scholarly journals Computerized versus hand-scored health literacy tools: a comparison of Simple Measure of Gobbledygook (SMOG) and Flesch-Kincaid in printed patient education materials

2018 ◽  
Vol 106 (1) ◽  
Author(s):  
Kelsey Leonard Grabeel ◽  
Jennifer Russomanno ◽  
Sandy Oelschlegel ◽  
Emily Tester ◽  
Robert Eric Heidel
Keyword(s):  
Health Literacy ◽  
Patient Education ◽  
Grade Level ◽  
Medical Center ◽  
Academic Medical Center ◽  
Reading Level ◽  
Rater Reliability ◽  
Simple Measure ◽  
Grade Levels ◽  
Academic Medical

Objective: The research compared and contrasted hand-scoring and computerized methods of evaluating the grade level of patient education materials that are distributed at an academic medical center in east Tennessee and sought to determine if these materials adhered to the American Medical Association’s (AMA’s) recommended reading level of sixth grade.Methods: Librarians at an academic medical center located in the heart of Appalachian Tennessee initiated the assessment of 150 of the most used printed patient education materials. Based on the Flesch-Kincaid (F-K) scoring rubric, 2 of the 150 documents were excluded from statistical comparisons due to the absence of text (images only). Researchers assessed the remaining 148 documents using the hand-scored Simple Measure of Gobbledygook (SMOG) method and the computerized F-K grade level method. For SMOG, 3 independent reviewers hand-scored each of the 150 documents. For F-K, documents were analyzed using Microsoft Word. Reading grade levels scores were entered into a database for statistical analysis. Inter-rater reliability was calculated using intra-class correlation coefficients (ICC). Paired t-tests were used to compare readability means.Results: Acceptable inter-rater reliability was found for SMOG (ICC=0.95). For the 148 documents assessed, SMOG produced a significantly higher mean reading grade level (M=9.6, SD=1.3) than F-K (M=6.5, SD=1.3; p<0.001). Additionally, when using the SMOG method of assessment, 147 of the 148 documents (99.3%) scored above the AMA’s recommended reading level of sixth grade.Conclusions: Computerized health literacy assessment tools, used by many national patient education material providers, might not be representative of the actual reading grade levels of patient education materials. This is problematic in regions like Appalachia because materials may not be comprehensible to the area’s low-literacy patients. Medical librarians have the potential to advance their role in patient education to better serve their patient populations.

scholarly journals Bladder Cancer Health Literacy: Assessing Readability of Online Patient Education Materials

2020 ◽  
pp. 1-8
Author(s):  
Lauren E. Powell ◽  
Theodore I. Cisu ◽  
Adam P. Klausner
Keyword(s):  
Bladder Cancer ◽  
Health Literacy ◽  
Patient Education ◽  
Search Engine ◽  
Reading Ability ◽  
Health Care Expenditure ◽  
Reading Level ◽  
T Test ◽  
Grade Levels ◽  
Grade Reading Level

BACKGROUND: Understanding of health-related materials, termed health literacy, affects decision makings and outcomes in the treatment of bladder cancer. The National Institutes of Health recommend writing education materials at a sixth-seventh grade reading level [6]. The goal of this study is to assess readability of bladder cancer materials available online. OBJECTIVE: The goal of this study is to characterize available information about bladder cancer online and evaluate readability. METHODS: Materials on bladder cancer were collected from the American Urological Association’s Urology Care Foundation (AUA-UCF) and compared to top 50 websites by search engine results. Resources were analyzed using four different validated readability assessment scales. The mean and standard deviation of the materials was calculated, and a two-tailed t test for used to assess for significance between the two sets of patient education materials. RESULTS: The average readability of AUA materials was 8.5 (8th–9th grade reading level). For the top 50 websites, average readability was 11.7 (11–12th grade reading level). A two-tailed t test between the AUA and top 50 websites demonstrated statistical significance between the readability of the two sets of resources (P = 0.0001), with the top search engine results being several grade levels higher than the recommended 6–7th grade reading level. CONCLUSIONS: Most health information provided by the AUA on bladder cancer is written at a reading ability that aligns with most US adults, with top websites for search engine results exceeding the average reading level by several grade levels. By focusing on health literacy, urologists may contribute lowering barriers to health literacy, improving health care expenditure and perioperative complications.

scholarly journals Implementation of a Routine Health Literacy Assessment at an Academic Medical Center

