Health literacy in rotator cuff repair: a quantitative assessment of the understandability of online patient education material
Background: The American Medical Association and National Institutes of Health recommend online health information be written at a 6th grade or lower reading level for clear understanding. While syntax reading grade level has previously been utilized, those analyses do not determine whether readers...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-11-01
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| Series: | JSES International |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666638323001627 |
| _version_ | 1797647787048828928 |
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| author | Matthew T. Gulbrandsen, MD Olivia C. O’Reilly, MD Burke Gao, MD Damion Cannon, MD Jose Jesurajan, MD Trevor R. Gulbrandsen, MD Wesley P. Phipatanakul, MD |
| author_facet | Matthew T. Gulbrandsen, MD Olivia C. O’Reilly, MD Burke Gao, MD Damion Cannon, MD Jose Jesurajan, MD Trevor R. Gulbrandsen, MD Wesley P. Phipatanakul, MD |
| author_sort | Matthew T. Gulbrandsen, MD |
| collection | DOAJ |
| description | Background: The American Medical Association and National Institutes of Health recommend online health information be written at a 6th grade or lower reading level for clear understanding. While syntax reading grade level has previously been utilized, those analyses do not determine whether readers are processing key information (understandability) or identifying available actions to take (actionability). The Patient Education Materials Assessment Tool (PEMAT-P) is a method to measure the understandability and actionability of online patient education materials. The purpose of this study was to evaluate online resources regarding rotator cuff repair utilizing measures of readability, understandability, and actionability. Methods: The search term “rotator cuff surgery” was used in two independent online searches to obtain the top 50 search results. The readability of included resources was quantified using valid objective algorithms: Flesch-Kincaid Grade-Level, Simple Measure of Gobbledygook grade, Coleman-Liau Index, and Gunning Fog Index. The PEMAT-P form was used to assess actionability and understandability. Results: A total of 49 unique websites were identified to meet our inclusion criteria and were included in our analysis. The mean Flesch-Kincaid Grade Level graded materials at a 10.6 (approximately a 10th grade reading level), with only two websites offering materials at a 6th grade reading level or below. The remaining readability studies graded the mean reading level at high school or greater, with the Gunning Fog Index scoring at a collegiate reading level. Mean understandability and actionability scores were 64.6% and 29.5%, respectively, falling below the 70% PEMAT score threshold for both scales. Fourteen (28.6%) websites were above the threshold for understandability, while no website (0%) scored above the 70% threshold for actionability. When comparing source categories, commercial health publishers provided websites that scored higher in understandability (P < .05), while private practice materials scored higher in actionability (P < .05). Resources published by academic institutions or organizations scored lower in both understandability and actionability than private practice and commercial health publishers (P < .05). No readability, understandability, or actionability score was significantly associated with search result rank. Conclusion: Overall, online patient education materials related to rotator cuff surgery scored poorly with respect to readability, understandability, and actionability. Only two (4.1%) of the patient education websites scored at the American Medical Association and National Institutes of Health recommended reading level. Fourteen (28.6%) scored above the 70% PEMAT score for understandability; however, no website met the threshold for actionability. |
| first_indexed | 2024-03-11T15:22:36Z |
| format | Article |
| id | doaj.art-ddffa46f4b0f47c2a0bd81234aac294b |
| institution | Directory Open Access Journal |
| issn | 2666-6383 |
| language | English |
| last_indexed | 2024-03-11T15:22:36Z |
| publishDate | 2023-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JSES International |
