Web-based Patient Education Materials Research Articles

Assessing readability and comprehension of web-based patient education materials by American Heart Association (AHA) and CardioSmart online platform by American College of Cardiology (ACC): How useful are these websites for patient understanding?

Cardiovascular diseases (CVD) are a leading cause of morbidity & mortality worldwide. Patient education materials help patients understand the disease and its management. Health literacy is an important challenge that may contribute to health inequities and disparities. The National Institute of Health and American Medical Association recommend patient education materials to be ≤6th-grade reading level. ObjectiveTo evaluate readability and comprehension of patient education materials related to CVD, available at the American Heart Association (AHA) & CardioSmart web platform by the American College of Cardiology (ACC) websites. MethodWe examined the readability and comprehension of 63 patient education materials (accessed June 2022) using: (a) Flesch Kincaid Readability Ease (FKRE): measures readability (0–100, goal > 70), (b) Flesch Kincaid Grade Level (FKGL) (goal = grade 7). We compared the AHA and ACC scores using descriptive and t-tests. P-value ≤ 0.05 was significant. ResultsSixty-three web pages of patient education materials (AHA 24, ACC 39) were reviewed in June 2022. Mean ± standard deviation (SD) FKRE was 54.9 ± 6.8 for all the web pages. FKRE 50–60 equates to “fairly difficult to read.” Mean ± SD FKGL was 10.0 ± 1.3. AHA patient education materials content was significantly more difficult to read and comprehend, were longer, and had more complex words than ACC patient education materials. ConclusionsCVD-related patient education materials available online through leading national organizations are not congruent with the recommendations from national healthcare organizations. They are not as user-friendly as they can be. Urgent recognition of the gaps and unmet needs are indicated to optimize patient health literacy.

Quality evaluation of patient educational resources for catheter ablation treatment of atrial fibrillation.

The prevalence of atrial fibrillation (AF) is increasing rapidly with the growing utilization of catheter ablation (CA) as a treatment strategy. Education for individuals undertaking this procedure is diverse, with varying degrees of information provided and little standardization. Many individuals utilize the internet as an educational resource. However, there is limited regulation of online patient information. To evaluate the quality of web-based patient education resources for patients undergoing CA for AF. A cross-sectional observational study was performed to obtain all freely accessible online educational resources about CA for AF from inception until 1 October 2019. Search engines used: Google, Yahoo!, and Bing. The Patient Education Materials Assessment Tool (PEMAT) was used to evaluate the quality of web-based patient education materials and printable tools. The PEMAT score objectively measures both the understandability and actionability of educational material. A total of 17 websites and 15 printable sources were included in the analysis. Non-government organizations developed 19% of materials and 75% were created by private or university hospitals. Nineteen sources (59.4%) were rated as highly understandable: 9 websites (52.9%) and 10 printable tools (66.7%). Seven sources (21.9%) were rated as highly actionable: 6 (35.3%) websites and 1 (6.7%) printable tool. The overall understandability of educational CA material was high, whilst improvement of actionability is warranted. The addition of summaries, visual aids, and tools, such as checklists may improve quality. These findings have significant implications for the development of patient educational material for CA in AF.

Quality evaluation of patient educational resources for catheter ablation of atrial fibrillation