2018 ◽  
Vol 40 (5) ◽  
pp. 247-255 ◽  
Author(s):  
Carrie D. Warring ◽  
Jacqueline R. Pinkney ◽  
Elaine D. Delvo-Favre ◽  
Michelle Robinson Rener ◽  
Jennifer A. Lyon ◽  
...  
Keyword(s):  
Health Literacy ◽  
Medical Center ◽  
Academic Medical Center ◽  
Literacy Assessment ◽  
Academic Medical

scholarly journals Health care and social media: What patients really understand

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 118 ◽  
Author(s):  
Kyle Hoedebecke ◽  
Lindsey Beaman ◽  
Joy Mugambi ◽  
Sanam Shah ◽  
Marwa Mohasseb ◽  
...  
Keyword(s):  
Health Care ◽  
Social Media ◽  
Health Literacy ◽  
Grade Level ◽  
Reading Level ◽  
Lower Grade ◽  
Grade Levels ◽  
Low Health Literacy ◽  
Patient Health ◽  
Grade Reading Level

Background: Low health literacy is associated with decreased patient compliance and worse outcomes - with clinicians increasingly relying on printed materials to lower such risks. Yet, many of these documents exceed recommended comprehension levels. Furthermore, patients look increasingly to social media (SoMe) to answer healthcare questions. The character limits built into Twitter encourage users to publish small quantities of text, which are more accessible to patients with low health literacy. The present authors hypothesize that SoMe posts are written at lower grade levels than traditional medical sources, improving patient health literacy. Methods: The data sample consisted of the first 100 original tweets from three trending medical hashtags, leading to a total of 300 tweets. The Flesch-Kincaid Readability Formula (FKRF) was used to derive grade level of the tweets. Data was analyzed via descriptive and inferential statistics. Results: The readability scores for the data sample had a mean grade level of 9.45. A notable 47.6% of tweets were above ninth grade reading level. An independent-sample t-test comparing FKRF mean scores of different hashtags found differences between the means of the following: #hearthealth versus #diabetes (t = 3.15, p = 0.002); #hearthealth versus #migraine (t = 0.09, p = 0.9); and #diabetes versus #migraine (t = 3.4, p = 0.001). Conclusions: Tweets from this data sample were written at a mean grade level of 9.45, signifying a level between the ninth and tenth grades. This is higher than desired, yet still better than traditional sources, which have been previously analyzed. Ultimately, those responsible for health care SoMe posts must continue to improve efforts to reach the recommended reading level (between the sixth and eighth grade), so as to ensure optimal comprehension of patients.

scholarly journals Impact of Health Literacy on Time Spent Seeking Hand Care

Hand ◽  
2017 ◽  
Vol 13 (5) ◽  
pp. 538-546 ◽  
Author(s):  
Aaron Alokozai ◽  
David N. Bernstein ◽  
Nicole Sheikholeslami ◽  
Lauren Uhler ◽  
David Ring ◽  
...  
Keyword(s):  
Health Literacy ◽  
Medical Center ◽  
Academic Medical Center ◽  
Hand Surgery ◽  
Limited Health Literacy ◽  
Low Health Literacy ◽  
Academic Medical ◽  
Efficient Access ◽  
Study Results ◽  
Limited Health

Background: Patients with limited health literacy may have less knowledge and fewer resources for efficient access and navigation of the health care system. We tested the null hypothesis that there is no correlation between health literacy and total time spent seeking hand surgery care. Methods: New patients visiting a hand surgery clinic at a suburban academic medical center were asked to complete a questionnaire to determine demographics, total time spent seeking hand surgery care, and outcomes. A total of 112 patients were included in this study. Results: We found health literacy levels did not correlate with total time seeking hand surgery care or from booking an appointment to being evaluated in clinic. Conclusions: In this suburban academic medical center, patients with low health literacy do not spend more time seeking hand surgery care and do have longer delays between seeking and receiving care. The finding that—at least in this setting—health literacy does not impact patient time seeking hand care suggests that resources to improve health disparities can be focused elsewhere in the care continuum.

scholarly journals Readability of Online Materials Related to Vocal Cord Leukoplakia

OTO Open ◽  
2021 ◽  
Vol 5 (3) ◽  
pp. 2473974X2110326
Author(s):  
Matthew Shneyderman ◽  
Grace E. Snow ◽  
Ruth Davis ◽  
Simon Best ◽  
Lee M. Akst
Keyword(s):  
Patient Education ◽  
Vocal Cord ◽  
Grade Level ◽  
Assessment Tool ◽  
Medical Center ◽  
Academic Medical Center ◽  
Entire Cohort ◽  
Flesch Reading Ease ◽  
Ease Score ◽  
Google Search

