The Readability of Pediatric Patient Education Materials on the World Wide Web

D’Alessandro, Donna M.; Kingsley, Peggy; Johnson-West, Jill

doi:10.1001/archpedi.155.7.807

Cited by 240 publications

(224 citation statements)

References 25 publications

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“…According to the National Assessment of Adult Literacy [45], the mean reading level for adults in the United States is of an eighth grade level [21,22,43,51]. Moreover, even patients with stronger literacy skills prefer lower grade level online content in simpler formats [19,56]. Taken together, the AMA/NIH recommend that patient education materials not exceed a sixth grade reading level [18,22,36,59,60].…”

Section: Discussionmentioning

confidence: 99%

“…Of the adults with ''below basic health literacy,'' 20% get their health information online [33]. Consequently, most studies assess online material readability compared with mean adult reading skill level [12,14,19,25,26,34,56]. Because www.orthoinfo.org is publically accessible, the reading level of these materials should match the reading skills of any potential orthopaedic patient or the general population.…”

Section: Discussionmentioning

confidence: 99%

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Most American Academy of Orthopaedic Surgeons’ Online Patient Education Material Exceeds Average Patient Reading Level

Eltorai

Sharma

Wang

et al. 2015

Clinical Orthopaedics &Amp; Related Research

102

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Background Advancing health literacy has the potential to improve patient outcomes. The American Academy of Orthopaedic Surgeons' (AAOS) online patient education materials serve as a tool to improve health literacy for orthopaedic patients; however, it is unknown whether the materials currently meet the National Institutes of Health/ American Medical Association's recommended sixth grade readability guidelines for health information or the mean US adult reading level of eighth grade. Questions/purposes The purposes of this study were (1) to evaluate the mean grade level readability of online AAOS patient education materials; and (2) to determine what proportion of the online materials exceeded recommended (sixth grade) and mean US (eighth grade) reading level.Methods Reading grade levels for 99.6% (260 of 261) of the online patient education entries from the AAOS were analyzed using the Flesch-Kincaid formula built into Microsoft Word software. Results Mean grade level readability of the AAOS patient education materials was 9.2 (SD ± 1.6). Two hundred fifty-one of the 260 articles (97%) had a readability score above the sixth grade level. The readability of the AAOS articles exceeded the sixth grade level by an average of 3.2 grade levels. Of the 260 articles, 210 (81%) had a readability score above the eighth grade level, which is the average reading level of US adults. Conclusions Most of the online patient education materials from the AAOS had readability levels that are far too advanced for many patients to comprehend. Efforts to adjust the readability of online education materials to the needs of the audience may improve the health literacy of orthopaedic patients. Patient education materials can be made more comprehensible through use of simpler terms, shorter sentences, and the addition of pictures. More broadly, all health websites, not just those of the AAOS, should aspire to be comprehensible to the typical reader.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Most American Academy of Orthopaedic Surgeons’ Online Patient Education Material Exceeds Average Patient Reading Level

Eltorai

Sharma

Wang

et al. 2015

Clinical Orthopaedics &Amp; Related Research

102

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show abstract

“…Even though readability of patient education materials has a considerable influence on comprehension by the patient [12,18], the reading and comprehension skills of patients are often overlooked when developing health education materials [10]. Investigators from various medical fields have consistently demonstrated patient education materials are often written at a level too difficult to read and be comprehended by a substantial portion of the adult US population [3,8,10,15,17,18,31,35,36].…”

Section: Where Are We Now? the Provider And Patient Educational Toolsmentioning

confidence: 99%

Assessing Readability of Patient Education Materials: Current Role in Orthopaedics

Badarudeen

Sabharwal²

2010

Clinical Orthopaedics &Amp; Related Research

405

433

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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.

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“…Moreover, authors who use readability statistics in their research note the differences among formulas. For example, D'Alessandro et al [10] found that the calculated Flesch-Kincaid reading levels were 4 to 5 grade levels lower than Fry for the same documents. Schriver [14] noted the inherent subjectivity of readability scores because they rely on comparison with a standard text.…”

Section: Assessing Readabilitymentioning

confidence: 99%

“…A score between 0 and 60 is difficult, 60 to 70 is standard, and greater than 70 is easy. Both Fry's and Flesch's Reading Ease have been used extensively in the literature to evaluate the readability of consumer health information online [6,7,10] and in printed form [2,11].…”

Section: Assessing Readabilitymentioning

confidence: 99%