Readability Tools

Table of Contents:

 

Readability: Creating literature that patients can and will read (BACK TO TOP)

Readability relates to the re-writing or production of literature that matches the literacy abilities of a targeted population of readers. Readability issues should be addressed at all age levels. However, for our purposes here, especially given the importance of readability as relates to medical prescriptions, written doctors' orders, directions to healthcare facilities, and general navigation of the healthcare system, we are addressing the literacy abilities of adults. In particular, we are addressing the need to create literature that is compatible with the reading skills of patients who only know English as a second language, or who are adults who are low literate, or who are seniors who may struggle with reading.

There are a number of tools available to help healthcare professionals address the readability levels of the literature they produce for patients. The most accessible readability tool can be found in the "Tools" option of Microsoft Word, under "Spelling and Grammar."

 

Rules for Enhancing Readability of Text (BACK TO TOP)

General rules of reducing the difficulty level of reading materials include the following:

  1. Use common or short words
  2. Use short sentences
  3. Use commands. That is, begin sentences with action words or verbs.

Here are nine formulas for testing readability (from The Electronic Writing Course (URL: www.ElectronicWritingCourse.com)

Formula # 1: Dale-Chall
A vocabulary-based formula normally used to assess upper elementary through secondary materials.

Formula # 2: Flesch Reading Ease
Normally used to assess adult materials, shows scores on a scale between 0 and 100.

Formula # 3: Flesch-Kincaid Grade Level
Most reliable when used with upper elementary and secondary materials.

Formula # 4: Fry Graph
Used over a wide grade range of materials, from elementary through college and beyond.

Formula # 5: FOG
Widely used in the health care and general insurance industries for general business publications.

Formula # 6: Powers-Sumner- Kear
Used in assessing primary through early elementary level materials.

Formula # 7: SMOG
Unlike any of the other formulas, SMOG predicts the grade level required for 100% comprehension. http://www.harrymclaughlin.com/SMOG.htm

Formula # 8: FORCAST Focuses on functional literacy. Used to assess non- running narrative, e.g. questionnaires, forms, tests ...

Formula # 9: Spache
A vocabulary-based formula widely used in assessing primary through fourth grade materials.

 

A National List of Websites Informing the Development of Patient Materials (BACK TO TOP)

The following list will be useful for professionals who are looking for resources to help aid the development of health related materials:

Clear & Simple: Developing Effective Print Materials for Low-Literate Readers http://www.cancer.gov/cancerinformation/clearandsimple
How to Write Easy-to-Read Health Materials http://www.nlm.nih.gov/medlineplus/etr.html
Plain Language: Examples and Tools for Developing Plain Language Materials http://www.plainlanguage.gov/

 

An Exercise in Adjusting Readability (BACK TO TOP)

(This exercise was done by gauging readability using the Flesch-Kincaid Grade Level tool in Microsoft Word)

Grade Level: 14.0

Did you know that African American babies are twice as likely to die during their first year of life in comparison to all infants?

The San Diego County Black Infant Health Program is here to help reduce African American infant deaths and improve the health and well-being of African American women and children. We provide free services to pregnant and parenting African American women, including case management, parenting classes, health assessments and referrals. If you or a loved one need our help, please call the Black Infant Health Program at 619-266-7466.

Grade Level: 10.6

Did you know that African American babies are twice as likely as other infants to die during their first year of life?

The San Diego County Black Infant Health Program is here to help. We reduce African American infant deaths and improve the health and well-being of African American women and children. We provide free services to pregnant and parenting African American women. We offer case management, parenting classes, health assessments and referrals. If you or a loved one needs our help, please call the Black Infant Health Program at 619-266-7466.

Grade Level: 7.8

Did you know that African American babies are more likely to die in their year of life than other babies?

The San Diego County Black Infant Health Program can help. We improve the health of African American women. We help their children. We offer free help to pregnant African American women. We offer training on being a parent. We offer counseling. Please call us at 619-266-7466.

Grade Level: 7.7

Did you know that African American babies are twice as likely as other infants to die during their first year of life?

The San Diego County Black Infant Health Program is here to help. We improve the health and well-being of African American women and children. We provide free services to pregnant African American women. We also offer training on being a parent. We offer counseling. We offer parenting classes. We do health assessments. If you or a loved one needs our help, please call the Black Infant Health Program at 619-266-7466.

Grade Level: 7.1

Did you know that African American babies are more likely to die in their year of life than other babies?

The San Diego County Black Infant Health Program is here to help. We improve the health of African American women and children. We provide free services to pregnant African American women. We offer training on being a parent. We offer counseling. We offer parenting classes. If you or a loved one need our help, please call us. We can be reached at 619-266-7466.

Grade Level: 7.0

African American babies are more likely to die in their year of life than other babies.

The San Diego County Black Infant Health Program can help. We improve the health of African American women. We improve the health of their children. We offer free services to pregnant African American women. We offer training on being a parent. We offer counseling. We offer parenting classes. Call us if you need help. Call us if you know someone who needs help. Call 619-266-7466.

Grade Level: 6.9

Did you know that African American babies are more likely to die in their year of life than other babies?

The San Diego County Black Infant Health Program is here to help. We improve the health of African American women and children. We provide free services to pregnant African American women. We offer training on being a parent. We offer counseling. We offer parenting classes. We do health assessments. If you or a loved one needs our help, please call us. We can be reached at 619-266-7466.

 

Signage and Symbols (BACK TO TOP)

Readability is also akin to the challenge of "signage." "Signage" in the case of healthcare, relates to the posting of signs that are visual in nature and that are successfully descriptive in directing patients who are low-level readers or patients who are non-readers, to medical services.

The Robert Wood Johnson Foundation's Hablamos Juntos (We Speak Together) is referred to in the Joint Health Literacy Report. The mission of the project is to improve communication between health care providers and their patients with limited English proficiency. The project has developed 28 copyrighted symbols that are available for download at: http://www.hablamosjuntos.org/signage/symbols/default.using_symbols.asp This website also includes information and kits on implementing the symbols, posters and the symbols in PDF and EPS formats. Health Literacy San Diego's website features symbols from this project throughout our website. For more information on this project in general, please visit: http://www.hablamosjuntos.org/

 

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