Abstract Funding Acknowledgements Type of funding sources: None. Background The prevalence of atrial fibrillation (AF) is increasing rapidly with growing utilisation of catheter ablation (CA) as a treatment strategy. Education of individuals undertaking this procedure is diverse, with varying degrees of information provided and little standardisation. Many individuals utilise the internet as an educational resource. However, there is limited regulation of online patient information. Aims The purpose of this study was to evaluate the quality of web based patient education resources for patients undergoing CA in the management of AF. Methods A cross-sectional observational study was performed to obtain all freely accessible online educational resources designed to inform AF patients about CA. from inception until 1st October 2019. Three search engines were used: Google, Yahoo! and Bing, using the search terms "atrial fibrillation" and "catheter ablation" combined with "patient information and patient education" in English and Spanish. The Patient Education Materials Assessment Tool (PEMAT) is a validated tool used to evaluate web-based patient education materials as well as printable tools. The PEMAT score objectively measures the understandability and actionability of printable tools for audio-visual material. Results A total of 17 websites and 15 printable tools were included in the analysis. Non-government organizations developed 19% of materials and 75% were created by private or university hospitals. Nineteen materials (59.3%) were rated as highly understandable and 25 materials (21%) were rated as highly actionable, whilst ten materials had an actionability of 0% (6 websites and 4 printable tools). Less than a half of the materials evaluated were highly rated by the PEMAT score, with a total of 7 websites (41%) and 7 printable tools (46,6%) scoring >70%. Conclusion The overall understandability of educational CA material was high, whilst improvement of actionability is warranted. The addition of summaries, visual aids and tools such as checklists may improve quality. These findings have significant implications for developing new patient educational material for CA in AF.

The Readability of Online Educational Materials for Femoroacetabular Impingement Syndrome.

Level III.

Evaluating the Understandability and Actionability of Web-Based Education Materials for Patients Taking Non-vitamin K Oral Anticoagulants.

More patients are now taking high-risk medicines such as non-vitamin K oral anticoagulants (NOACs). Hence, patient education materials need to be in an understandable format so that they can be empowered to act on their knowledge. Factors such as health literacy and the design of the medicine information material may influence the patient's ability to understand and act on key information. The PRISMA checklist was used to inform the study design. A structured search was conducted to obtain all freely accessible online educational resources designed for patients about the non-vitamin K antagonists (NOACs) during August 2018. Three search engines were used: Google, Yahoo! and Bing, using the search terms "NOAC" and "anticoagulant" combined with "patient/consumer information and patient/consumer resources."We applied the Patient Education Materials Assessment Tool (PEMAT) to evaluate web-based patient education materials in terms of understandability and actionability for patients taking NOACs. Of the 35 materials included, the majority of the materials (n=32, 91%) were rated as highly understandable (PEMAT score ≥70%), and more than three-quarters of all the materials (n=29, 83%) were rated as poorly actionable (PEMAT score <70%). For understandability, the majority of materials neither provided a summary of the key points nor used visual aids for several items such as simple tables, illustrations, and photographs. For actionability, few materials provided a tangible tool, such as a checklist, to prompt the user into action (n=4). Few used visual aids such as nonverbal cues to the written instructions (n=4). To improve the understandability and actionability of most of the NOAC patient education materials, there is a need to include more summaries of information, visual aids, and tangible tools such as checklists. Further research is warranted where patients are involved in providing feedback on the design of medicine information materials for NOACs.

Evaluating the Understandability and Actionability of Web-Based Education Materials for Patients Taking Non–vitamin K Oral Anticoagulants

More patients are now taking high-risk medicines such as non-vitamin K oral anticoagulants (NOACs). Hence, patient education materials need to be in an understandable format so that they can be empowered to act on their knowledge. Factors such as health literacy and the design of the medicine information material may influence the patient's ability to understand and act on key information. The PRISMA checklist was used to inform the study design. A structured search was conducted to obtain all freely accessible online educational resources designed for patients about the non-vitamin K antagonists (NOACs) during August 2018. Three search engines were used: Google, Yahoo! and Bing, using the search terms "NOAC" and "anticoagulant" combined with "patient/consumer information and patient/consumer resources." We applied the Patient Education Materials Assessment Tool (PEMAT) to evaluate web-based patient education materials in terms of understandability and actionability for patients taking NOACs. Of the 35 materials included, the majority of the materials (n = 32, 91%) were rated as highly understandable (PEMAT score ≥70%), and more than three-quarters of all the materials (n = 29, 83%) were rated as poorly actionable (PEMAT score <70%). For understandability, the majority of materials neither provided a summary of the key points nor used visual aids for several items such as simple tables, illustrations, and photographs. For actionability, few materials provided a tangible tool, such as a checklist, to prompt the user into action (n = 4). Few used visual aids such as nonverbal cues to the written instructions (n = 4). To improve the understandability and actionability of most of the NOAC patient education materials, there is a need to include more summaries of information, visual aids, and tangible tools such as checklists. Further research is warranted where patients are involved in providing feedback on the design of medicine information materials for NOACs.

