Readability of written health information provided to people with aphasia

Abstract

Background: Providing appropriate written health materials to people with aphasia presents a challenge for health professionals. To overcome this dilemma, the suitability of current written health materials intended for people with aphasia, and the measures that examine their suitability, need to be assessed. Aims: The primary aims of this research were to investigate the readability levels of written health materials given to people with aphasia, and to further analyse their appropriateness by considering linguistic parameters that contribute to reading difficulties for people with aphasia. The secondary aims were to investigate if commonly used readability measures are useful tools for assessing the suitability of written information for people with aphasia by: determining the readability measures' applicability to the wide range of health information received by people with aphasia, determining if there is a significant difference between three commonly applied readability measures, and investigating if there is a relationship between the most applicable readability measure and the linguistic measures. Methods & Procedure: A total of 114 written health documents were collected from 18 people living with aphasia. Of the materials collected, there were 84 different items, 28 of which could be analysed using three readability formulas: Flesch‐Kincaid, Fry, and Simple Measure of Gobbledygook (SMOG). The written health materials were also analysed according to number of sentences and embedded clauses, proportion of passive, complex, and compound sentences, and average word frequency and imageability. Outcomes & Results: This study found that written health materials obtained from people with aphasia were written at an average grade nine readability level and contained low‐frequency words, low‐imageability words, and complex sentences. There was no significant difference between the readability of aphasia or speech pathology materials compared to other more general health information. The Flesch‐Kincaid readability formula could be applied to more documents than the Fry and SMOG formulas and the mean reading grade levels calculated by these formulas were significantly different. The number of sentences was found to be the only linguistic measure directly related to the readability of a text. Conclusion: Written health materials are not sufficiently modified to suit the reading ability of people with aphasia. Reducing the readability level of texts is one process that authors can use to ensure that written health information is more accessible for people with aphasia.