Readability levels of selected hypercholesterolemia patient education literature

Abstract

Objectives: To assess the readability of selected hypercholesterolemia print materials, summarize the limitations of readability formulas, describe how expert judgement can be used to enhance readability determinations of printed materials, and discuss indirect and direct methods for assessing patient literacy levels.

Design: Descriptive, retrospective, convenience sample

Outcome measures: Readability of four AHA/NLHBI hypercholesterolemia patient education pamphlets by use of three readability formulas and the Reading Materials Checklist.

Results: The FOG, Fry, and SMOG formulas were used to calculate reading levels by two raters who independently applied the formulas to the same word passages chosen from the beginning, middle, and end of the pamphlets. The mean reading grade levels were 14.4, 15.8, 14, and 14.4, demonstrating that all four pamphlets were written for people with college level reading skills. The limitations of readability formulas such as variations in reading estimates were demonstrated. When expert judgement was applied with the Reading Materials Checklist, all pamphlets were found lacking in the areas of legibility, usability, and motivational appeal.

Conclusions: The results indicate that the pamphlets may not be appropriate for use with most of the adults in the United States who may be candidates for hypercholesterolemia patient education. Because reading formulas are limited in the information they provide, expert judgement regarding readability of print materials should also be applied. Additionally, indirect and direct techniques need to be used to assess the literacy level of the patient population who will be using the printed materials.