This guide provides foundational accessibility guidance for content editors, communicators, and subject matter experts who create or maintain digital content in the form of PDF documents and web pages. Rather than functioning as a highly technical compliance manual, this guide is for beginners who are new to accessibility and focuses on practical accessibility best practices that can be applied during everyday content creation.
Introduction to Accessibility
Accessibility ensures digital content can be used by people with a wide range of abilities, devices, and technologies.
This includes individuals who:
- use screen readers to read content out loud,
- navigate using a keyboard instead of a mouse,
- enlarge text or zoom screens,
- rely on captions or transcripts,
- or experience visual, auditory, cognitive, or motor disabilities.
Accessibility also benefits users in temporary or situational circumstances, such as:
- using a mobile device in bright sunlight,
- navigating a webpage with one hand,
- experiencing temporary injuries,
- or accessing content in noisy environments.
Accessible content is not a special type of content. It is an essential part of creating clear, usable, and inclusive digital experiences for all users.
Many accessibility best practices also improve:
- readability,
- mobile usability,
- search engine optimization (SEO),
- and overall user experience.
Accessibility is an organizational responsibility and should be considered throughout the content creation process, not added at the end.
Understanding Accessible Heading Structure
Headings help organize content into clear sections and create a logical hierarchy for users navigating a webpage or document.
Many users do not read digital content from beginning to end. Instead, they scan pages to locate the information most relevant to them. Clear heading structure helps users understand:
- what content is included on the page,
- how information is organized,
- and where to find specific topics.
Screen reader users may also navigate directly between headings to quickly move through content.
Headings Create Structure
Headings should follow a logical hierarchy, similar to an outline.
In most cases:
- Heading 1 (H1) is the main page title
- Heading 2 (H2) identifies major sections
- Heading 3 (H3) identifies subsections within an H2 section
- Heading 4 (H4) identifies subsections within an H3 section
Each heading level should support the section above it.
Example of Accessible Heading Structure
H1 Medi-Cal Benefits and Services
H2 Medical Benefits
H3 Primary Care
H3 Specialist Care
H2 Dental Benefits
H3 Preventive Services
H3 Emergency ServicesThis structure clearly communicates how information is grouped and related.
Example of Poor Heading Structure
H1 Benefits and Services
H4 Medical Benefits
H2 Emergency Services
H5 Primary CareSkipping heading levels or using headings inconsistently can make content more difficult to navigate and understand.
Important Best Practices
Use Headings for Structure — Not Appearance
Headings should communicate the organization of content, not simply create larger or bolder text.
Avoid selecting heading styles only because they “look right” visually.
If text needs visual emphasis without representing a new section, use approved formatting options instead of changing heading levels.
Making text larger, bold, underlined, or a different color does not automatically create an accessible heading.
For example, manually increasing font size to make text “look like a heading” may create a visual section title for sighted users, but assistive technologies will not recognize it as a heading.
Instead, use the built-in heading styles available in Word or Powerpoint when creating PDFs and the proper heading components in your website CMS.
Using Headings in Microsoft Word
In Microsoft Word, headings should be created using the built-in Styles panel.
To apply a heading style:
- Highlight the text.
- Open the Home tab.
- Select the appropriate heading style, such as:
- Heading 1
- Heading 2
- Heading 3
Using Headings in Microsoft PowerPoint
In Microsoft PowerPoint, slide titles function as important navigational headings.
Each slide should include a unique and descriptive title whenever possible.
Slide titles help:
- users understand slide organization,
- improve navigation,
- and support accessibility tools.
Avoid creating slide titles using manually positioned text boxes when standard title fields are available within the slide layout.
When creating presentations:
- use built-in slide layouts,
- maintain consistent heading structure,
- and ensure section titles clearly describe slide content.
Keep Headings Clear and Descriptive
Headings should help users understand the topic of the section that follows.
Good examples:
- Provider Eligibility Requirements
- How to Schedule an Appointment
- Frequently Asked Questions
Less effective examples:
- Information
- Details
- Important Notes
Creating Accessible Links
Links help users navigate between pages, documents, and resources. Clear and descriptive links improve accessibility, usability, and overall user experience.