Objectives To assess readability and understandability of online materials for vocal cord leukoplakia. Study Design Review of online materials. Setting Academic medical center. Methods A Google search of “vocal cord leukoplakia” was performed, and the first 50 websites were considered for analysis. Readability was measured by the Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), and Simple Measure of Gobbledygook (SMOG). Understandability and actionability were assessed by 2 independent reviewers with the PEMAT-P (Patient Education Materials Assessment Tool for Printable Materials). Unpaired t tests compared scores between sites aimed at physicians and those at patients, and a Cohen’s kappa was calculated to measure interrater reliability. Results Twenty-two websites (17 patient oriented, 5 physician oriented) met inclusion criteria. For the entire cohort, FRES, FKGL, and SMOG scores (mean ± SD) were 36.90 ± 20.65, 12.96 ± 3.28, and 15.65 ± 3.57, respectively, indicating that materials were difficult to read at a >12th-grade level. PEMAT-P understandability and actionability scores were 73.65% ± 7.05% and 13.63% ± 22.47%. Statistically, patient-oriented sites were more easily read than physician-oriented sites ( P < .02 for each of the FRES, FKGL, and SMOG comparisons); there were no differences in understandability or actionability scores between these categories of sites. Conclusion Online materials for vocal cord leukoplakia are written at a level more advanced than what is recommended for patient education materials. Awareness of the current ways that these online materials are failing our patients may lead to improved education materials in the future.

scholarly journals Readability of Patient Education Materials From High-Impact Medical Journals: A 20-Year Analysis

2021 ◽  
Vol 8 ◽  
pp. 237437352199884
Author(s):  
Michael K Rooney ◽  
Gaia Santiago ◽  
Subha Perni ◽  
David P Horowitz ◽  
Anne R McCall ◽  
...  
Keyword(s):  
Patient Education ◽  
Grade Level ◽  
Treatment Options ◽  
Sixth Grade ◽  
High Impact ◽  
Reading Level ◽  
Eighth Grade ◽  
Medical Journals ◽  
Grade Levels ◽  
Grade Reading Level

Comprehensive patient education is necessary for shared decision-making. While patient–provider conversations primarily drive patient education, patients also use published materials to enhance their understanding. In this investigation, we evaluated the readability of 2585 patient education materials published in high-impact medical journals from 1998 to 2018 and compared our findings to readability recommendations from national groups. For all materials, mean readability grade levels ranged from 11.2 to 13.8 by various metrics. Fifty-four (2.1%) materials met the American Medical Association recommendation of sixth grade reading level, and 215 (8.2%) met the National Institutes of Health recommendation of eighth grade level. When stratified by journal and material type, general medical education materials from Annals of Internal Medicine were the most readable ( P < .001), with 79.8% meeting the eighth grade level. Readability did not differ significantly over time. Efforts to standardize publication practice with the incorporation of readability evaluation during the review process may improve patients’ understanding of their disease processes and treatment options.

Readability of Online Patient Education Materials Related to Lipoprotein(a): Systematic Review (Preprint)

2021 ◽  
Author(s):  
Keon Pearson ◽  
Summer Ngo ◽  
Eson Ekpo ◽  
Ashish Sarraju ◽  
Grayson Baird ◽  
...  
Keyword(s):  
Health Literacy ◽  
Patient Education ◽  
Grade Level ◽  
Lipid Fraction ◽  
Significant Risk ◽  
Reading Level ◽  
Search Term ◽  
Lipoprotein A ◽  
The Impact ◽  
Online Patient Education

BACKGROUND Lipoprotein (a) (Lp(a)) is a highly proatherogenic lipid fraction that is a clinically significant risk modifier. Patients wanting to learn more about Lp(a) are likely to use online patient educational materials (OPEM). However, the readability of OPEM may exceed the health literacy of the general public. OBJECTIVE This study aims to assess the readability of online patient education materials related to Lp(a). We hypothesized that the readability of these online materials would exceed the 6th grade level recommended by the American Medical Association (AMA). METHODS Using an online search engine, we queried the top 20 search results from 10 commonly used Lp(a)-related search terms to identify a total of 200 websites. We excluded duplicate websites, advertised results, research journal articles, or non-patient-directed materials, such as those intended only for health professionals or researchers. Grade-level readability was calculated using 5 standard readability metrics (Automated Readability Index, SMOG Index, Coleman Liau Index, Gunning Fog Score, Flesch Kincaid score) to produce robust point (mean) and interval (confidence interval) estimates of readability. Generalized estimating equations were used to model grade-level readability by each search term, with the 5 readability scores nested within each OPEM. RESULTS A total of 27 unique websites were identified for analysis. The average readability score for the aggregated results was 12.2 grade level (95% CI, 10.9798 - 13.3978). OPEM were grouped into 6 categories by primary source: industry, lay press, research foundation and non-profit organizations, university or government, clinic, and other. The most readable category was OPEM published by universities or government agencies (9.0, 95% CI 6.8-11.3). The least readable OPEM on average were the ones published by the lay press (13.0, 95% CI 11.2-14.8). All categories exceeded the 6th grade reading level recommended by the AMA. CONCLUSIONS Conclusions: Lack of access to readable OPEM may disproportionately affect patients with low health literacy. Ensuring that online content is understandable by broad audiences is a necessary component of increasing the impact of novel therapeutics and recommendations regarding Lp(a).

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