Health Literacy and Gastroenterology: A Quantitative Readability Analysis of Patient Education Materials on the Internet

Abstract

Introduction: As the American public is becoming more reliant on the Internet as a source of medical knowledge, ensuring that this information is comprehensible is of the utmost importance. The American Medical Association (AMA) and the National Institutes of Health (NIH) recommend that patient education materials be written between a 3rd and 7th grade level, given an 8th grade average reading level of the lay public. We aim to determine whether the gastroenterology information for patients available online meets the AMA and NIH readability guidelines. Methods: We evaluated 214 individual patient education articles available on the websites for the American College of Gastroenterology (ACG), the American Gastroenterological Association (AGA), the American Society of Gastrointestinal Endoscopy (ASGE), the British Society of Gastroenterology (BSG), and the NIH's National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) with 10 wellestablished readability scales. One-way ANOVA and Tukey's HSD post hoc analysis were conducted to determine any differences in the level of readability between websites. Results: The 214 articles were found to be written at an 11.8 ± 2.1 grade level with a range of 8.0 to 16.0 grade level. A one-way ANOVA and Tukey's HSD post hoc analysis determined the ACG materials were written at a significantly (p < 0.05) more difficult level when compared to the AGA, the BSG, and NIDDK websites. No differences were noted when comparing to the ASGE website. Conclusion: None of the patient education materials evaluated were written at a level that met the AMA and the NIH guidelines. This suggests that a redrafting of this information will likely lead to a more effective understanding of the material by the average American reader and ultimately may have an impact on healthcare delivery and outcomes.