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Erschienen in: Clinical Orthopaedics and Related Research® 10/2010

01.10.2010 | Symposium: ABJS Carl T. Brighton Workshop on Health Informatics

Assessing Readability of Patient Education Materials: Current Role in Orthopaedics

verfasst von: Sameer Badarudeen, MD, Sanjeev Sabharwal, MD

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 10/2010

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Abstract

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.
Literatur
2.
Zurück zum Zitat Albright J, de Guzman C, Acebo P, Paiva D, Faulkner M, Swanson J. Readability of patient education materials: implications for clinical practice. Appl Nurs Res. 1996;9:139–143.CrossRefPubMed Albright J, de Guzman C, Acebo P, Paiva D, Faulkner M, Swanson J. Readability of patient education materials: implications for clinical practice. Appl Nurs Res. 1996;9:139–143.CrossRefPubMed
3.
Zurück zum Zitat Alexander RE. Readability of published dental educational materials. J Am Dent Assoc. 2000;131:937–942.PubMed Alexander RE. Readability of published dental educational materials. J Am Dent Assoc. 2000;131:937–942.PubMed
4.
Zurück zum Zitat Badarudeen S, Sabharwal S. Readability of patient education materials from the American Academy of Orthopaedic Surgeons and Pediatric Orthopaedic Society of North America web sites. J Bone Joint Surg Am. 2008;90:199–204.CrossRefPubMed Badarudeen S, Sabharwal S. Readability of patient education materials from the American Academy of Orthopaedic Surgeons and Pediatric Orthopaedic Society of North America web sites. J Bone Joint Surg Am. 2008;90:199–204.CrossRefPubMed
5.
Zurück zum Zitat Baker DW, Parker RM, Williams MV, Clark WS, Nurss J. The relationship of patient reading ability to self-reported health and use of health services. Am J Public Health. 1997;87:1027–1030.CrossRefPubMed Baker DW, Parker RM, Williams MV, Clark WS, Nurss J. The relationship of patient reading ability to self-reported health and use of health services. Am J Public Health. 1997;87:1027–1030.CrossRefPubMed
6.
Zurück zum Zitat Baker DW, Williams MV, Parker RM, Gazmararian JA, Nurss J. Development of a brief test to measure functional health literacy. Patient Educ Couns. 1999;38:33–42.CrossRefPubMed Baker DW, Williams MV, Parker RM, Gazmararian JA, Nurss J. Development of a brief test to measure functional health literacy. Patient Educ Couns. 1999;38:33–42.CrossRefPubMed
7.
Zurück zum Zitat Bass L. Health literacy: implications for teaching the adult patient. J Infus Nurs. 2005;28:15–22.CrossRefPubMed Bass L. Health literacy: implications for teaching the adult patient. J Infus Nurs. 2005;28:15–22.CrossRefPubMed
8.
Zurück zum Zitat Berland GK, Elliott MN, Morales LS, Algazy JI, Kravitz RL, Broder MS, Kanouse DE, Munoz JA, Puyol JA, Lara M, Watkins KE, Yang H, McGlynn EA. Health information on the Internet: accessibility, quality, and readability in English and Spanish. JAMA. 2001;285:2612–2621.CrossRefPubMed Berland GK, Elliott MN, Morales LS, Algazy JI, Kravitz RL, Broder MS, Kanouse DE, Munoz JA, Puyol JA, Lara M, Watkins KE, Yang H, McGlynn EA. Health information on the Internet: accessibility, quality, and readability in English and Spanish. JAMA. 2001;285:2612–2621.CrossRefPubMed
9.
Zurück zum Zitat Bill-Harvey D, Rippey R, Abeles M, Donald MJ, Downing D, Ingenito F, Pfeiffer CA. Outcome of an osteoarthritis education program for low-literacy patients taught by indigenous instructors. Patient Educ Couns. 1989;13:133–142.CrossRefPubMed Bill-Harvey D, Rippey R, Abeles M, Donald MJ, Downing D, Ingenito F, Pfeiffer CA. Outcome of an osteoarthritis education program for low-literacy patients taught by indigenous instructors. Patient Educ Couns. 1989;13:133–142.CrossRefPubMed
10.
