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The National Heart, Lung, and Blood Institute (NHLBI) Learn About Chronic Obstructive Pulmonary Disease (COPD) YouTube playlist educates the public on diagnosing, treating, and managing COPD. Despite its potential benefits, it is unknown if users with inadequate health literacy will likely understand and apply the information described in these videos. Assess the Learn About COPD playlist's readability, actionability, and understandability. Central tendency statistics were computed to describe the meta-data of 28 videos available as of April 2023. Assessments included the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-AV), Accessible Health IT for Limited-Literacy Populations Checklist (LLPC), and the Modified Centers for Disease Control and Prevention (CDC)-Clear Communication Index (CCI) for audiovisual materials. Playlist videos received an average of over 2,000 views (Mdn = 2,220, IQR = 496–8336), with very few "likes" (Mdn = 13, IQR = 1–48 "likes"). PEMAT-understandability (Mdn = 81.81%, IQR = 80–97.72%) and LLPC (Mdn = 87.50%, IQR = 75–93.75%) scores were high (above 80%). However, the modified CDC-CCI median score was 57.14% (IQR = 42.86–75%), and the median PEMAT-actionability score was 50% (IQR = 0–66.67%). The playlist earned passing understandability, acceptability, and usability scores but scored poorly on actionability and communication clarity. Findings could inform enhancements to NHLBI's Learn About COPD YouTube playlist. [ABSTRACT FROM AUTHOR]

With the introduction of face mask orders to prevent the spread of COVID-19, the general public may have turned to their state government or health department's website to find information on face coverings. This study seeks to evaluate the readability, suitability, and content of masking guidance on state government or state health department websites from U.S. states with face mask orders during the beginning of the COVID-19 pandemic. Each state's education on face coverings (n = 41) was assessed using three readability indices and the Suitability Assessment for Materials tool for suitability. A novel masking guidance- specific score was developed to evaluate the content on face coverings. Masking guidance varied in literacy demand, format, and content. The mean readability surpasses the recommended grade level and is too difficult for most Americans to understand. The mean SAM score is considered "adequate" for suitability, and over half of the states' masking guidance contained all seven points of information related to face coverings. During a public health crisis like the COVID-19 pandemic, readable, suitable, and consistent online information is vital in encouraging adherence to public health orders and promoting other preventive health behaviors. [ABSTRACT FROM AUTHOR]

Informed consent forms (ICFs) in clinical trials are the only objective testimony whether the information provided to participants is comprehensive and presented in an accessible language. We evaluated the length of Hebrew ICFs and their English translations and evaluated the readability of the latter. In fifteen clinical trials (5 with pharmacogentic sub-study), the median number (IQR) of pages and words were: English clinical ICFs – 16 pages (13,18) and 7360 words (6959,8289); Hebrew clinical ICFs – 12 pages (10,14), 5807 words (5258,6403); English pharmacogenetics ICFs – 7 pages (4,11), 2930 words (2234,5100); Hebrew pharmacogenetics ICFs – 5 pages (4,8.5), 2273 words (1663,3889); the two English ICFs combined – 23 pages (18;29.5), 10,820 words (9515,15,600); and the two Hebrew ICFs combined – 19 pages (16,23), 8258 words (7340,10,515). Differences between the Hebrew clinical trial ICFs and their English translations were significant (p < 0.001). Median (IQR) Flesch Reading Ease scores for the clinical and the pharmacogenetics ICFs were 48.4 (42.7, 49.9) and 42.2 (41.7,42.65), respectively. Thirteen studies were multinational. Twelve were conducted simultaneously in the United States, where an assessment of readability scores is customary. In conclusion, the consent forms evaluated in this study were long, and readability scores were low. [ABSTRACT FROM AUTHOR]

Many Americans use smartphone-based mobile applications to acquire health information. Our study evaluated the readability of mobile application-based patient educational materials (PEMs) about five prevalent cancers in the United States. The Apple and Google mobile application marketplaces were queried for breast, colon, lung, prostate, and stomach cancer-related applications, which were subsequently screened for PEMs and assessed with 10 validated readability assessments. Twenty-one pertinent applications yielded 249 articles that were written at an 11.8 ± 2.3 grade level; only 12 (4.8%) articles were written below an eighth grade level. The majority of cancer-related PEMs were written at too difficult reading levels for American patients. [ABSTRACT FROM AUTHOR]

Many Americans use smartphone-based mobile applications to acquire health information. Our study evaluated the readability of mobile application-based patient educational materials (PEMs) about five prevalent cancers in the United States. The Apple and Google mobile application marketplaces were queried for breast, colon, lung, prostate, and stomach cancer-related applications, which were subsequently screened for PEMs and assessed with 10 validated readability assessments. Twenty-one pertinent applications yielded 249 articles that were written at an 11.8 ± 2.3 grade level; only 12 (4.8%) articles were written below an eighth grade level. The majority of cancer-related PEMs were written at too difficult reading levels for American patients. [ABSTRACT FROM AUTHOR]

