Evaluation of the readability, validity, and user-friendliness of written web-based patient education materials for aphasia

Abstract

ABSTRACTBackground: Despite the importance of written healthcare information in improving an individual’s health status, patients may not be able to sufficiently utilize available resources because of a disparity between the accessibility of online written materials and patients’ ability to process that information. For individuals with impairments in written language comprehension, such as persons with aphasia, this disparity may be magnified. It is crucial that written health resources be cognitively accessible, accurate, and understandable for persons with aphasia.Aims: The aims of this study were to: (1) objectively measure the accessibility of current written educational materials for persons with aphasia and (2) examine the relationship between levels of readability, validity, and user-friendliness of materials accessed.Methods & Procedures: Aphasia-related webpages likely to be accessed during an Internet search were retrieved and analysed. These webpages were determined by selecting the first 10 search results generated from entering the terms: “aphasia”, “aphasia treatment”, and “aphasia help”, into Google, Bing, and Yahoo. This method resulted in 30 website resources per search engine. For each webpage, readability was evaluated using the following readability formulae: Flesch-Kincaid Reading Ease, Flesch–Kincaid Grade Level (F–K), Simple Measure of Gobbledygook, and FORCAST. Additionally, validity and user-friendliness were evaluated for each webpage using the following measures: Site, Publisher, Audience, Timeliness (SPAT) and Suitability Assessment of Materials (SAM), respectively.Outcomes & Results: A significant disparity was found between the desired and current level of readability, validity, and user-friendliness of the written information provided within the top search results related to aphasia. Based on the readability formulae output the average reading grade level of 10th grade was well above the average 5th grade reading level recommended for written materials. A third of the websites were unacceptable using the SPAT’s quality standards and overall user-friendliness was deemed poor with an average SAM score of 27.4 out of 52 total points. No relationship was found between the validity or user-friendliness of websites and their readability.Conclusions: These data clearly demonstrate inadequacies in written web-based information about aphasia across several measures and provide insight into how the presentation of this information can be improved to facilitate useful information dissemination. Highlighting these disparities is important for promoting increased consideration and improvement in the usefulness and accessibility of healthcare information for persons with aphasia.