Zurück zum Zitat Boulos MN. British internet-derived patient information on diabetes mellitus: is it readable? Diabetes Technol Ther. 2005;7:528–535.CrossRefPubMed Boulos MN. British internet-derived patient information on diabetes mellitus: is it readable? Diabetes Technol Ther. 2005;7:528–535.CrossRefPubMed
12.
Zurück zum Zitat Cooley ME, Moriarty H, Berger MS, Selm-Orr D, Coyle B, Short T. Patient literacy and the readability of written cancer educational materials. Oncol Nurs Forum. 1995;22:1345–1351.PubMed Cooley ME, Moriarty H, Berger MS, Selm-Orr D, Coyle B, Short T. Patient literacy and the readability of written cancer educational materials. Oncol Nurs Forum. 1995;22:1345–1351.PubMed
13.
Zurück zum Zitat Cotugna N, Vickery CE, Carpenter-Haefele KM. Evaluation of literacy level of patient education pages in health-related journals. J Community Health. 2005;30:213–219.CrossRefPubMed Cotugna N, Vickery CE, Carpenter-Haefele KM. Evaluation of literacy level of patient education pages in health-related journals. J Community Health. 2005;30:213–219.CrossRefPubMed
14.
Zurück zum Zitat Dale E, O’Rourke J. The Living Word Vocabulary: The Words We Know: A National Vocabulary Inventory Study. Elgin, IL: Dome Press; 1979. Dale E, O’Rourke J. The Living Word Vocabulary: The Words We Know: A National Vocabulary Inventory Study. Elgin, IL: Dome Press; 1979.
15.
Zurück zum Zitat D’Alessandro DM, Kingsley P, Johnson-West J. The readability of pediatric patient education materials on the World Wide Web. Arch Pediatr Adolesc Med. 2001;155:807–812.PubMed D’Alessandro DM, Kingsley P, Johnson-West J. The readability of pediatric patient education materials on the World Wide Web. Arch Pediatr Adolesc Med. 2001;155:807–812.PubMed
16.
Zurück zum Zitat Davis TC, Long SW, Jackson RH, Mayeaux EJ, George RB, Murphy PW, Crouch MA. Rapid estimate of adult literacy in medicine: a shortened screening instrument. Fam Med. 1993;25:391–395.PubMed Davis TC, Long SW, Jackson RH, Mayeaux EJ, George RB, Murphy PW, Crouch MA. Rapid estimate of adult literacy in medicine: a shortened screening instrument. Fam Med. 1993;25:391–395.PubMed
17.
Zurück zum Zitat Davis TC, Mayeaux EJ, Fredrickson D, Bocchini JA, Jr., Jackson RH, Murphy PW. Reading ability of parents compared with reading level of pediatric patient education materials. Pediatrics. 1994;93:460–468.PubMed Davis TC, Mayeaux EJ, Fredrickson D, Bocchini JA, Jr., Jackson RH, Murphy PW. Reading ability of parents compared with reading level of pediatric patient education materials. Pediatrics. 1994;93:460–468.PubMed
18.
Zurück zum Zitat Doak CC, Doak LG, Root JH. Teaching Patients With Low Literacy Skills. Philadelphia, PA: J.B. Lippincott; 1996. Doak CC, Doak LG, Root JH. Teaching Patients With Low Literacy Skills. Philadelphia, PA: J.B. Lippincott; 1996.
19.
Zurück zum Zitat DuBay W. The Principles of Readability. Costa Mesa, CA: Impact Information; 2004. DuBay W. The Principles of Readability. Costa Mesa, CA: Impact Information; 2004.
20.
Zurück zum Zitat Fouad MN, Kiefe CI, Bartolucci AA, Burst NM, Ulene V, Harvey MR. A hypertension control program tailored to unskilled and minority workers. Ethn Dis. 1997;7:191–199.PubMed Fouad MN, Kiefe CI, Bartolucci AA, Burst NM, Ulene V, Harvey MR. A hypertension control program tailored to unskilled and minority workers. Ethn Dis. 1997;7:191–199.PubMed
21.