Readability is an important element of any published material. In recent years, various health organisations have utilised infographics to communicate important medical information. Established guidelines for readability suggest levels should be targeted between a 4th and 6th grade education level (United States) in order to avoid disadvantaging individuals with lower literacy skills. The purpose of this case study was to evaluate the readability levels of several published materials from the field of athletic training and demonstrate a model for evaluating readability levels in other medical and health professions. [ABSTRACT FROM AUTHOR]

Background: The U.S. Department of Health & Human Services (USDHHS) recommends that health material be written at or below a sixth-grade reading level to ensure readability.Purpose: The aim of this study was to investigate the readability of online smoking cessation materials from several government and voluntary health organizations.Methods: A purposive sample of publicly accessible governmental and voluntary health organization websites was selected. The readability of the websites’ smoking cessation information was estimated using the previously validated SMOG readability formula, which determined reading level by correlating the number of polysyllabic words.Results: Of the 55 websites included in the analysis, none had cessation information at the USDHHS’s recommended reading level. The material ranged in reading level from seventh grade to a third year in college.Discussion: The findings indicate that the online cessation materials need to be modified in order to reach recommended reading levels.Translation to Health Education Practice: This study can be of practical use to Health Educators when designing, modifying, and evaluating smoking cessation materials. Several free, online government resources are available to assist Health Educators in using simple, non-polysyllable words to ensure that smoking cessation materials are written at the recommended reading levels. [ABSTRACT FROM PUBLISHER]

Minority populations with health disparities are underrepresented in research designed to address those disparities. One way to improve minority representation is to use community-based participatory methods to overcome barriers to research participation, beginning with the informed consent process. Relevant barriers to participation include lack of individual or community awareness or acceptance of research processes and purposes. These barriers are associated with limited health literacy. To inform recommendations for an improved consent process, we examined 97 consent documents and 10 associated Institutional Review Board websites to determine their health literacy demands and degree of adherence to principles of community-based research. We assessed the reading level of consent documents and obtained global measures of their health literacy demand by using the Suitability and Comprehensibility Assessment of Materials instrument. Although these documents were deemed suitable as medical forms, their readability levels were inappropriate, and they were unsuitable for educating potential participants about research purposes. We also assessed consent forms and Institutional Review Board policies for endorsement of community-based participatory principles, finding that very few acknowledged or adhered to such principles. To improve comprehension of consent documents, we recommend restructuring them as educational materials that adhere to current health literacy guidelines. [ABSTRACT FROM AUTHOR]

Purpose: This study developed standardized vignettes that depict a mild traumatic brain injury (TBI) from one of several causes and subjected them to formal expert review. Method: A base vignette was developed using the World Health Organization operational criteria for mild TBI. Eight specific causes (e.g. sport vs assault) were examined. A convenience sample of mild TBI experts with a discipline background of Neuropsychology from North America, Australasia and Europe (n= 21) used an online survey to evaluate the vignettes and rated the role of cause on outcome. Results: The vignette suite was rated as fitting the mild TBI WHO operational diagnostic criteria at least moderately well. When compared to other factors, cause was not rated as significantly contributing to outcome. When evaluated in isolation, approximately half of the sample rated cause as important or very important and at least two of three clinical outcomes were associated with a different cause. Discussion: The vignettes may be useful in experimental mild TBI research. They enable the injury parameters to be controlled so that the effects of cause can be isolated and examined empirically. Such studies should advance understanding of the role of this factor in mild TBI outcome. [ABSTRACT FROM PUBLISHER]

As more individuals turn to the Internet for health-related information and technology increases the availability and use of implantable medical devices (IMDs), the websites marketing these devices will increase. Healthy People 2020 mandates increased understandability and usability of health-related websites. This project used social cognitive theory (SCT) and health literacy constructs from the Institute of Medicine and National Institutes of Health to analyze eight IMD websites. Despite current recommendations, none of the websites considered for this study offered content of an appropriate reading level in conjunction with the United States average of eighth grade, and 75% of the sites failed to satisfy more than one health literacy construct. Most of the websites lacked many of the SCT constructs. More attention is needed to improve the usability of these and future IMD websites to simultaneously meet the goal of marketing IMDs and the Healthy People 2020 goals to educate patients and promote public health. [ABSTRACT FROM AUTHOR]

Hispanics who speak Spanish are at risk for low health literacy. We evaluated Spanish language hypertension (HTN) and diabetes mellitus (DM) patient education materials from U.S. federal agency public sector sources using the Suitability of Assessment (SAM) instrument. Mean readability for HTN materials was grade 7.9 and for DM materials was grade 6.6. Mean SAM score for HTN materials was 43.9 and for DM materials was 63.2. SAM scores were significantly better for DM than for HTN materials in overall score, content, graphics, layout, stimulation/motivation, and cultural appropriateness (p < .05). Clinicians should evaluate suitability of Spanish language HTN and DM materials that they use in patient teaching. [ABSTRACT FROM PUBLISHER]

