College of Medicine, University of Cincinnati, Cincinnati, OH, United States.
Department of Computer Science, University of Cincinnati, Cincinnati, OH, United States.
J Med Internet Res. 2023 Aug 30;25:e46346. doi: 10.2196/46346.
Patient education materials (PEMs) can be vital sources of information for the general population. However, despite American Medical Association (AMA) and National Institutes of Health (NIH) recommendations to make PEMs easier to read for patients with low health literacy, they often do not adhere to these recommendations. The readability of online PEMs in the obstetrics and gynecology (OB/GYN) field, in particular, has not been thoroughly investigated.
The study sampled online OB/GYN PEMs and aimed to examine (1) agreeability across traditional readability measures (TRMs), (2) adherence of online PEMs to AMA and NIH recommendations, and (3) whether the readability level of online PEMs varied by web-based source and medical topic. This study is not a scoping review, rather, it focused on scoring the readability of OB/GYN PEMs using the traditional measures to add empirical evidence to the literature.
A total of 1576 online OB/GYN PEMs were collected via 3 major search engines. In total 93 were excluded due to shorter content (less than 100 words), yielding 1483 PEMs for analysis. Each PEM was scored by 4 TRMs, including Flesch-Kincaid grade level, Gunning fog index, Simple Measure of Gobbledygook, and the Dale-Chall. The PEMs were categorized based on publication source and medical topic by 2 research team members. The readability scores of the categories were compared statistically.
Results indicated that the 4 TRMs did not agree with each other, leading to the use of an averaged readability (composite) score for comparison. The composite scores across all online PEMs were not normally distributed and had a median at the 11th grade. Governmental PEMs were the easiest to read amongst source categorizations and PEMs about menstruation were the most difficult to read. However, the differences in the readability scores among the sources and the topics were small.
This study found that online OB/GYN PEMs did not meet the AMA and NIH readability recommendations and would be difficult to read and comprehend for patients with low health literacy. Both findings connected well to the literature. This study highlights the need to improve the readability of OB/GYN PEMs to help patients make informed decisions. Research has been done to create more sophisticated readability measures for medical and health documents. Once validated, these tools need to be used by web-based content creators of health education materials.
患者教育材料（PEM）可以成为普通民众获取信息的重要来源。然而，尽管美国医学协会（AMA）和美国国立卫生研究院（NIH）建议使 PEM 更易于阅读低健康素养的患者，但它们通常不符合这些建议。妇产科（OB/GYN）领域在线 PEM 的可读性尤其没有得到彻底调查。
本研究对在线 OB/GYN PEM 进行了抽样调查，旨在检查（1）传统可读性测量（TRM）之间的一致性，（2）在线 PEM 是否符合 AMA 和 NIH 的建议，以及（3）在线 PEM 的可读性是否因基于网络的来源和医疗主题而异。本研究不是范围综述，而是侧重于使用传统方法对 OB/GYN PEM 的可读性进行评分，为文献提供经验证据。
通过 3 个主要搜索引擎共收集了 1576 份在线 OB/GYN PEM。由于内容较短（少于 100 字），共有 93 份被排除在外，因此共有 1483 份 PEM 进行分析。每个 PEM 均由 4 种 TRM 评分，包括弗莱什-金纳德年级水平、冈宁雾度指数、简单胡言乱语测量和戴尔-查尔。由 2 名研究团队成员根据出版来源和医疗主题对 PEM 进行分类。统计比较了类别的可读性评分。
结果表明，4 种 TRM 之间不一致，因此使用平均可读性（综合）评分进行比较。所有在线 PEM 的综合评分均呈非正态分布，中位数为 11 年级。政府来源的 PEM 最容易阅读，而关于月经的 PEM 最难阅读。然而，来源和主题之间的可读性评分差异很小。
本研究发现，在线 OB/GYN PEM 不符合 AMA 和 NIH 的可读性建议，对于低健康素养的患者来说，阅读和理解这些 PEM 将非常困难。这两个发现都与文献很好地联系在一起。本研究强调需要提高 OB/GYN PEM 的可读性，以帮助患者做出明智的决策。已经进行了研究以创建更复杂的医疗和健康文件可读性测量工具。一旦经过验证，这些工具就需要由在线健康教育材料内容创建者使用。
