Empirical Evaluation of Understandability and Usability of Health Handbooks Commonly Used in Japan

Abstract

Objective: Various types of handbooks that summarize and record health information (health handbooks) have been used in Japan for many years. The purpose of this study was to explore ways to evaluate the understandability and usability of commonly used printed health handbooks in Japan.Methods: An internet search was performed to identify health handbooks used in Japan. The handbooks were then collected, searched, and evaluated for the quality and functionality of the health-information. The overall understandability was assessed using the Suitability Assessment of Material (SAM) and the Centers for Disease Control and Prevention Clear Communication Index (CCI), and overall usability was assessed using a purpose-user matrix.Results: A total of 14 health handbooks were extracted and analyzed. The median scores for SAM and CCI were 39 (min 25, max 45) and 81.5% (60%, 100%), respectively, and no significant association was observed between the two evaluation scores. Based on the matrix, the most common type of handbook was those designed for preventive purposes that the user or their family completed (n = 9).Conclusion: Our sampled health handbooks were used mostly for preventive purposes and their understandability varied. SAM and CCI assess different aspects of written materials and it is recommended they be used together when evaluating the understandability of health handbooks. To facilitate more effective use of health handbooks in public health activities, we suggest the content of handbooks be assessed by a purpose-user matrix.

Participatory approaches for developing a practical handbook integrating health information for supporting individuals with mild cognitive impairment and their families

“…In a previous study evaluating handbooks on child care, the CCI scores ranged from 40% to 80% with a median of 67% 24 . In another study evaluating 14 health handbooks published in Japan, the CCI scores ranged from 69% to 100% with a median score of 81.5% 5 . The revised CCI scores for the PQs in the current handbook ranged from 79% to 96%, suggesting that our handbook scores favourably among health handbooks.…”

“…However, the health handbooks regarding dementia have not been as effective. A review of 14 health handbooks published in Japan revealed that all three handbooks that focused on dementia scored below average in health literacy owing to poor clarity and usability 5 . Therefore, there is an urgent need to develop an effective handbook for dementia prevention among older adults with MCI.…”

“…Several studies in Japan have analyzed the materials intended to provide health information 5 . The Maternal and Child Health Handbook , a multidimensional health information handbook for long‐term practical use in Japan, is a representative example.…”

“…13 Several studies in Japan have analyzed the materials intended to provide health information. 5 The Maternal and Child Health Handbook, a multidimensional health information handbook for long-term practical use in Japan, is a representative example. This handbook provides health information for parents, children and physicians and is used as a valuable resource from pregnancy until the child is 6 years old and starts school.…”

“…In Japan's community‐based integrated care system, the effective utilization of limited healthcare resources requires coordination not only among hospital outpatient and inpatient units but also welfare facilities, home‐visit care services and mutual support activities in neighbourhoods 4 . Dementia is a long‐term prognosis requiring continuous care from the preclinical stage to the end of life; therefore, there is an increasing need for health information among patients, their families and professionals across multiple medical and welfare sectors 5 . Health literacy is the key to facilitating collaboration between patients, families and professionals.…”