Readability of Patient Education Materials
Health care providers must assure that patients understand print instructions and reminders. Literacy skills are associated with health status, and national accreditation standards specify that patient literacy and language should be considered when providing instruction. Methods to check and reduce reading level of health information are offered.
The recommended reading level for health instructions and consents is 6th grade or lower. The average adult reading level in the U.S. is 8th grade, and the average reading level of Medicaid enrollees is 5th grade. However, patients with good reading skills may prefer simpler materials.
Among the common reading level formulas are SMOG, Fry, and Flesch-Kincaid. All scoring methods use sample sections of the text and generate a score based on the number of multi-syllable words and the length of the sentences. Word processing computer programs also have grade-level readability tools.
Reading levels are reduced by using: one or two syllable words, e.g., "give" rather than "administer;" short sentences of 15 or fewer words; second-person pronoun, "you," rather than third-person "the patient;" active rather than passive verbs, and numerals rather than spelled numbers.
Accuracy, pertinence and "tone" also influence reader interest and understanding. Content should be adapted to be totally consistent with the agency or setting if using pre-prepared information.
- Record the date on forms to indicate when to review or replace the information item.
- Arrange information according to importance - what most readers need and want to know first.
- Use affirmative directions, such as "doˇ¦" rather than negative "do not"
- Select a 12-point or larger size font and a style with serifs (short lines connected to the ends of letters, e.g., Times New Roman).
- Test new material with representatives of the intended audience to review understandability and usefulness.
(Winslow E. Am J Nurs 2001;101(10):33-38)
Comment: My word processing program scored this abstract with Flesch-Kincaid at 11.4 grade-level and counted an average of 18 words per sentence. Ask the school resource person how to check the readability of your forms and newsletters. --J.O.
