Level of reading difficulty in the American College of Obstetricians and Gynecologists patient education pamphlets

Abstract

Written educational and informational materials are an important and potentially useful means to complement verbal instructions, assure that consent for tests and procedures is informed, and enhance compliance with treatment. In specialties other than obstetrics and gynecology, many of these materials have been found to be written at a level of difficulty above the reading ability of the intended audience. The SMOG formula was used to assess the level of reading difficulty of all 74 English-language patient education pamphlets developed by The American College of Obstetricians and Gynecologists (ACOG) Committee on Patient Education. Sixty-one of these pamphlets are written at a reading difficulty level of 11th grade or higher. Although the mean reading education level in the United States is at grade 12.6, the mean literacy level is at or below eighth grade. With the exception of one ACOG pamphlet written specifically for low-readability audiences (p-063, Birth Control Pills), all the pamphlets are written at a level higher than the literacy level of many women. The information is unlikely to be understood if it is written above the reading ability of the intended audience. This disparity is accentuated for health-education materials because scientific and technical terms further reduce the level of comprehension. The SMOG formula is a simple means to ensure that educational materials are written at a level appropriate for the intended audience.