Readability, content, quality and accuracy assessment of internet-based patient education materials relating to labor analgesia

BackgroundWith over 90% of parturients searching the internet for health information, the quality of information is important. Web-based patient education materials (PEMs) related to labor analgesia are frequently of low readability. This study compares the readability, content, quality and accuracy of labor analgesia-related PEMs from relevant healthcare society websites and the top internet search results. MethodsThe first ten PEMs from Google searches for “labor epidural” and “labor pain relief” were compared with PEMs from North American and United Kingdom anesthesiology, obstetric and medical society websites. Readability was assessed utilizing five validated readability indices. Quality was assessed using Patient Education Materials Assessment Tool for Print (PEMAT). The PEMs were graded for accuracy by four obstetric anesthesiologists. Readability, quality and accuracy scores were compared using the independent t-test and content using Chi-square analysis. ResultsSociety PEMs were significantly more readable than non-society PEMs for three of five readability indices, though the mean of both groups was at or above an eighth-grade (average age 13–14 years-old) reading level. The PEMAT understandability and accuracy scores were significantly higher for society websites. The most frequently mentioned topics were benefits, effects of epidural analgesia on labor and delivery, definitions, post-dural puncture headache and alternative analgesics. ConclusionsGoogle search results for labor analgesia lead to PEMs of variable quality and readability. For readers to be better informed, web-based PEMs should be improved or women directed to society PEMs. Inaccurate information may lead to incorrect expectations and conflict during labor, with potentially lower maternal satisfaction.

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

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.

Readability, Content, and Quality Assessment of Web-Based Patient Education Materials Addressing Neuraxial Labor Analgesia.

Studies in a variety of disciplines have shown that the readability of Web-based patient education materials is above that of the sixth grade reading level recommended by the U.S. Department of Health and Human Services. The aim of this study was to evaluate the readability, content, and quality of English- and Spanish-language patient education materials addressing neuraxial labor analgesia. The websites of 122 U.S. academic medical centers with obstetric anesthesia divisions were searched for English- and Spanish-language patient education materials. Readability of English-language patient education materials was assessed with 3 validated indices: Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook, and Gunning Frequency of Gobbledygook. Readability of Spanish-language patient education materials was assessed using the Spanish Lexile Measure. A 1-sample t test was used to evaluate the mean readability level against the recommended sixth grade reading level. A scoring matrix was developed to evaluate the content of patient education materials. Website quality was assessed using the Patient Education Materials Assessment Tool for Print. We identified 72 English-language and 29 Spanish-language patient education materials. The mean readability levels of all patient education materials were higher than the recommended sixth grade reading level using all indices (Flesch-Kincaid Grade Level: 9.1 ± 1.9, Simple Measure of Gobbledygook: 8.6 ± 1.4, Gunning Frequency of Gobbledygook: 11.8 ± 2.1; P < 0.001 for all). All patient education materials discussed the benefits of neuraxial analgesia. However, only 14% (upper 95% confidence interval: 24%) discussed contraindications to neuraxial anesthesia. Postdural puncture headache and hypotension were the most commonly addressed complications (92%). All other complications were addressed by less than half of patient education materials. Patient Education Materials Assessment Tool for Print scores were consistent with poor website understandability (median score, 64%; interquartile range, 64-73). The mean readability of Web-based patient education materials addressing neuraxial labor analgesia was above the recommended sixth grade reading level. Although most patient education materials explained the benefits of neuraxial analgesia, possible contraindications and complications were not consistently presented. The content, readability, and quality of patient education materials are poor and should be improved to help patients make more informed decisions about analgesic options during labor and delivery.

