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BackgroundHealth materials to promote health behaviors should be readable and generate favorable evaluations of the message. Processing fluency (the subjective experience of ease with which people process information) has been increasingly studied over the past decade. In this review, we explore effects and instantiations of processing fluency and discuss the implications for designing effective health materials. We searched seven online databases using “processing fluency” as the key word. In addition, we gathered relevant publications using reference snowballing. We included published records that were written in English and applicable to the design of health materials.ResultsWe found 40 articles that were appropriate for inclusion. Various instantiations of fluency have a uniform effect on human judgment: fluently processed stimuli generate positive judgments (e.g., liking, confidence). Processing fluency is used to predict the effort needed for a given task; accordingly, it has an impact on willingness to undertake the task. Physical perceptual, lexical, syntactic, phonological, retrieval, and imagery fluency were found to be particularly relevant to the design of health materials.ConclusionsHealth-care professionals should consider the use of a perceptually fluent design, plain language, numeracy with an appropriate degree of precision, a limited number of key points, and concrete descriptions that make recipients imagine healthy behavior. Such fluently processed materials that are easy to read and understand have enhanced perspicuity and persuasiveness.

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Processing fluency (the inferred subjective ease with which people process information) has been a topic of increasing research attention in the field of psychology over the past decade. We examined the effect of improving written materials in terms of processing fluency with regard to encouragement for obtaining breast and cervical cancer screening. We randomly assigned 670 women to intervention or control conditions; the 215 who mailed back distributed questionnaires were the study participants. A standard leaflet for cancer screening was mailed to the control group, while the materials mailed to the intervention group were improved in terms of perceptual fluency (e.g., legibility), linguistic fluency (e.g., readability), retrieval fluency (e.g., reducing amount of information) and imagery fluency (having recipients imagine future behavior and events). The screening rate of the intervention group was significantly higher than that of the control group (29.4% vs. 14.2%, χ = 7.275, df = 1, p = .007, φ = .184). Improving the processing fluency of written materials may be useful for encouraging individuals to obtain breast and cervical cancer screening.

Historically, anti-vaccination sentiment has existed in many populations. Mass media plays a large role in disseminating and sensationalizing vaccine objections, especially via the medium of the Internet. Based on studies of processing fluency, we assumed that anti-influenza vaccination online messages to be more readable and more fluently processed than pro-influenza vaccination online messages, which may consequently sway the opinions of some audiences. The aim of this study was to compare readability of anti- and pro-influenza vaccination online messages in Japan using a measure of readability.Web searches were conducted at the end of August 2016 using two major Japanese search engines (Google.jp and Yahoo!.jp). The included websites were classified as “anti”, “pro”, or “both” depending on the claims, and “health professional” or “non-health professional” depending on the writers' expertise. Readability was determined using a validated measure of Japanese readability (the Japanese sentence difficulty discrimination system). Readability of “health professional” websites was compared with that of “non-health professional” websites, and readability of “anti” websites was compared with that of “pro” websites, using the t-test.From a total of 145 websites, the online messages written by non-health professionals were significantly easier to read than those written by health professionals (p = 0.002, Cohen's d = 0.54). Anti-influenza vaccination messages were significantly easier to read than pro-influenza vaccination messages (p < 0.001, Cohen's d = 0.74).When health professionals prepare pro-influenza vaccination materials for publication online, we recommend they check for readability using readability assessment tools and improve the text for easy reading if necessary.