Assessment of the Readability of Online Patient Education Material from Major Canadian Pediatric Associations (Preprint)

2021 ◽  
Author(s):  
Alice Man ◽  
Courtney van Ballegooie
Keyword(s):  
Patient Education ◽  
Medical Information ◽  
Health Behaviours ◽  
Reading Level ◽  
Pediatric Society ◽  
Word Analysis ◽  
Education Material ◽  
Preventative Health ◽  
Grade Reading Level ◽  
Online Patient Education

BACKGROUND Online patient education materials (PEMs) are frequently written above the recommended reading level in North America. Poor PEM readability limits the accessibility of medical information to individuals with average to lower literacy levels. Pediatric hospital and association websites have not only been shown to be a preferred source of information among caregivers but have also become a necessity in the COVID-19 pandemic. The readability of Canadian pediatric association websites has not yet been assessed quantitatively. OBJECTIVE To assess the readability of online Canadian pediatric association PEMs to determine if the content of the material is written at a reading level that the majority of Canadians can understand. METHODS PEMs were extracted from ten Canadian pediatric associations and evaluated for their reading level using ten validated readability scales. Associations underwent a difficult word analysis and cross association comparisons were assessed. RESULTS Online PEMs were identified from three pediatric association websites, where the grade reading level was found to be 8.8 +/- 1.8 for the Caring for Kids website, 9.5 +/- 2.2 for the Pediatric Endocrine Group website and 13.1 +/- 2.1 for the Atlantic Pediatric Society website. The difficulty word analysis identified that 19.9% of words were unfamiliar overall. CONCLUSIONS The online PEMs were found to be written above the recommended seventh grade reading level for Canadians. Consideration should be made to create PEMs at an appropriate grade reading level for both patients and their caregivers to encourage health literacy and ultimately promote preventative health behaviours and child health outcomes.

Readability Assessment of Patient Education Materials on Major Otolaryngology Association Websites

2012 ◽  
Vol 147 (5) ◽  
pp. 848-854 ◽  
Author(s):  
Jean Anderson Eloy ◽  
Shawn Li ◽  
Khushabu Kasabwala ◽  
Nitin Agarwal ◽  
David R. Hansberry ◽  
...  
Keyword(s):  
Patient Education ◽  
Sixth Grade ◽  
Reading Level ◽  
Flesch Reading Ease ◽  
Education Material ◽  
Individual Assessment ◽  
Honestly Significant Difference ◽  
Significant Difference ◽  
Grade Reading Level ◽  
Post Hoc

Objective Various otolaryngology associations provide Internet-based patient education material (IPEM) to the general public. However, this information may be written above the fourth- to sixth-grade reading level recommended by the American Medical Association (AMA) and National Institutes of Health (NIH). The purpose of this study was to assess the readability of otolaryngology-related IPEMs on various otolaryngology association websites and to determine whether they are above the recommended reading level for patient education materials. Study Design and Setting Analysis of patient education materials from 9 major otolaryngology association websites. Methods The readability of 262 otolaryngology-related IPEMs was assessed with 8 numerical and 2 graphical readability tools. Averages were evaluated against national recommendations and between each source using analysis of variance (ANOVA) with post hoc Tukey’s honestly significant difference (HSD) analysis. Mean readability scores for each otolaryngology association website were compared. Results Mean website readability scores using Flesch Reading Ease test, Flesch-Kincaid Grade Level, Coleman-Liau Index, SMOG grading, Gunning Fog Index, New Dale-Chall Readability Formula, FORCAST Formula, New Fog Count Test, Raygor Readability Estimate, and the Fry Readability Graph ranged from 20.0 to 57.8, 9.7 to 17.1, 10.7 to 15.9, 11.6 to 18.2, 10.9 to 15.0, 8.6 to 16.0, 10.4 to 12.1, 8.5 to 11.8, 10.5 to 17.0, and 10.0 to 17.0, respectively. ANOVA results indicate a significant difference ( P < .05) between the websites for each individual assessment. Conclusion The IPEMs found on all otolaryngology association websites exceed the recommended fourth- to sixth-grade reading level.

scholarly journals Achilles Tendon Repair: Can Patients Read, Understand, and Act on Online Educational Resources?

