BACKGROUND Patient education materials (PEMs) can be vital sources of information for the general population. However, despite American Medical Association (AMA) and National Institute of Health (NIH) recommendations to make PEMs easier to read for patients with low health literacy, they often do not adhere to these recommendations. The readability of online PEMs in the Obstetrics and Gynecology (OB/GYN) field, in particular, has not been thoroughly investigated. OBJECTIVE The study sampled online OB/GYN PEMs and aimed to examine agreeability across traditional readability measures (RMs), adherence of online PEMs to AMA and NIH recommendations, and whether readability level of online PEMs varied by publication source and medical topic. METHODS A total of 1,576 online OB/GYN PEMs were collected via three major search engines. Ninety-three were excluded due to shorter content (less than 100 words), yielding 1,483 PEMs for analysis. Each PEM was scored by four traditional readability measures (TRMs), including Flesch-Kincaid Grade Level (FKGL), Gunning-Fog Index (GFI), Simple Measure of Gobbledygook (SMOG), and the Dale-Chall (DCL). The PEMs were categorized based on publication source and medical topic by two research team members. The readability scores of the categories were compared statistically. RESULTS Results indicated that the four TRMs did not agree with each other, leading to the use of an averaged readability (composite) score for comparison. The composite scores across all online PEMs were not normally distributed and had a median at the 11th grade. Governmental PEMs had the lowest readability level amongst source categorization and PEMs about menstruation had the highest readability. CONCLUSIONS This study found that online OB/GYN PEMs did not meet the AMA and NIH readability recommendations and would be difficult to read and comprehend for patients with low health literacy. Both findings connected well to the literature. This study highlights the need to improve the readability of OB/GYN PEMs to help patients make informed decisions. While research has been done to create more sophisticated readability measures for medical and health documents. Once validated, these tools need to be utilized by online content creators of health education materials.
Background Patient education materials (PEMs) can be vital sources of information for the general population. However, despite American Medical Association (AMA) and National Institutes of Health (NIH) recommendations to make PEMs easier to read for patients with low health literacy, they often do not adhere to these recommendations. The readability of online PEMs in the obstetrics and gynecology (OB/GYN) field, in particular, has not been thoroughly investigated. Objective The study sampled online OB/GYN PEMs and aimed to examine (1) agreeability across traditional readability measures (TRMs), (2) adherence of online PEMs to AMA and NIH recommendations, and (3) whether the readability level of online PEMs varied by web-based source and medical topic. This study is not a scoping review, rather, it focused on scoring the readability of OB/GYN PEMs using the traditional measures to add empirical evidence to the literature. Methods A total of 1576 online OB/GYN PEMs were collected via 3 major search engines. In total 93 were excluded due to shorter content (less than 100 words), yielding 1483 PEMs for analysis. Each PEM was scored by 4 TRMs, including Flesch-Kincaid grade level, Gunning fog index, Simple Measure of Gobbledygook, and the Dale-Chall. The PEMs were categorized based on publication source and medical topic by 2 research team members. The readability scores of the categories were compared statistically. Results Results indicated that the 4 TRMs did not agree with each other, leading to the use of an averaged readability (composite) score for comparison. The composite scores across all online PEMs were not normally distributed and had a median at the 11th grade. Governmental PEMs were the easiest to read amongst source categorizations and PEMs about menstruation were the most difficult to read. However, the differences in the readability scores among the sources and the topics were small. Conclusions This study found that online OB/GYN PEMs did not meet the AMA and NIH readability recommendations and would be difficult to read and comprehend for patients with low health literacy. Both findings connected well to the literature. This study highlights the need to improve the readability of OB/GYN PEMs to help patients make informed decisions. Research has been done to create more sophisticated readability measures for medical and health documents. Once validated, these tools need to be used by web-based content creators of health education materials.
BACKGROUND Health literacy is the ability to make informed decisions using health information. As health data and information availability increases due to online clinic notes and patient portals, it is important to understand how health literacy relates to social determinants of health and the place of informatics in mitigating disparities. OBJECTIVE This systematic literature review aims to examine the role of health literacy in interactions with social determinants of health and to identify feasible health literacy-based interventions that address low patient understanding of health information to improve clinic note sharing efficacy. METHODS The review examined two databases, Scopus and PubMed, for English language articles relating to health literacy and social determinants of health. We conducted a quantitative analysis of study characteristics and qualitative synthesis to determine roles of health literacy and interventions. RESULTS The results (n=43) were analyzed quantitatively and qualitatively for study characteristics, role of health literacy, and interventions. A majority (n=30) identified a correlate role for health literacy in relation to social determinants of health, but others noted that health literacy could also be a mediator (n=5), a result of social determinants of health (n=5), or considered a modifiable social determinant of health (n=2). CONCLUSIONS The multivariable nature of health literacy indicates that it could form the basis for many interventions to combat low patient understandability, including interventions using informatics-based solutions. Health literacy is a crucial, multidimensional skill in supporting patient understanding of health materials. Designing interventions aimed at improving health literacy or addressing poor health literacy in patients can help increase comprehension of health information, including the information contained in clinic notes that are shared with patients.
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