Program Session

2 - Dream: Improving Health Literacy Dare: Enhancing Readability of Patient Education Material Do: One Document at a Time

Monday, May 29
1:20 PM - 1:35 PM
Room: 613

Objectives: Our institution’s Patient/Family Education Subcommittee is tasked with revising and updating written material directed at patients and family members. A member of this subcommittee, a librarian, is participating in the editing process of patient education material by applying plain language and easy-to-read principles while increasing readability to improve health literacy of patients and family members.

Methods: The subcommittee receives internal requests for revisions and updates of patient education material from staff, departments, and specialty areas within our institution. The subcommittee revises terminology, repairs grammatical errors, and updates changes in contact information or room locations. To meet the objective of this project, the librarian selects and edits documents that appear to contain sophisticated language, medical jargon, or complex sentences or paragraphs. Before editing begins, original text is ‘tested’ and scored for readability and reading level by Readability-Score.com, a free online tool that assesses text for readability and grade level using multiple reading assessment formulas. Next, using plain language resources, wordlists, toolkits and guidelines, the librarian edits the document, aiming for a 6th grade reading level. After revision, text is re-scored by Readability-Score.com. Last, ‘before and after’ documents are compared to determine if readability or grade level changed.


Results: Four patient education documents were edited during this project.  The average grade level of material before revisions was 10.35 and the average grade level of material after revisions was 9.15. On average, readability improved by a 1.2 grade level. In addition, revised material became more visually appealing due to the use of white space, larger font, headings and smaller words. Page counts increased after revision, however, this was inconsequential. During the project, subcommittee members were educated about the global movement of plain language and health literacy, and members adopted and implemented plain language and easy-to-read principles to the editing process. Recently, the subcommittee experienced administrative re-organization, resulting in changes to the review process of patient education material. To sustain the project, existing patient education material is being randomly selected for rating, and data is being collected with the purpose of proposing an enterprise-wide project with the Office of Patient Education. 

Conclusion:   This project inspired staff to adopt plain language practices and to become proactively involved in the effort of improving health literacy. Even small-scale changes have the power to improve readability of patient education material. Librarians should continue to contribute to plain language and health literacy awareness and practice.

Keywords: Health Literacy, plain language, consumer health information, patient education

References:


1.           Federal Plain Language Guidelines. Available from: http://www.plainlanguage.gov/howto/guidelines/bigdoc/fullbigdoc.pdf.


2.           Plainlanguage.gov  [cited 2016 March 7]. Available from: http://www.plainlanguage.gov/.


3.           How to Write Easy-to-Read Health Materials Bethesda, Maryland: National Library of Medicine;  [cited 2016 March 8]. Available from: https://www.nlm.nih.gov/medlineplus/etr.html#plan.


4.           Create a health literacy improvement plan toolkit. 2nd:[Available from: https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/tools/literacy-toolkit/healthlittoolkit2_tool2.pdf.


5.           Assess select and create easy to understand materials toolkit. Available from: https://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/literacy-toolkit/healthlittoolkit2-tool11.html.


6.           Quick Guide To Health Litearcy: Health Literacy Basics. What is Health Literacy? Available from: http://health.gov/communication/literacy/quickguide/factsbasic.htm#one.


7.           Promoting Health Literacy Through Easy-to-Read Materials  [3/14/16]. Available from: http://nnlm.gov/training/healthliteracy.


8.           National Assessment in Adult Literacy (NAAL) Key Findings 2003 [2/9/17]. Available from: https://nces.ed.gov/naal/kf_demographics.asp.


9.           The Health Literacy of America’s Adults: Results From the 2003 National Assessment of Adult Literacy2006.


10.         Plain Language Thesaurus for Health Communications: Centers for Disease Control and Prevention (CDC); 2007 [updated September 2007; cited 2016 March 8].


11.         Busselman KM, Holcomb CA. Reading skill and comprehension of the dietary guidelines by WIC participants. Journal of the American Dietetic Association. 1994;94(6):622-5.


12.         Lee SY, Bender DE, Ruiz RE, Cho YI. Development of an easy-to-use Spanish Health Literacy test. Health services research. 2006;41(4 Pt 1):1392-412.


13.         Lee SY, Stucky BD, Lee JY, Rozier RG, Bender DE. Short Assessment of Health Literacy-Spanish and English: a comparable test of health literacy for Spanish and English speakers. Health services research. 2010;45(4):1105-20.


14.         Medicine NNoNLo. Health Literacy  [March 10 2016]. Available from: https://nnlm.gov/outreach/consumer/hlthlit.html.


15.         Nielsen-Bohlman L, Institute of M, Committee on Health L. Health literacy : a prescription to end confusion. Washington, D.C.: National Academies Press; 2004.


16.         Wilson FL, Mood DW, Risk J, Kershaw T. Evaluation of education materials using Orem's self-care deficit theory. Nursing science quarterly. 2003;16(1):68-76.


 


 





Program Session

Diana Almader-Douglas

Librarian
Hospital Library
Phoenix, Arizona

Diana Almader-Douglas received her MA in Library Resources from The University of Arizona School of Information Resources and Library Science in 2011, and is currently a librarian at Mayo Clinic Libraries- Arizona. Prior to earning her library degree, Diana was a licensed behavioral health therapist interested in evidence based clinical practice. Diana is dedicated to research, consumer health, health disparities, and health literacy. From 2012-2014, Diana participated in the National Library of Medicine’s Associate Fellowship Program.

In her current role as hospital librarian, Diana conducts literature searches for patrons, assists patrons with research projects, and teaches patrons how to access and utilize library resources. She is a member of the Nursing Research Subcommittee and the Patient and Family Education Subcommittee.

Diana lives in Glendale, Arizona with her family and enjoys reading, cooking, and acrylic painting.

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2 - Dream: Improving Health Literacy Dare: Enhancing Readability of Patient Education Material Do: One Document at a Time

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