Seafood consumption is a main source of human exposure to certain environmental contaminants. Therefore, it is valuable to assess the online health risk messages focused on this topic, as people in the US are increasingly accessing the Internet for health-related information. Previous research indicates that online health information tends to be written at a reading level that is more advanced than ability of the general population. The purpose of this research was to examine the content and readability of Internet resources targeted toward consumers in the US regarding the health risks from consumption of contaminated seafood. Sources for analysis were gathered through a targeted search of state and national government websites, as well as through a Google search. The overall mean readability level was Grade 9.21, which is slightly above the average reading level of US adults. Future research should evaluate the accuracy of the health risk messages, as well as consumer perceptions of risk. [ABSTRACT FROM AUTHOR]

This study examined possible ways to ensure that participants provide fully informed consent for online surveys. Participants were randomly assigned to read either a traditional informed consent or one of three modified versions: enhanced (e.g., images, bullet points), consent for each key element, or a combination of these two. Those who read the combination version scored higher on a comprehension quiz, guessed at fewer questions, and were more likely to read all of the informed consent than those who received the traditional version. These findings suggest that comprehension can be improved by adopting alternatives to the traditional informed consent. [ABSTRACT FROM AUTHOR]

Objective: To formally evaluate the written discharge advice for people with mild traumatic brain injury (mTBI). Methods: Eleven publications met the inclusion criteria: (1) intended for adults; (2) ≤two A4 pages; (3) published in English; (4) freely accessible; and (5) currently used (or suitable for use) in Australian hospital emergency departments or similar settings. Two independent raters evaluated the content and style of each publication against established standards. The readability of the publication, the diagnostic term(s) contained in it and a modified Patient Literature Usefulness Index (mPLUI) were also evaluated. Results: The mean content score was 19.18 ± 8.53 (maximum = 31) and the mean style score was 6.8 ± 1.34 (maximum = 8). The mean Flesch-Kincaid reading ease score was 66.42 ± 4.3. The mean mPLUI score was 65.86 ± 14.97 (maximum = 100). Higher scores on these metrics indicate more desirable properties. Over 80% of the publications used mixed diagnostic terminology. One publication scored optimally on two of the four metrics and highly on the others. Discussion: The content, style, readability and usefulness of written mTBI discharge advice was highly variable. The provision of written information to patients with mTBI is advised, but this variability in materials highlights the need for evaluation before distribution. Areas are identified to guide the improvement of written mTBI discharge advice. [ABSTRACT FROM AUTHOR]

For groups like the elderly who are at risk for low levels of health literacy, documents must be easily comprehensible, particularly as the information becomes increasingly complex. The current research focused on a multilevel examination of a procedural excerpt of a handbook on Medicare, the US government program providing financial assistance to senior citizens for healthcare. Complementing assessments of readability, syntax, and verb mood were content analysis and the validated SAM (suitability of materials) instrument. The research focused on techniques used within this document excerpt (excluding hyperlinks), along with suggested actions for improvement. The excerpt targeted an audience with average to low levels of literacy in terms of shorter words and paragraphs; proportions of complex sentences, conditional mood, and the subordinating conjunction 'if' signal potential difficulty in comprehension. Results from the SAM analysis identified specific improvements within the broad categories of organization, visualization, and simplification. Tools like the SAM instrument, in conjunction with related techniques, can assist in the design and revision of healthcare documents suitable to the target audience intended to benefit. [ABSTRACT FROM AUTHOR]

Close to 43% of adults have difficulties reading and understanding printed materials. Given the fact that so many American adults have difficulty reading basic text, we were interested in looking at the readability levels of the marriage amendment ballots of the 2004 election. Results indicated, with the exception of two states, a mismatch between the educational levels and the readability levels of the proposed amendments. Legal recognition of same-sex civil marriages can be considered a mental health public policy issue and therefore public health professionals should advocate for easier to read and understand ballots. [ABSTRACT FROM AUTHOR]

Although several studies and professional texts address the issue of required reading levels for self-report psychopathology inventories such as the Minnesota Multiphasic Personality Inventory-2 and Personality Assessment Inventory, little research effort has been directed to the examination of required reading levels for inventories measuring normal personality characteristics. In order to establish guidelines for clinical use of commonly used personality inventories, this study examined the text complexity of four widely used tests: the California Psychological Inventory, the 16 Personality Factor Questionnaire, the Personality Research Form, and the revised NEO Personality Inventory. Analysis of the text complexity of complete item sets indicated that the inventories had overall reading levels at the fifth- to sixth-grade range. However, examination of the text difficulty of individual scales revealed reading level estimates as high as the eighth grade. Guidelines for test administration with subjects of varying education levels are discussed. [ABSTRACT FROM AUTHOR]

The effects of altering prose style on the readability of college textbook material were examined. Two 1000-word science passages were rewritten to create seven stylistically "simpler" versions—by substituting frequently occurring for infrequently occurring nontechnical vocabulary, by shortening the average sentence length, by restructuring sentences, and by combining these factors. High school seniors read the passages, each passage altered by one of the above methods. Their responses to the text were assessed by five measures of text difficulty. Readability, as measured in this study, was unaffected by the alterations. Consideration of patterns of scores suggests that readability may be changed only when significant sources of difficulty, such as concept familiarity, are addressed. Perhaps, then, because the essential content was unchanged in the present adaptations, the readability was unaffected. [ABSTRACT FROM AUTHOR]