Spanish-Language Patient Education Materials for Obstetric Anesthesia: A Comparison of Readability and Quality of Online Spanish-Language Resources

Abstract

Introduction: Thousands of Hispanic parturients give birth in the United States annually, necessitating accessible health education resources in Spanish. Given the known Hispanic maternal care disparities and high reading levels of Spanish-written patient education materials (PEMs), this study aims to assess the readability and quality of obstetric (OB) anesthesia Spanish-language PEMs from a general internet search and academic leaders. We hypothesize that the readability and quality of PEMs from academic leaders will be superior to those found via general internet search.

Methods: To identify Spanish-written PEMs on OB anesthesia, the webpages of 62 academic medical centers (AMCs) recognized as OB anesthesia leaders were screened. A general internet search using "anestesia y alivio del dolor durante el parto" ("anesthesia and pain relief during labor and delivery") was conducted to find an equal number of additional resources. Readability was assessed using the Fernandez-Huerta Readability Index (FHRI) and Indice de Legibilidad de Flesch-Szigriszt (INFLESZ) analyses, while quality was evaluated using the DISCERN instrument and the Health Education Materials Assessment Tool (HEMAT).

Results: Twenty-eight Spanish-language PEMs from AMCs and 28 from a general internet search were identified. The FHRI and INFLESZ readability analyses revealed that PEMs from both cohorts primarily aligned with a 9-10th grade reading level. These reading levels significantly exceeded the recommended 4-6th grade level (p < 0.001). DISCERN scores indicated no quality difference between cohorts. Both groups achieved high HEMAT scores for understandability.

Conclusion: The readability of online OB anesthesia Spanish-written PEMs from AMCs and a general internet search was both similar and higher than recommended. Quality did not differ between both cohorts. Improvements in readability and quality are needed for better patient-centered care and to emphasize the importance of shared decision-making.

Keywords: obstetric anesthesia; patient education materials; quality analysis; readability analysis.

FIG. 1.

Screening process for academic medical centers (AMCs) and general internet search PEMs.