Tu1508 Readability, Suitability, and Health Content Assessment of Web-Based Patient Education Materials on Colorectal Cancer Screening

Colorectal cancer (CRC) screening rates in Unites States are still below target level. Web-based patient education materials are used by patients and providers to provide supplemental information on CRC screening. Low literacy levels and patient perceptions are significant barriers to screening. There is little data on the quality of these online materials from a health literacy standpoint and if they address patients' perceptions.

Readability, suitability, and health content assessment of web-based patient education materials on colorectal cancer screening

Colorectal cancer (CRC) screening rates in the Unites States are still below target level. Web-based patient education materials are used by patients and providers to provide supplemental information on CRC screening. Low literacy levels and patient perceptions are significant barriers to screening. There are little data on the quality of these online materials from a health literacy standpoint or whether they address patients' perceptions. To evaluate the readability, suitability, and health content of web-based patient education materials on colon cancer screening. Descriptive study. Web-based patient materials. Twelve reputable and popular online patient education materials were evaluated. Readability was measured by using the Flesch-Kincaid Reading Grade Level, and suitability was determined by the Suitability Assessment of Materials, a scale that considers characteristics such as content, graphics, layout/typography, and learning stimulation. Health content was evaluated within the framework of the Health Belief Model, a behavioral model that relates patients' perceptions of susceptibility to disease, severity, and benefits and barriers to their medical decisions. Each material was scored independently by 3 reviewers. Flesch-Kincaid Reading Grade Level score, Suitability Assessment of Materials score, health content score. Readability for 10 of 12 materials surpassed the maximum recommended sixth-grade reading level. Five were 10th grade level and above. Only 1 of 12 materials received a superior suitability score; 3 materials received inadequate scores. Health content analysis revealed that only 50% of the resources discussed CRC risk in the general population and <25% specifically addressed patients at high risk, such as African Americans, smokers, patients with diabetes, and obese patients. For perceived barriers to screening, only 8.3% of resources discussed embarrassment, 25% discussed pain with colonoscopy, 25% addressed cost of colonoscopy, and none specifically mentioned the need to get colonoscopy when no symptoms are present. No material discussed the social benefits of screening. Descriptive design. Most online patient education materials for CRC screening are written beyond the recommended sixth-grade reading level, with suboptimal suitability. Health content is lacking in addressing key perceived risks, barriers, and benefits to CRC screening. Developing more appropriate and targeted patient education resources on CRC may improve patient understanding and promote screening.

Readability and Suitability Assessment of Patient Education Materials in Rheumatic Diseases

Web-based patient education materials and printed pamphlets are frequently used by providers to inform patients about their rheumatic disease. Little attention has been given to the readability and appropriateness of patient materials. The objective of this study was to examine the readability and suitability of commonly used patient education materials for osteoarthritis (OA), rheumatoid arthritis, systemic lupus erythematosus, and vasculitis. Five or 6 popular patient resources for each disease were chosen for evaluation. Readability was measured using the Flesch-Kincaid reading grade level and suitability was determined by the Suitability Assessment of Materials (SAM), a score that considers characteristics such as content, graphics, layout/topography, and cultural appropriateness. Three different reviewers rated the SAM score and means were used in the analysis. Twenty-three resources written on the 4 diseases were evaluated. The education material for all 4 diseases studied had readability above the eighth-grade level and readability did not differ among the diseases. Only 5 of the 23 resources received superior suitability scores, and 3 of these 5 resources were written for OA. All 4 diseases received adequate suitability scores, with OA having the highest mean suitability score. Most patient education materials for rheumatic diseases are written at readability levels above the recommended sixth-grade reading level and have only adequate suitability. Developing more appropriate educational resources for patients with rheumatic diseases may improve patient comprehension.