Using a home blood pressure monitor: do accompanying instructional materials meet low literacy guidelines?

To evaluate the readability and related features of English language Quick Reference Guides (QRGs) and User Manuals (UMs) accompanying home blood pressure monitors (HBPMs). We evaluated QRGs and UMs for 22 HBPMs [arm (n=12); wrist (n=10)]. Using established criteria, we evaluated reading grade level, language availability, dimensions, text point size, use of illustrations, layout/formatting characteristics, and emphasis of key points of English-language patient instructions accompanying HBPMs. Readability was calculated using McLaughlin's Simplified Measure of Gobbledygoop. Items from the Suitability of Materials Assessment and User-Friendliness Tool were used to assess various layout features. Simplified Measure of Gobbledygoop scores of both QRGs (mean+/-SD=9.1+/-0.8) and UMs (9.3+/-0.8) ranged from 8th to 10th grade. QRGs and UMs presented steps in chronological order, used active voice throughout, avoided use of specialty fonts, focused on need to know, and used realistic illustrations. Seven sets of instructions included all seven key points related to proper HPBM use, whereas three sets of instructions included less than or equal to three key points (mean=4.8+/-1.9). Although most QRGs and UMs met at least some recommended low-literacy formatting guidelines, all instructional materials should be developed and tested to meet the needs of the patient population at large. Key points related to proper HBPM use should not only be included within these instructions, but highlighted to emphasize their importance.