| spelling | doaj.art-ddffa46f4b0f47c2a0bd81234aac294b2023-10-28T05:09:48ZengElsevierJSES International2666-63832023-11-017623442348Health literacy in rotator cuff repair: a quantitative assessment of the understandability of online patient education materialMatthew T. Gulbrandsen, MD0Olivia C. O’Reilly, MD1Burke Gao, MD2Damion Cannon, MD3Jose Jesurajan, MD4Trevor R. Gulbrandsen, MD5Wesley P. Phipatanakul, MD6Department of Orthopedic Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA; Corresponding author: Matthew T. Gulbrandsen, MD, Department of Orthopaedic Surgery, STE 218, 11406 Loma Linda Dr, Loma Linda, CA 92354-3711, USA.Department of Orthopedic Surgery, University of Iowa Hospital, Iowa City, IA, USADepartment of Orthopedic Surgery, University of Iowa Hospital, Iowa City, IA, USADepartment of Orthopedic Surgery, Loma Linda University Medical Center, Loma Linda, CA, USADepartment of Orthopedic Surgery, Loma Linda University Medical Center, Loma Linda, CA, USADepartment of Orthopedic Surgery, University of Iowa Hospital, Iowa City, IA, USADepartment of Orthopedic Surgery, Loma Linda University Medical Center, Loma Linda, CA, USABackground: The American Medical Association and National Institutes of Health recommend online health information be written at a 6th grade or lower reading level for clear understanding. While syntax reading grade level has previously been utilized, those analyses do not determine whether readers are processing key information (understandability) or identifying available actions to take (actionability). The Patient Education Materials Assessment Tool (PEMAT-P) is a method to measure the understandability and actionability of online patient education materials. The purpose of this study was to evaluate online resources regarding rotator cuff repair utilizing measures of readability, understandability, and actionability. Methods: The search term “rotator cuff surgery” was used in two independent online searches to obtain the top 50 search results. The readability of included resources was quantified using valid objective algorithms: Flesch-Kincaid Grade-Level, Simple Measure of Gobbledygook grade, Coleman-Liau Index, and Gunning Fog Index. The PEMAT-P form was used to assess actionability and understandability. Results: A total of 49 unique websites were identified to meet our inclusion criteria and were included in our analysis. The mean Flesch-Kincaid Grade Level graded materials at a 10.6 (approximately a 10th grade reading level), with only two websites offering materials at a 6th grade reading level or below. The remaining readability studies graded the mean reading level at high school or greater, with the Gunning Fog Index scoring at a collegiate reading level. Mean understandability and actionability scores were 64.6% and 29.5%, respectively, falling below the 70% PEMAT score threshold for both scales. Fourteen (28.6%) websites were above the threshold for understandability, while no website (0%) scored above the 70% threshold for actionability. When comparing source categories, commercial health publishers provided websites that scored higher in understandability (P < .05), while private practice materials scored higher in actionability (P < .05). Resources published by academic institutions or organizations scored lower in both understandability and actionability than private practice and commercial health publishers (P < .05). No readability, understandability, or actionability score was significantly associated with search result rank. Conclusion: Overall, online patient education materials related to rotator cuff surgery scored poorly with respect to readability, understandability, and actionability. Only two (4.1%) of the patient education websites scored at the American Medical Association and National Institutes of Health recommended reading level. Fourteen (28.6%) scored above the 70% PEMAT score for understandability; however, no website met the threshold for actionability.http://www.sciencedirect.com/science/article/pii/S2666638323001627Rotator cuffPatient educationOnline patient educationShoulderUnderstandabilityReadability |
| spellingShingle | Matthew T. Gulbrandsen, MD Olivia C. O’Reilly, MD Burke Gao, MD Damion Cannon, MD Jose Jesurajan, MD Trevor R. Gulbrandsen, MD Wesley P. Phipatanakul, MD Health literacy in rotator cuff repair: a quantitative assessment of the understandability of online patient education material JSES International Rotator cuff Patient education Online patient education Shoulder Understandability Readability |
| title | Health literacy in rotator cuff repair: a quantitative assessment of the understandability of online patient education material |
| title_full | Health literacy in rotator cuff repair: a quantitative assessment of the understandability of online patient education material |
| title_fullStr | Health literacy in rotator cuff repair: a quantitative assessment of the understandability of online patient education material |
| title_full_unstemmed | Health literacy in rotator cuff repair: a quantitative assessment of the understandability of online patient education material |
| title_short | Health literacy in rotator cuff repair: a quantitative assessment of the understandability of online patient education material |
| title_sort | health literacy in rotator cuff repair a quantitative assessment of the understandability of online patient education material |
| topic | Rotator cuff Patient education Online patient education Shoulder Understandability Readability |
| url | http://www.sciencedirect.com/science/article/pii/S2666638323001627 |
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