Assessing Readability of Patient Education Materials: Current Role in Orthopaedics

Abstract

Background Health literacy is the single best predictor of an individual's health status. It is important to customize health-related education material to the individual patient's level of reading skills. Readability of a given text is the objective measurement of the reading skills one should possess to understand the written material. Questions/purposes In this article, some of the commonly used readability assessment tools are discussed and guidelines to improve the comprehension of patient education handouts are provided. Where are we now? Several healthcare organizations have recommended the readability of patient education materials be no higher than sixth-to eighth-grade level. However, most of the patient education materials currently available on major orthopaedic Web sites are written at a reading level that may be too advanced for comprehension by a substantial proportion of the population. Where do we need to go? There are several readily available and validated tools for assessing the readability of written materials. While use of audiovisual aids such as video clips, line drawings, models, and charts can enhance the comprehension of a health-related topic, standard readability tools cannot construe such enhancements. How do we get there? Given the variability in the capacity to comprehend health-related materials among individuals seeking orthopaedic care, stratifying the contents of patient education materials at different levels of complexity will likely improve health literacy and enhance patient-centered communication.

Readability of Patient Education Materials Available at the Point of Care

“…In 2004 Wallace et al 13 found that only 7% of the American Academy of Family Practice's PEMS were written below an 8 th grade reading level. Various subspecialties such as cardiology 14,15 , infectious disease, 16 plastic surgery, 17 dermatology, 18 orthopedics, 19,20 palliative care, 21 oncology 22,23 and obstetrics and gynecology 24,25 have studied the readability of the PEMs utilized in their fields, and findings consistently indicate that 9 th -12 th grade reading levels are necessary to read and comprehend these documents.…”

Oral Health Literacy and Behavior of Health Sciences University Students

“…2,3 Oral health literacy on the other hand, is defined as "the degree to which individuals have the capacity to obtain, process, and understand basic oral health information and services needed to make appropriate health decisions". 4 Hence, an individual's health literacy is considered the single best predictor of their health status 5 . Studies have shown that an individual with limited health literacy skills make greater use of services designed to treat complication of disease and less use of services designed to prevent complications.…”

A Cross-Sectional Study of Musculoskeletal Health Literacy in Patients With Carpal Tunnel Syndrome

“…This is problematic, as it is only with adequate health literacy that patients can truly make informed decisions regarding their care. 5,25 Furthermore, patients with limited health literacy have been shown to experience inferior outcomes with regard to their given conditions. 11,19,33 This was the impetus for our investigation into the prevalence of and factors related to inadequate health literacy in patients undergoing elective CTR, as the identification of such patients will enable orthopedic surgeons to identify this subset of at-risk individuals.…”

“…11,19,33 Conversely, patients with adequate health literacy experience more effective and meaningful interactions with their physicians and are better equipped to make informed and appropriate treatment decisions. 5,25 In the United States, studies of health literacy have estimated that between 33% and 48% of Americans possess inadequate health literacy. 2,8,15,24 This is troubling, as the annual cost of low health literacy is estimated to range from $106 to $238 billion.…”