Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Department of Advertising and Public Relations, University of Texas at Austin, Austin, Texas, USA.
Gastrointest Endosc. 2014 Aug;80(2):284-90. doi: 10.1016/j.gie.2014.01.034. Epub 2014 Mar 25.
Colorectal cancer (CRC) screening rates in the Unites States are still below target level. Web-based patient education materials are used by patients and providers to provide supplemental information on CRC screening. Low literacy levels and patient perceptions are significant barriers to screening. There are little data on the quality of these online materials from a health literacy standpoint or whether they address patients' perceptions.
To evaluate the readability, suitability, and health content of web-based patient education materials on colon cancer screening.
Descriptive study.
Web-based patient materials.
Twelve reputable and popular online patient education materials were evaluated. Readability was measured by using the Flesch-Kincaid Reading Grade Level, and suitability was determined by the Suitability Assessment of Materials, a scale that considers characteristics such as content, graphics, layout/typography, and learning stimulation. Health content was evaluated within the framework of the Health Belief Model, a behavioral model that relates patients' perceptions of susceptibility to disease, severity, and benefits and barriers to their medical decisions. Each material was scored independently by 3 reviewers.
Flesch-Kincaid Reading Grade Level score, Suitability Assessment of Materials score, health content score.
Readability for 10 of 12 materials surpassed the maximum recommended sixth-grade reading level. Five were 10th grade level and above. Only 1 of 12 materials received a superior suitability score; 3 materials received inadequate scores. Health content analysis revealed that only 50% of the resources discussed CRC risk in the general population and <25% specifically addressed patients at high risk, such as African Americans, smokers, patients with diabetes, and obese patients. For perceived barriers to screening, only 8.3% of resources discussed embarrassment, 25% discussed pain with colonoscopy, 25% addressed cost of colonoscopy, and none specifically mentioned the need to get colonoscopy when no symptoms are present. No material discussed the social benefits of screening.
Descriptive design.
Most online patient education materials for CRC screening are written beyond the recommended sixth-grade reading level, with suboptimal suitability. Health content is lacking in addressing key perceived risks, barriers, and benefits to CRC screening. Developing more appropriate and targeted patient education resources on CRC may improve patient understanding and promote screening.
美国的结直肠癌（CRC）筛查率仍低于目标水平。基于网络的患者教育材料被患者和提供者用于提供 CRC 筛查的补充信息。低文化水平和患者认知是筛查的重大障碍。从健康素养的角度来看，关于这些在线材料的质量，或者它们是否解决了患者的认知问题，数据很少。
评估基于网络的结直肠癌筛查患者教育材料的可读性、适宜性和健康内容。
描述性研究。
基于网络的患者材料。
评估了 12 种可靠且流行的在线患者教育材料。使用弗莱什-金凯德阅读水平等级来衡量可读性，适宜性通过适宜性评估材料来确定，该量表考虑了内容、图形、布局/排版和学习刺激等特征。健康内容是在健康信念模型的框架内进行评估的，健康信念模型是一种行为模型，它将患者对疾病易感性、严重程度以及对其医疗决策的益处和障碍的认知联系起来。每个材料都由 3 名评审员独立评分。
弗莱什-金凯德阅读水平等级评分、适宜性评估材料评分、健康内容评分。
12 种材料中有 10 种的可读性超过了推荐的最高六年级阅读水平。有 5 种达到了 10 年级及以上水平。只有 1 种材料获得了优秀的适宜性评分；3 种材料的评分较低。健康内容分析显示，只有 50%的资源讨论了普通人群中的 CRC 风险，<25%的资源专门讨论了高危人群，如非裔美国人、吸烟者、糖尿病患者和肥胖患者。对于筛查的感知障碍，只有 8.3%的资源讨论了尴尬，25%的资源讨论了结肠镜检查的疼痛，25%的资源讨论了结肠镜检查的费用，没有一个资源专门提到没有症状时需要进行结肠镜检查。没有一个材料讨论了筛查的社会益处。
描述性设计。
大多数 CRC 筛查的基于网络的患者教育材料的写作水平都超过了推荐的六年级阅读水平，适宜性较差。健康内容在讨论 CRC 筛查的关键感知风险、障碍和益处方面有所欠缺。开发更合适和有针对性的 CRC 患者教育资源可能会提高患者的理解能力，并促进筛查。
