Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
J Cardiovasc Nurs. 2012 Nov-Dec;27(6):485-94. doi: 10.1097/JCN.0b013e318220720c.
Health literacy (HL) is an established independent predictor of cardiovascular outcomes. Approximately 90 million Americans have limited HL and read at the fifth grade level or lower. Therefore, we sought to determine the suitability and readability level of common cardiovascular patient education materials (PEM) related to heart failure and heart-healthy lifestyle.
The suitability and readability of written PEMs were assessed using the suitability assessment of materials (SAM) and Fry readability formula. The SAM criteria are composed of the following categories: message content, text appearance, visuals, and layout and design. We obtained a convenience sample of 18 English-written cardiovascular PEMs freely available from major health organizations. Two reviewers independently appraised the PEMs. Final suitability scores ranged from 12% to 87%. Readability levels ranged between 3rd and 15th grade level; the average readability level was 8th grade. Ninety-four percent of the PEMs were rated either superior or adequate on text appearance, but 50% or more of the PEMs were rated inadequate on each of the other categories of the SAM criteria. Only 2 (11%) PEMs had the optimum suitability score of 70% or higher and 5th grade or lower readability level suitable for populations with limited HL.
Commonly available cardiovascular PEMs used by some major healthcare institutions are not suitable for the average American patient. The true prevalence of suboptimal PEMs needs to be determined because it potentially negatively impacts optimal healthcare delivery and outcomes.
健康素养（HL）是心血管结局的既定独立预测因素。大约有 9000 万美国人的 HL 有限，阅读水平仅为五年级或更低。因此，我们试图确定与心力衰竭和心脏健康生活方式相关的常见心血管患者教育材料（PEM）的适用性和可阅读性水平。
使用材料适用性评估（SAM）和弗莱阅读公式评估书面 PEM 的适用性和可阅读性。SAM 标准由以下几类组成：信息内容、文本外观、视觉效果以及布局和设计。我们从主要卫生组织获得了 18 种免费提供的英文心血管 PEM 的便利样本。两名审查员独立评估了 PEM。最终适用性评分范围从 12%到 87%。可读性水平在 3 到 15 年级之间；平均可读性水平为 8 年级。94%的 PEM 在文本外观方面被评为优秀或良好，但超过 50%的 PEM 在 SAM 标准的其他类别中被评为不足。只有 2 种（11%）PEM 的适用性评分为 70%或更高，且可读性水平为 5 年级或更低，适合 HL 有限的人群。
一些主要医疗机构使用的常见心血管 PEM 不适合普通美国患者。需要确定亚适性 PEM 的真实流行率，因为它可能会对最佳医疗保健的提供和结果产生负面影响。