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0022
Author(s):  
Burke Gao ◽  
Alan G. Shamrock ◽  
Trevor Gulbrandsen ◽  
John E. Femino ◽  
Cesar de Cesar Netto ◽  
...  
Keyword(s):  
Patient Education ◽  
Achilles Tendon ◽  
Grade Level ◽  
Elective Surgery ◽  
Tendon Repair ◽  
Reading Level ◽  
Achilles Tendon Repair ◽  
Grade Reading Level ◽  
Google Search ◽  
Online Patient Education

Category: Sports; Trauma Introduction/Purpose: Patients often access online resources to learn about orthopedic procedures prior to undergoing elective surgery. In order to be fully understood by the average English-speaking adult, online health information must be written at an elementary school reading level. To be helpful to patients, educational resources should also be generally understandable and have actionable direction that positively affects healthcare interactions. There are several previously validated indices for accessing the reading level of written materials. The Patient Education Materials Assessment Tool (PEMAT) provides a reliable and validated method to measure the understandability and actionability of education materials. The purpose of this study was to utilize PEMAT and readability algorithms to quantify readability, understandability and actionability of online patient education materials related to Achilles tendon repair. Methods: Online patient education materials were identified using two independently conducted Google engine searches with the term ‘Achilles tendon repair’. Using the top 50 search results, articles were included if they specifically served to educate patients regarding TAA. Exclusion criteria included news articles, non-text materials (video), research manuscripts, industry websites, and articles not related to Achilles tendon repair. The readability of included articles was quantified using the validated Flesch-Kincaid Grade Level index. The PEMAT form for printed materials was used to assess understandability and actionability using a 0-100 scale for both measures of interest. Spearman’s correlation coefficient was utilized to examine the relationship between a website’s average rank on Google (from first to last) and its readability, understandability, and actionability. P-values of less than 0.05 were considered significant. Results: Thirty-one websites met inclusion criteria. The mean Flesch Kincaid reading grade level was 10.8+-2.9, with only one website written below the 6th grade reading level. Higher Flesch-Kincaid grade was associated with later Google seach rank (rho: 0.488, p=0.010). Mean understandability and actionability scores were 67.1+-16.4% and 38.3+-28.4%, respectively. Among understandability criteria, only 12.9% (n=4) of articles included summaries and just 38.7% (n=12) included visual aids. Among actionability categories, 74% (n=23) of websites identified at least one action for readers, while only 60.8% (n=14) of these studies broke down actions into explicit, easy to understand steps. Actionability scores were not correlated with Google search rank (rho: -0.02, p=0.888), while higher understandability scores were associated with later Google search rank (rho: 0.45, p=0.017). Conclusion: Only one website describing Achilles tendon repair was written at or below the nationally recommended 6th grade reading level. Overall, Achilles tendon repair online educational materials scored poorly with respect to readability, understandability, and actionability. Articles that appeared earlier in the Google search had lower readability and understandability scores. In the era of shared decision making, it is vital that patients understand procedures, as well as the risks and benefits prior to undergoing elective surgery. These results suggest that current publicly available resources for Achilles tendon repair remain inadequate for patient education.

scholarly journals Health Services: A Mixed Methods Assessment of Canadian Cancer Patient Education Materials Related to the 2019 Novel Coronavirus

2021 ◽  
Vol 28 ◽  
pp. 107327482198970
Author(s):  
Courtney van Ballegooie ◽  
Peter Hoang
Keyword(s):  
Patient Education ◽  
Cancer Patients ◽  
Cancer Care ◽  
Reading Level ◽  
Eastern Health ◽  
Cancer Society ◽  
Education Material ◽  
Novel Coronavirus ◽  
Grade Reading Level ◽  
Complex Words

The 2019 novel coronavirus (COVID-19) pandemic has prompted the reorganization in the scheduling and method of care for many patients, including patients diagnosed with cancer. Cancer patients, who have an immunocompromised status, may be at a higher risk of severe symptoms from infection with COVID-19. While information is rapidly evolving regarding COVID-19, Canada, both nationally and provincially, has been conveying new information to patients online. We assessed the content and readability of COVID-19-related online Canadian patient education material (PEM) for cancer patients to determine if the content of the material was written at a grade reading level that the majority of Canadians can understand. PEMs were extracted from provincial cancer agencies and the national Canadian Cancer Society, evaluated using 10 readability scales, qualitatively analyzed to identify their themes and difficult word content. Thirty-eight PEMs from both national and provincial cancers associations were, on average, written above the recommended 7th grade level. Each of the associations’ average grade levels were: BC Cancer (11.00 95% confidence interval [CI] 8.27-13.38), CancerControl Alberta (10.46 95% CI 8.29-12.62), Saskatchewan Cancer Agency (11.08 95% CI 9.37-12.80), Cancer Care Manitoba (9.55 95% CI 6.02-13.01), Cancer Care Ontario (9.35 95% CI 6.80-11.90), Cancer Care Nova Scotia (10.95 95% CI 9.86-12.04), Cancer Care Eastern Health Newfoundland and Labrador (10.14 95% CI 6.87-13.41), and the Canadian Cancer Society (10.06 95% CI 8.07-12.05). Thematic analysis identified 4 themes: public health strategy, information about COVID-19, patient instructions during COVID-19, and resources. Fifty-three percent of the complex words identified were medical jargon. This represents an opportunity to improve PEM readability, to allow for greater comprehension amongst a wider target audience.

