Adjust consecutive headings that skip
from Heading 1 to Heading 3, for example.
TO TEST: Select the text. Check the Reveal
Formatting pane. In the Paragraph section,
Paragraph Style: “List Paragraph” should appear.
TO FIX: Use Home> Bullets, or Home>
Numbering.
TO TEST: View the document in Draft view
(View> Draft); if the text disappears, a text box
was used.
Yes / No / NA
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Description
boxes.
Additional Instructions
TO FIX: Cut and paste the text from the text box
into the main document area. Select the text to
format and right click> Paragraph> adjust text as
desired.
Yes / No / NA
Additional Instructions
TO FIX: Use 12 points or greater; Home> Font
size.
TO FIX: Use Times New Roman, Verdana, Arial,
Tahoma, Helvetica, or Calibri; Home> Font.
TO TEST: Select the text. Check the Reveal
Formatting pane. In the Paragraph section,
Paragraph Style: “Header” or “Footer” should
appear.
TO FIX: Cut and paste Header or Footer text into
the main document area.
TO TEST: Use the Reveal Formatting pane; at
the bottom of the pane, check the box next to
“Show all formatting marks” to display paragraph
marks and other hidden symbols. If formatting
and indenting was used, multiple paragraph
breaks and indents may exist.
TO FIX: Delete repeated hidden symbols within
the text. Then select the text to format and right
click> Paragraph> adjust text as desired.
TO TEST: Use the Reveal Formatting pane; at
the bottom of the pane, check the box next to
“Show all formatting marks” to display paragraph
marks and other hidden symbols.
TO FIX: Delete repeated hidden symbols within
the text (hard returns and tabs). Use Page
Layout> Breaks> Page, or Column.
TO TEST: Select the page number. Check the
Reveal Formatting Pane. In the Paragraph
section, Paragraph Style: “Header” or “Footer”
should appear.
TO Fix: Use Insert> Page Number> choose
desired formatting.
TO TEST: Select the superscripted number.
Check the Reveal Formatting Pane. In the Font
section, Character Style: “Footnote Reference”
should appear. Select the footnoted text. In the
Paragraph section, “Footnote Text” should
appear.
TO FIX: Place curser where you want the
footnote to be inserted; use References> Insert
Footnote.
Yes / No / NA
Body Text
Description
Sufficient font size is used.
An easy-to-read font is used.
Important information such as
document titles, page headings,
and signatures are placed in the
main document area, not in the
“Header" or “Footer” area of
the page.
Formatting and indenting are
used to create whitespace,
rather than by using repeated
blank characters.
New pages and columns are
started by inserting a page or
column break, rather than by
using hard returns or the tab key.
Page numbering is used, rather
than by manually typing the
numbers.
Footnotes are created through
Word Footnote.
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Description
Long document has a Table of
Contents.
Additional Instructions
TO TEST: Select the text. Check the Reveal
Formatting Pane. In the Paragraph section,
Paragraph Style: “TOC Heading” or “TOC #”
should appear. Also, ensure that page numbers
are correct and that the curser goes to the right
place in the document when the number is
control-clicked.
TO FIX: Place curser where you want the TOC to
be inserted; use References> TOC> Insert TOC
(ensure the "Use Hyperlinks instead of page
numbers" is checked)> select desired options.
Yes / No / NA
Alternative Text
508 Standard: A text equivalent for every non-text element shall be provided (e.g., via "alt,"
"longdesc," or in element content).
Description
All images, grouped images and
non-text elements that convey
information (pictures, shapes,
SmartArt graphics, charts,
graphs, and embedded objects)
have Alternative (Alt)Text.
Additional Instructions
Yes/ No / NA
TO TEST: Right click image> Format Shape> Alt
Text. An accurate description of the image should
appear in the Alternative Text box.
Alt text is brief and to the point.
It is not vague, misleading,
inaccurate, or redundant.
Alt text for charts and graphs
provide a complete and accurate
account of the data displayed.
Complex images (charts and
graphs) are accompanied with an
equivalent text description, which
fully conveys the content of the
image, in the body of the page.
Multiple associated images on
the same page are arranged as a
group (e.g. boxes in an
organizational chart).
TO TEST: The Alt Text description does not
include “picture of...", "image of...,” etc. Alt text is
not a duplicate of the adjacent text.
TO TEST: The developer / analyst of the chart or
graph has provided an accurate text description
that is included in the Alt text.
TO FIX: Place the text description immediately
adjacent to the image on the page, and provide a
brief description in the Alt Text.
Images have an "In Line with
Text" or "Top and Bottom”
wrapping style.
TO TEST: Click on an image. If it is grouped with
another object, the selection box will surround
both images.
TO FIX: Select images by pressing the shift key
and clicking on each one in turn. Right click.
Select "Group." Then right click on the grouped
images> Format Shape> Alt Text. Provide and
accurate description.
TO TEST: Use the Reveal Formatting pane; at
the bottom of the pane, check the box next to
“Show all formatting mark” to display paragraph
marks and other hidden symbols. An anchor
symbol DOES NOT APPEAR next to any
graphic/image if properly inline.
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Description
Use of watermarks and
background images has been
avoided.
Additional Instructions
TO FIX: Use Picture Tools> Format> Wrap Text>
choose “In Line with Text” or “Top and Bottom.”
If used and the watermark/background
information is essential, include the information
elsewhere in the document.
Yes/ No / NA
Sensory Characteristics / Color
508 Standard: Web pages shall be designed so that all information conveyed with color is also
available without color, for example from context or markup.
Description
Sufficient color contrast is used.
Color or Sensory
Characteristics are not relied
upon as the only way to convey
content.