Users should be able to understand the purpose of a link without needing additional surrounding context.
All of the information in this section applies to buttons as well.
Write Descriptive Link Text
Link text should clearly describe:
- where the link goes,
- or what action it performs.
Avoid vague phrases such as:
- Click here
- Read more
- Learn more
- More information
These phrases may not provide enough context for users navigating quickly or using assistive technologies.
Ideally, each link on a web page should only be used once. If two links on the same page go to the exact same destination, the link text should either be identical or clearly communicate why the context is different.
If both links truly serve the same purpose, keeping the same text is often fine if the destination is identical, purpose is identical, and repetition is limited.
Examples
Less Accessible
For provider information, click here.
More Accessible
View the Provider Directory.
Less Accessible
Read more
Read more
More Accessible
Review Medical Benefits
Review Dental Benefits
Keep Link Text Concise
Links should be descriptive without becoming excessively long.
Good link text:
- Provider Search Tool
- Download the Member Handbook (PDF)
- Request Transportation Services
Avoid using full sentences or large blocks of linked text when possible.
Identify File Types When Appropriate
If a link opens a document or downloadable file, identify the file type in the link text.
Examples:
- Download the Provider Directory (PDF)
- Complete the Enrollment Form (Word Document)
This helps users understand what to expect before selecting the link.
Avoid Using Raw URLs
Whenever possible, avoid displaying full web addresses within content.
Less Accessible
https://www.examplewebsite.com/member/provider-search-tool
More Accessible
Use the Provider Search Tool.Descriptive links help all users locate information more quickly and understand where actions or resources will lead before selecting them.
Writing Accessible Alt Text
Alternative text, commonly called “alt text,” is a short description added to images, graphics, charts, and other visual elements.
Alt text helps communicate visual information to users who may not be able to see the image clearly or at all.
What Alt Text Should Do
Alt text should communicate:
- the purpose of the image,
- the important information it contains,
- or the meaning it adds to the content.
Good alt text is concise, clear, and relevant to the surrounding content.
Ask This Question
When writing alt text, consider: “If someone could not see this image, what information would they miss?”
The answer to that question is usually the information the alt text should provide.
Informative Images
If an image provides meaningful content or context, the alt text should describe that information.
Less Effective
Doctor speaking to patient
More Effective
Doctor reviewing medication instructions with a patient during an office visit
Chart or Graphic
Less Effective
Bar chart
More Effective
Bar chart showing increased preventive care visits between 2024 and 2025
Decorative Images
If an image is purely decorative and does not provide meaningful information, detailed alt text may not be necessary.
Examples may include:
- decorative patterns,
- stylistic background images,
- or purely visual design elements.
Avoid adding unnecessary descriptions that may distract from important content.
Avoid Redundant Phrases
Do not begin alt text with phrases such as:
- “Image of”
- “Picture of”
- “Graphic showing”
Screen readers already identify images as images.
Less Effective
Image of a nurse helping a patient
More Effective
Nurse helping a patient complete registration paperwork
Include Important Information in Visible Content
Important information contained in images should also appear within the visible page or document content in the form of a caption whenever possible.
This improves:
- accessibility,
- readability,
- translation consistency,
- and usability across different devices and technologies.
For example:
- charts should include a written summary of key findings,
- infographics should not contain critical information only visible within the image,
- and important visual content should be supported by surrounding text or captions when appropriate.
Consider Language Accessibility
Alt text should generally be written in the same language as the surrounding document or webpage.
For multilingual content:
- Spanish documents should include Spanish alt text,
- Vietnamese documents should include Vietnamese alt text,
- and translated content should ensure image descriptions are also reviewed for language accuracy.
Keeping visible image descriptions or supporting text within the document can help improve translation consistency across languages.
Adding Alt Text in Microsoft Word
To add alt text in Microsoft Word:
- Right-click the image.
- Select View Alt Text or Edit Alt Text.