Zurück zum Zitat Friedland R. Understanding Health Literacy: New Estimates of the Cost of Inadequate Health Literacy. Washington, DC: National Academy on an Aging Society; 1998. Friedland R. Understanding Health Literacy: New Estimates of the Cost of Inadequate Health Literacy. Washington, DC: National Academy on an Aging Society; 1998.
22.
Zurück zum Zitat Friedman DB, Hoffman-Goetz L. A systematic review of readability and comprehension instruments used for print and web-based cancer information. Health Educ Behav. 2006;33:352–373.CrossRefPubMed Friedman DB, Hoffman-Goetz L. A systematic review of readability and comprehension instruments used for print and web-based cancer information. Health Educ Behav. 2006;33:352–373.CrossRefPubMed
23.
Zurück zum Zitat Hoffmann T, McKenna K. Analysis of stroke patients’ and carers’ reading ability and the content and design of written materials: recommendations for improving written stroke information. Patient Educ Couns. 2006;60:286–293.CrossRefPubMed Hoffmann T, McKenna K. Analysis of stroke patients’ and carers’ reading ability and the content and design of written materials: recommendations for improving written stroke information. Patient Educ Couns. 2006;60:286–293.CrossRefPubMed
24.
Zurück zum Zitat Hussey LC. Minimizing effects of low literacy on medication knowledge and compliance among the elderly. Clin Nurs Res. 1994;3:132–145.CrossRefPubMed Hussey LC. Minimizing effects of low literacy on medication knowledge and compliance among the elderly. Clin Nurs Res. 1994;3:132–145.CrossRefPubMed
25.
26.
Zurück zum Zitat Jackson RH, Davis TC, Bairnsfather LE, George RB, Crouch MA, Gault H. Patient reading ability: an overlooked problem in health care. South Med J. 1991;84:1172–1175.CrossRefPubMed Jackson RH, Davis TC, Bairnsfather LE, George RB, Crouch MA, Gault H. Patient reading ability: an overlooked problem in health care. South Med J. 1991;84:1172–1175.CrossRefPubMed
27.
Zurück zum Zitat Johnson K, Weiss BD. How long does it take to assess literacy skills in clinical practice? J Am Board Fam Med. 2008;21:211–214.CrossRefPubMed Johnson K, Weiss BD. How long does it take to assess literacy skills in clinical practice? J Am Board Fam Med. 2008;21:211–214.CrossRefPubMed
28.
Zurück zum Zitat Juzych MS, Randhawa S, Shukairy A, Kaushal P, Gupta A, Shalauta N. Functional health literacy in patients with glaucoma in urban settings. Arch Ophthalmol. 2008;126:718–724.CrossRefPubMed Juzych MS, Randhawa S, Shukairy A, Kaushal P, Gupta A, Shalauta N. Functional health literacy in patients with glaucoma in urban settings. Arch Ophthalmol. 2008;126:718–724.CrossRefPubMed
29.
Zurück zum Zitat Kemp EC, Floyd MR, McCord-Duncan E, Lang F. Patients prefer the method of “Tell Back-Collaborative Inquiry” to assess understanding of medical information. J Am Board Fam Med. 2008;21:24–30.CrossRefPubMed Kemp EC, Floyd MR, McCord-Duncan E, Lang F. Patients prefer the method of “Tell Back-Collaborative Inquiry” to assess understanding of medical information. J Am Board Fam Med. 2008;21:24–30.CrossRefPubMed
30.
Zurück zum Zitat Kripalani S, Bengtzen R, Henderson LE, Jacobson TA. Clinical research in low-literacy populations: using teach-back to assess comprehension of informed consent and privacy information. IRB. 2008;30:13–19.PubMed Kripalani S, Bengtzen R, Henderson LE, Jacobson TA. Clinical research in low-literacy populations: using teach-back to assess comprehension of informed consent and privacy information. IRB. 2008;30:13–19.PubMed
31.
Zurück zum Zitat Ley P, Florio T. The use of readability formulas in health care. Psychol Health Med. 1996;1:7–28.CrossRef Ley P, Florio T. The use of readability formulas in health care. Psychol Health Med. 1996;1:7–28.CrossRef
32.