Additional Instructions
Yes / No / NA
TO TEST: TGP Contrast Analyser
(http://www.paciellogroup.com/resources/contrast
Analyser)
TO FIX: Use a red "no" rather than a red "x," for
example, or refer to an image by the figure’s
number rather than by appearance (i.e., "the
bigger one").
Tables
508 Standard: Row and column headers shall be identified for data tables.
Description
Tables are not used to format a
page, such as to position
columns.
Additional Instructions
TO FIX: Use Page Layout> Breaks> Column.
Tables are used to provide
tabular information.
TO FIX: Use Insert> Table.
Top header row in data tables
are marked with "Repeat Header
Rows."
Table construction is simple.
TO TEST: Select top row. Table Tools> Layout>
“Repeat Header Rows” should be clicked on.
Rows do not break across
pages.
Reading order is logical: left to
right, top to bottom.
Tables have alternative text
descriptions.
Yes / No / NA
TO FIX: Provide column headings at the top of
each column and row headings in the first lefthand column. Use short and descriptive
headings. Position captions either directly above
or below tables with the number and title of the
table. Describe the table in the body text of the
document. Do not split cells in headings and
rows.
TO TEST: Select Table. Table Tools> Layout>
Properties > Row> “Allow rows to break across
pages” should not be checked.
TO TEST: Verify by tabbing through the cells.
TO TEST: Right click on table> Table
Properties> An accurate description of the table
should appear in the Alternative Text box.
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Hyperlinks
Description
A clear description of the link
destination is provided for
electronic material, rather than
by providing only the URL (e.g.,
Montana Diabetes Project State
Plan 2009-2014)
Additional Instructions
TO FIX: Select text and right click> Edit
Hyperlink> Text to Display. In the “Text to
Display” box, describe the link. The link should
make sense with or without the surrounding
content. Avoid simple phrases such as “click
here” and “more.”
The URL is included in the “Text
to Display” for print material. (
e.g.,
MDP State Plan 2009-2014
(http://www.dphhs.mt.gov/publich
ealth/diabetes/documents/StatePl
an.pdf)
TO FIX: Select text and right click> Edit
Hyperlink> Text to Display. In the “Text to
Display” box, describe the link; Use the full URL
(e.g., http://www.dphhs.mt.gov rather than
www.dphhs.mt.gov ).
Links can be activated with the
keyboard.
TO TEST: Place cursor over the link and press
Enter. This should activate the link.
TO FIX: Shorten the text in “Text to Display.”
Yes / No / NA
Electronic Forms
508 Standard: When electronic forms are designed to be completed on-line, the form shall allow
people using assistive technology to access the information, field elements, and functionality required
for completion and submission of the form, including all directions and cues.
Description
The Developer Tab is used for
creating forms.
Legacy Form tools are used,
rather than ActiveX Controls and
Content Controls or ZoomText.
Tables are created using Table
layout.
Every text field, checkbox, and
dropdown list has a label that is
descriptive.
Instructions, cues, and required
form fields are clearly identified.
The structure of the form is
logical.
Additional Instructions
Yes / No / NA
TO FIX: Use File> Options> Customize Ribbon>
check Developer option.
TO FIX: Use Developer> Controls Panel> Legacy
Form tools.
TO FIX: Use Insert> Table
TO TEST: If the surrounding text was not
available, the label’s description would provide
sufficient information for a person to fill out the
form.
TO FIX: Use Properties> Status Bar> type in
descriptive text.
TO TEST: If the surrounding text was not
available, a person would have sufficient
instruction to fill out the form, given the label
descriptions.
TO FIX: Use Properties> Status Bar> type in
descriptive text.
TO TEST: Verify by tabbing through the form.
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Other
Description
Flashing elements will not
cause the screen to flicker with a
frequency greater than 2 Hz and
lower than 55 Hz.
All Track changes are accepted
or rejected.
Hidden properties or personal
information is removed.
Title, Author, Subject, Keywords,
and Language are properly filled
out.
Default Language is set.
Additional Instructions
(508 Standard)
TO FIX: Eliminate flashing/flickering text and or
animated text.
Accessibility Check has been
run.
Security options are set.
A text-only version is available
with the equivalent information or
functionality when compliance
cannot be accomplished in any
other way.
TO RUN: File> Info> Check for Issues
Yes / No / NA
TO FIX: Use Review> Changes> Accept, or
Reject
TO FIX: Use File> Info> Check for Issues>
Inspect document
TO FIX: Use File> Info> Properties (far right)>
Advanced Properties> Summary
TO SET: Use File> Options> Language
TO SET: File> Info> Protect Document
(508 Standard)
TO FIX: Provide a separate accessible version
when content cannot be accessible in any other
way. Update the accessible version whenever the
material is updated.
Resources
Resources for understanding and implementing Section 508 (http://www.section508.gov/)
Creating Accessible Word Documents (http://office.microsoft.com/en-us/word-help/creatingaccessible-word-documents-HA101999993.aspx)
WebAim: Accessible Word Documents (http://webaim.org/techniques/word/)
For additional information please contact: Meg Ann Traci, Ph.D.
Research and Training Center on Disability in Rural Communities, The University of Montana Rural
Institute;52 Corbin Hall, Missoula, MT 59812-7056; 888-268-2743 or 406-243-4956; 406-243-4200
(TTY); 406-243-2349 (Fax); meg.traci@mso.umt.edu; Montana Disability and Health Program; RTC:
Rural
©2014 RTC:Rural. Our research is supported by CDC grant #1U59DD000991from the Centers for
Disease Control and Prevention. Opinions expressed are the author’s and do not necessarily reflect
those of the funding agency.
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