Background Plain language summaries (PLSs) are intended for a non-expert audience in order to make health research accessible and understandable to the public. This is important because most research is written with jargon and at a high reading level. However, there is a high degree of variability in the instructions for writing PLSs, which may impede their usefulness as a tool for communicating health research to the public. Objective The aim of this scoping review was to conduct a detailed analysis of the author instructions for PLSs provided by leading biomedical and health journals. Method We screened 534 health journals covering 11 categories selected from the InCites Journal Citation Reports linked to the top 10 non-communicable diseases. We included journals published in English that recommended the inclusion of a PLS (as defined by the National Institute for Health Research) and provided authors with text-based instructions on how it should be written. Two independent reviewers extracted data pertaining to common elements identified in author instructions, such as word count/PLS length, content, structure, purpose, wording to support plain language, and the use of jargon, acronyms and abbreviations. Other aspects of PLSs were recorded, such as the label used (e.g., plain language summary, lay summary, and patient summary), journal publisher, consumer involvement and whether the PLS is optional or mandatory. We recorded the frequency of each element and qualitative details of specific instructions. A consumer representative provided ongoing and iterative feedback on the methods, results, and reporting of this study Results Despite reviewing 534 journals across 10 non-communicable disease areas and 11 journal categories, we found only 27 (5.1%) contained text-based instructions for PLS. Of the 27 journals included in this review, most (70%) did not require a PLS. Approximately 70% of journals with PLS instructions included advice about the use of jargon, abbreviations, and acronyms. Only one journal recommended the use of a readability tool, however five noted that the reading level of the audience or readability of the PLS should be considered. Author instructions were highly heterogeneous between journals. There was inconsistency regarding the word count/PLS length (e.g., between 100 and 850 words), structure (e.g., paragraphs or bullet points), and varying levels of detail for other elements in the instructions. Although only one journal recommended consumer involvement in the development of PLSs, many recommended authors consult those who are not an expert in their field to review their summary prior to submission. Conclusion The development of consistent author instructions could enhance the effectiveness and use of PLSs. Such instructions should be developed with consumers to ensure they met the needs of a lay non-expert audience. Supplementary Information...
Objective To better understand the characteristics of, and requirements for, lay summaries by reviewing journals, global health organisations, professional medical associations and multi-disciplinary organisations, consumer advocacy groups and funding bodies. Design Using a scoping review methodology, we searched the websites of each identified data source to determine if they require, suggest, or refer to lay summaries. Two reviewers extracted lay summary writing instructions from eligible data sources from Australia, USA, UK, Canada and New Zealand. Data sources were linked to the top 10 non-communicable diseases. Main Outcome Measures Using an inductive approach, we identified characteristics of lay summaries and lay summary writing instructions and extracted data on these characteristics. These characteristics are lay summary formats, audience, requirements, authorship and labels, and elements of lay summary writing instructions (e.g. word count/length). We also noted who was expected to write the lay summaries, whether they were mandatory or optional, and the terms used for to denote them. Results The websites of 526 data sources were searched. Of these, 124 published or mentioned lay summaries and 108 provided writing instructions. For lay summaries, most were in journals, written by the author of the published paper, and only half were mandatory. Thirty-three distinct labels for a lay summary were identified, the most common being graphical abstract, highlights and key points. From the lay summary writing instructions, the most common elements for written lay summaries referred to: structure (86%), content (80%) and word count/length (74%). The least common elements were readability (3%), use of jargon, acronyms and abbreviations (24%), and wording (29%). The target audience was unclear in 68 of 108 (63.0%) of lay summary instructions. Discussion Although we identified over 100 sources provided instructions for writing lay summaries, very few provided instructions related to readability, use of jargon, acronyms and abbreviations, and wording. Some instructions provided structured formats via subheadings or questions to guide content, but not all. Only half mandated the use of lay summaries. Conclusion For lay summaries to be effective, writing instructions should consider the intended audience, ideally incorporating consumer input into their development. Presently, lay summaries are likely to be inaccessible to many consumers, written at a high reading level, with jargon, acronyms and abbreviations. Ideally, all research articles will have an accompanying lay summary. Mandatory lay summaries, however, are of limited value without clear and thorough instructions to guide authors. Public and patient involvement statement Patients or the public were not involved in the design, or conduct, or reporting, or dissemination plans of our research study. Protocol and registration We conducted a scoping review using methods outlined in the PRISMA extension for scoping reviews and information in the Joanna Briggs Institute Reviewers Manual for scoping reviews. A protocol for this study was completed prior to data analysis and is on Open Science Framework.
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