Zurück zum Zitat Lillington L, Royce J, Novak D, Ruvalcaba M, Chlebowski R. Evaluation of a smoking cessation program for pregnant minority women. Cancer Pract. 1995;3:157–163.PubMed Lillington L, Royce J, Novak D, Ruvalcaba M, Chlebowski R. Evaluation of a smoking cessation program for pregnant minority women. Cancer Pract. 1995;3:157–163.PubMed
33.
Zurück zum Zitat Mailloux SL, Johnson ME, Fisher DG, Pettibone TJ. How reliable is computerized assessment of readability? Comput Nurs. 1995;13:221–225.PubMed Mailloux SL, Johnson ME, Fisher DG, Pettibone TJ. How reliable is computerized assessment of readability? Comput Nurs. 1995;13:221–225.PubMed
35.
Zurück zum Zitat Meade CD, Byrd JC. Patient literacy and the readability of smoking education literature. Am J Public Health. 1989;79:204–206.CrossRefPubMed Meade CD, Byrd JC. Patient literacy and the readability of smoking education literature. Am J Public Health. 1989;79:204–206.CrossRefPubMed
36.
Zurück zum Zitat Meade CD, Diekmann J, Thornhill DG. Readability of American Cancer Society patient education literature. Oncol Nurs Forum. 1992;19:51–55.PubMed Meade CD, Diekmann J, Thornhill DG. Readability of American Cancer Society patient education literature. Oncol Nurs Forum. 1992;19:51–55.PubMed
37.
Zurück zum Zitat Meade CD, Smith CF. Readability formulas: Cautions and criteria. Patient Educ Couns. 1991;17:153–158.CrossRef Meade CD, Smith CF. Readability formulas: Cautions and criteria. Patient Educ Couns. 1991;17:153–158.CrossRef
38.
Zurück zum Zitat Mulrow C, Bailey S, Sonksen PH, Slavin B. Evaluation of an Audiovisual Diabetes Education Program: negative results of a randomized trial of patients with non-insulin-dependent diabetes mellitus. J Gen Intern Med. 1987;2:215–219.CrossRefPubMed Mulrow C, Bailey S, Sonksen PH, Slavin B. Evaluation of an Audiovisual Diabetes Education Program: negative results of a randomized trial of patients with non-insulin-dependent diabetes mellitus. J Gen Intern Med. 1987;2:215–219.CrossRefPubMed
39.
Zurück zum Zitat Murero M, D’Ancona G, Karamanoukian H. Use of the Internet by patients before and after cardiac surgery: telephone survey. J Med Internet Res. 2001;3:E27.CrossRefPubMed Murero M, D’Ancona G, Karamanoukian H. Use of the Internet by patients before and after cardiac surgery: telephone survey. J Med Internet Res. 2001;3:E27.CrossRefPubMed
40.
Zurück zum Zitat National Cancer Institute. Clear & Simple: Developing Effective Print Materials for Low-literate Readers. Bethesda, MD: National Cancer Institute; 1994. National Cancer Institute. Clear & Simple: Developing Effective Print Materials for Low-literate Readers. Bethesda, MD: National Cancer Institute; 1994.
41.
Zurück zum Zitat National Center for Education Statistics. Adult Literacy in America: A First Look at the Results of the National Adult Literacy Survey. Washington, DC: U.S. Dept. of Education; 1993. National Center for Education Statistics. Adult Literacy in America: A First Look at the Results of the National Adult Literacy Survey. Washington, DC: U.S. Dept. of Education; 1993.
42.
Zurück zum Zitat National Center for Education Statistics. A First Look at the Literacy of America’s Adults in the 21st Century. Washington, DC: U.S. Dept. of Education; 2006:28. National Center for Education Statistics. A First Look at the Literacy of America’s Adults in the 21st Century. Washington, DC: U.S. Dept. of Education; 2006:28.
44.
