Original Article
The readability of American Academy of Pediatrics patient education brochures

https://doi.org/10.1016/j.pedhc.2005.01.013Get rights and content

Introduction

The purpose of this study was to evaluate the readability of American Academy of Pediatrics (AAP) patient education brochures.

Method

Seventy-four brochures were analyzed using two readability formulas.

Results

Mean readability for all 74 brochures was grade 7.94 using the Flesch-Kincaid formula, and grade 10.1 with SMOG formula (P = .001). Using the SMOG formula, no brochures were of acceptably low (≤8th grade) readability levels (range 8.3 to 12.7). Using the Flesch-Kincaid formula, 41 of the 74 had acceptable readability levels (≤8th grade). The SMOG formula routinely assessed brochures 2 to 3 grade levels higher than did the Flesch-Kincaid formula.

Discussion

Some AAP patient education brochures have acceptably low levels of readability, but at least half are written at higher than acceptable readability levels for the general public. This study also demonstrated statistically significant variability between the two different readability formulas; had only the SMOG formula been used, all of the brochures would have had unacceptably high readability levels. Readability is an essential concept for patient education materials. Professional associations that develop and market patient education materials should test for readability and publish those readability levels on each piece of patient education so health care providers will know if the materials are appropriate for their patients.

Section snippets

Methods

This was a descriptive study of the readability of AAP patient education brochures.

Flesch-kincaid formula

Using the Flesch-Kincaid reading level formula, 55% of the AAP patient education brochures were found to be written at higher readability levels than generally recommended for the general public; only 41 of the 74 brochures had readability levels at the acceptable level of ≤8th grade. The mean readability level for all 74 brochures was grade 7.94 with this formula (range 5.7-11.7). When examined by decade of copyright, the mean readability levels for those developed or revised during the 1990s

Discussion

This study demonstrated that while some of the AAP patient education brochures have acceptable levels of readability as measured by the Flesch-Kincaid readability formula, more than half are written at higher than acceptable readability levels for the general public, no matter which of the two readability formulas were used for evaluation. When examined by decade of copyright, the brochures were found to have no significant differences in grade level by decade of copyright or revision. This

Clinical implications

Readability is a basic necessity for health education materials, for if the patient or family cannot read the information, they cannot comprehend it or follow its instructions. Clinical health professionals who distribute patient education materials to their patients should be aware of the issue of readability, and should know if the materials they use are readable by the population they serve. This is a challenge for providers, for there is no easy way for clinicians to merely look at patient

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    Margaret Comerford Freda is Professor, Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY.

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