Health Literacy: Readability of ACC/AHA Online Patient Education Material

Cardiology ◽  
2017 ◽  
Vol 138 (1) ◽  
pp. 36-40 ◽  
Author(s):  
Karan Kapoor ◽  
Praveen George ◽  
Matthew C. Evans ◽  
Weldon J. Miller ◽  
Stanley S. Liu
Keyword(s):  
Patient Education ◽  
Grade Level ◽  
Heart Association ◽  
Reading Level ◽  
Patient Education Material ◽  
Education Material ◽  
Reading Grade Level ◽  
8Th Grade ◽  
The Mean ◽  
Online Patient Education

Objectives: To determine whether the online patient education material offered by the American College of Cardiology (ACC) and the American Heart Association (AHA) is written at a higher level than the 6th-7th grade level recommended by the National Institute of Health (NIH). Methods: Online patient education material from each website was subjected to reading grade level (RGL) analysis using the Readability Studio Professional Edition. One-sample t testing was used to compare the mean RGLs obtained from 8 formulas to the NIH-recommended 6.5 grade level and 8th grade national mean. Results: In total, 372 articles from the ACC website and 82 from the AHA were studied. Mean (±SD) RGLs for the 454 articles were 9.6 ± 2.1, 11.2 ± 2.1, 11.9 ± 1.6, 10.8 ± 1.6, 9.7 ± 2.1, 10.8 ± 0.8, 10.5 ± 2.6, and 11.7 ± 3.5 according to the Flesch-Kincaid grade level (FKGL), Simple Measure of Gobbledygook (SMOG Index), Coleman-Liau Index (CLI), Gunning-Fog Index (GFI), New Dale-Chall reading level formula (NDC), FORCAST, Raygor Readability Estimate (RRE), and Fry Graph (Fry), respectively. All analyzed articles had significantly higher RGLs than both the NIH-recommended grade level of 6.5 and the national mean grade level of 8 (p < 0.00625). Conclusions: Patient education material provided on the ACC and AHA websites is written above the NIH-recommended 6.5 grade level and 8th grade national mean reading level. Additional studies are required to demonstrate whether lowering the RGL of this material improves outcomes among patients with cardiovascular disease.

scholarly journals Readability Assessment of Oculoplastic Surgery Patient Education Materials

2021 ◽  
Vol 8 (1) ◽  
pp. 1-5
Author(s):  
Haaris M Khan ◽  
Keyword(s):  
Patient Education ◽  
Medical Information ◽  
Treatment Options ◽  
Reading Level ◽  
Difficult Patient ◽  
Multifaceted Approach ◽  
Patient Education Material ◽  
Education Material ◽  
Surgery Patient ◽  
Readability Assessment

Our study found that the majority of websites analyzed contained patient education material that was at a reading level much higher than recommended for the general public. Difficult patient education material can lead to misinterpretation of health information which can negatively affect patient care. We suggest a multifaceted approach in order to ensure patients are able to comprehend complex medical information and feel comfortable making decisions about treatment options

scholarly journals Evaluating the complexity of online patient education materials about brain aneurysms published by major academic institutions

2017 ◽  
Vol 127 (2) ◽  
pp. 278-283 ◽  
Author(s):  
Raghav Gupta ◽  
Nimer Adeeb ◽  
Christoph J. Griessenauer ◽  
Justin M. Moore ◽  
Apar S. Patel ◽  
...  
Keyword(s):  
Patient Education ◽  
Education Level ◽  
Reading Level ◽  
College Level ◽  
Academic Institutions ◽  
Patient Anxiety ◽  
Flesch Reading Ease ◽  
Brain Aneurysms ◽  
Grade Reading Level ◽  
Online Patient Education

OBJECTIVEHealth care education resources are increasingly available on the Internet. A majority of people reference these resources at one point or another. A threshold literacy level is needed to comprehend the information presented within these materials. A key component of health literacy is the readability of educational resources. The National Institutes of Health (NIH) and the American Medical Association have recommended that patient education materials be written between a 4th- and a 6th-grade education level. The authors assessed the readability of online patient education materials about brain aneurysms that have been published by several academic institutions across the US.METHODSOnline patient education materials about brain aneurysms were downloaded from the websites of 20 academic institutions. The materials were assessed via 8 readability scales using Readability Studio software (Oleander Software Solutions), and then were statistically analyzed.RESULTSNone of the patient education materials were written at or below the NIH's recommended 6th-grade reading level. The average educational level required to comprehend the texts across all institutions, as assessed by 7 of the readability scales, was 12.4 ± 2.5 (mean ± SD). The Flesch Reading Ease Scale classified the materials as “difficult” to understand, correlating with a college-level education or higher. An ANOVA test found that there were no significant differences in readability among the materials from the institutions (p = 0.215).CONCLUSIONSBrain aneurysms affect 3.2% of adults 50 years or older across the world and can cause significant patient anxiety and uncertainty. Current patient education materials are not written at or below the NIH's recommended 4th- to 6th-grade education level.

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