Zurück zum Zitat Nielsen-Bohlman L, Panzer AM, Kindig DA. Health Literacy: A Prescription to End Confusion. Washington, DC: Institute of Medicine, National Academies Press; 2004. Nielsen-Bohlman L, Panzer AM, Kindig DA. Health Literacy: A Prescription to End Confusion. Washington, DC: Institute of Medicine, National Academies Press; 2004.
45.
Zurück zum Zitat Parker RM, Baker DW, Williams MV, Nurss JR. The test of functional health literacy in adults: a new instrument for measuring patients’ literacy skills. J Gen Intern Med. 1995;10:537–541.CrossRefPubMed Parker RM, Baker DW, Williams MV, Nurss JR. The test of functional health literacy in adults: a new instrument for measuring patients’ literacy skills. J Gen Intern Med. 1995;10:537–541.CrossRefPubMed
46.
Zurück zum Zitat Ryan JG, Leguen F, Weiss BD, Albury S, Jennings T, Velez F, Salibi N. Will patients agree to have their literacy skills assessed in clinical practice? Health Educ Res. 2008;23:603–611.CrossRefPubMed Ryan JG, Leguen F, Weiss BD, Albury S, Jennings T, Velez F, Salibi N. Will patients agree to have their literacy skills assessed in clinical practice? Health Educ Res. 2008;23:603–611.CrossRefPubMed
47.
Zurück zum Zitat Sabharwal S, Badarudeen S, Unes Kunju S. Readability of online patient education materials from the AAOS web site. Clin Orthop Relat Res. 2008;466:1245–1250.CrossRefPubMed Sabharwal S, Badarudeen S, Unes Kunju S. Readability of online patient education materials from the AAOS web site. Clin Orthop Relat Res. 2008;466:1245–1250.CrossRefPubMed
48.
Zurück zum Zitat Vives M, Young L, Sabharwal S. Readability of spine-related patient education materials from subspecialty organization and spine practitioner websites. Spine (Phila Pa 1976). 2009;34:2826–2831. Vives M, Young L, Sabharwal S. Readability of spine-related patient education materials from subspecialty organization and spine practitioner websites. Spine (Phila Pa 1976). 2009;34:2826–2831.
49.
Zurück zum Zitat Wallace LS, Turner LW, Ballard JE, Keenum AJ, Weiss BD. Evaluation of web-based osteoporosis educational materials. J Womens Health (Larchmt). 2005;14:936–945.CrossRef Wallace LS, Turner LW, Ballard JE, Keenum AJ, Weiss BD. Evaluation of web-based osteoporosis educational materials. J Womens Health (Larchmt). 2005;14:936–945.CrossRef
50.
Zurück zum Zitat Wang SW, Capo JT, Orillaza N. Readability and comprehensibility of patient education material in hand-related web sites. J Hand Surg Am. 2009;34:1308–1315.CrossRefPubMed Wang SW, Capo JT, Orillaza N. Readability and comprehensibility of patient education material in hand-related web sites. J Hand Surg Am. 2009;34:1308–1315.CrossRefPubMed
51.
Zurück zum Zitat Weiss BD. Health Literacy: A Manual for Clinicians. Chicago, IL: American Medical Association, American Medical Foundation; 2003. Weiss BD. Health Literacy: A Manual for Clinicians. Chicago, IL: American Medical Association, American Medical Foundation; 2003.
52.
Zurück zum Zitat Weiss BD, Blanchard JS, McGee DL, Hart G, Warren B, Burgoon M, Smith KJ. Illiteracy among Medicaid recipients and its relationship to health care costs. J Health Care Poor Underserved. 1994;5:99–111.PubMed Weiss BD, Blanchard JS, McGee DL, Hart G, Warren B, Burgoon M, Smith KJ. Illiteracy among Medicaid recipients and its relationship to health care costs. J Health Care Poor Underserved. 1994;5:99–111.PubMed
Metadaten
Titel
Assessing Readability of Patient Education Materials: Current Role in Orthopaedics
verfasst von
Sameer Badarudeen, MD
Sanjeev Sabharwal, MD
Publikationsdatum
01.10.2010
Verlag
Springer-Verlag
Erschienen in
Clinical Orthopaedics and Related Research® / Ausgabe 10/2010
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-010-1380-y

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