- Enter a brief, meaningful description in the Alt Text panel.
Avoid relying entirely on auto-generated descriptions, as they may be inaccurate or unclear.
Adding Alt Text in Microsoft PowerPoint
To add alt text in Microsoft PowerPoint:
- Right-click the image, chart, or graphic.
- Select View Alt Text or Edit Alt Text.
- Add a concise description in the Alt Text panel.
All meaningful visuals within presentations should include appropriate alt text, including:
- photos,
- icons,
- charts,
- graphs,
- and infographics.
Making Accessible Tables
Tables should be used to present structured data that users need to compare, review, or reference.
Examples include:
- benefit comparisons,
- provider information,
- schedules,
- cost breakdowns,
- or contact information.
When used correctly, tables can help organize complex information clearly. However, poorly structured tables may be difficult to understand and navigate across different devices and technologies.
Use Tables Only for Data
Tables should only be used for actual data relationships.
Avoid using tables:
- to control page layout,
- position images,
- create spacing,
- or organize visual design elements.
Using tables for layout purposes can create confusion for users and assistive technologies.
Keep Table Structure Simple
Simple tables are generally easier to read, maintain, and navigate.
Whenever possible:
- use a single header row,
- keep columns and rows clearly labeled,
- and avoid overly complex formatting.
Avoid:
- merged cells,
- nested tables,
- excessive blank rows or columns,
- and complicated visual layouts that may not translate well across devices.
Use Clear Header Rows
Tables should include clear column headings that describe the information contained within each column.
Example of Accessible Table Structure
| Plan Type | Monthly Premium | Dental Coverage |
|---|---|---|
| Covered California | $500 | Not Included |
| Medi-Cal | $0 | Included |
Clear headers help users understand how information is organized and related.
Keep Content Understandable
Content within tables should remain concise and easy to scan.
Avoid:
- large paragraphs inside cells,
- excessive abbreviations,
- or unclear labels.
If a table becomes too large or complicated, consider whether the information could be:
- simplified,
- separated into multiple tables,
- or presented another way.
Consider Mobile and Zoomed Views
Large or complex tables may become difficult to read on:
- mobile devices,
- smaller screens,
- or zoomed displays.
When creating tables:
- keep layouts as simple as possible,
- minimize the number of columns,
- and ensure important information remains understandable when viewed on smaller screens.
Adding Accessible Tables in Microsoft Word
When creating tables in Microsoft Word:
- Use the built-in table creation tools instead of drawing tables manually.
- Identify a clear header row.
- Avoid using blank cells for visual spacing.
- Keep table structures consistent and organized.
To designate a header row in Word:
- Select the top row of the table.
- Open the Table Design tab.
- Check the Header Row option.
Adding Accessible Tables in Microsoft PowerPoint
When creating tables in Microsoft PowerPoint:
- Use simple table layouts whenever possible.
- Avoid overcrowding slides with large amounts of table data.
- Ensure column headers clearly identify the content below them.
- Use readable font sizes and adequate spacing.
If complex data cannot be simplified, consider providing:
- a supplemental document,
- a summarized version,
- or additional explanatory content.
Additional Support
Accessibility is a shared responsibility and should be considered throughout the content creation process.
Content creators and subject matter experts are not expected to know every accessibility requirement. However, following basic accessibility best practices helps ensure digital content remains understandable, usable, and accessible for a wider audience.
Questions are encouraged early in the content development process, especially when working with:
- tables,
- images,
- charts,
- multilingual content,
- PDFs,
- or complex document layouts.
Addressing accessibility considerations earlier in the process is typically more efficient than making corrections after content has already been published or distributed.
Accessibility Support Contacts
For questions or support related to accessibility, please contact:
- insert best contact in your org here
Conclusion
Accessible content helps ensure digital information remains clear, usable, understandable, and available to a wider range of users, devices, and technologies.
Many accessibility best practices also improve readability, usability, mobile experience, and overall content quality.
Accessibility is not a separate step added at the end of a project. It is part of creating effective digital communication from the beginning.