C. M. Rentas1, S. Baker1, E. Malone1, J. Richman1, G. Yang1, M. Morris1 1University Of Alabama at Birmingham,Birmingham, Alabama, USA
Introduction: Health literacy is a predictor of a patient’s health status. Despite variability of patient health literacy, patient education handouts remain the most widely used form of medical information. The American Medical Association (AMA) and National Institutes of Health (NIH) recommend that patient information be presented at 6th grade reading level or lower. Not only do patient education handouts need to be readable, the medical information presented should also be understandable to the general public. We hypothesized that patient education handouts at our local Veterans Affairs Medical Center general surgery clinic were written above a 6th grade reading level and contained information that was not understandable to the average patient.
Methods: Routine patient education materials were collected from the general surgery clinic. The Flesch-Kincaid Grade Level (FKGL) instrument was used to analyze the texts to generate a FKGL score without any correction of misspellings or grammatical errors. To assess understandability, we used the Patient Education Materials Assessment Tool (PEMAT) and recorded scores of “understandability” and “actionability” for each patient education handout. Then, patient education handouts were re-written using recommendations from the Centers for Disease Control and Prevention’s “Simply Put” guide for creating easy-to-understand materials and re-assessed using the FKGL and PEMAT tools.
Results: We collected 5 patient education handouts from the general surgery clinic covering various topics such as: colectomy, hernia repair, cholecystectomy. The overall average FKGL for the handouts was 7.94 (SD 0.49), exceeding the NIH/AMA standards sixth grade level by an average of 1.94 grade levels (95% CI=7.33-8.55; p <0.0002). The overall average PEMAT scores for both understandabilty and actionability were 40% (SD 6%). Handouts were then rewritten. The average time to rewrite a handout was 1 hour. Upon re-assessment the average FKGL for the rewritten handouts was 5.4 (SD 0.35, 95% CI=4.97-5.83) % below the grade level. The average PEMAT understandability and actionability scores for the rewritten material are 100% and 82%, respectively (SD 0, 2%), compared to 40% for both before.
Conclusion: The readability of patient education material in our VA general surgery clinic is poor and deviates significantly from AMA/NIH recommendations. With limited time and resources, the FKGL and PEMAT scores for the patient education handouts were improved using the “Simply Put” guidelines to ensure readability and understandability of medical information.
