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Drug Safety
Published in: Drug Safety 12/2013

Open Access 01-12-2013 | Original Research Article

Evaluating the Health Literacy Burden of Canada’s Public Advisories: A Comparative Effectiveness Study on Clarity and Readability

Authors: Matthew LeBrun, Jason DiMuzio, Brittany Beauchamp, Susanne Reid, Vicky Hogan

Published in: Drug Safety | Issue 12/2013

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Abstract

Background

Significant knowledge gaps exist related to evaluating health product risk communication effectiveness in a regulatory setting. To this end, Health Canada is assessing methods to evaluate the effectiveness of their health product risk communications in an attempt to identify best practices.

Objective

We examined the health literacy burden of Public Advisories (PAs) before and after implementation of a new template. We also compared two methods for their usefulness and applicability in a regulatory setting.

Methods

Suitability assessment of materials (SAM) and readability tests were run by three independent evaluators on 46 PAs (14 “Pre-format change” and 32 “Post-format change”). These tests provided adequacy scores for various health literacy elements and corresponding scholastic grades.

Results

PAs using the new template scored better, with an average increase of 18 percentage points (p < 0.001), on the SAM test. All of the 46 PAs evaluated were rated as “requiring a college/university education comprehension level” using readability tests. Results among readability tests were comparable.

Conclusion

Improvements made to Health Canada’s PA template had a measurable, positive effect on reducing the health literacy burden, based on the SAM results. A greater focus on the use of plain language would likely add to this effect. The SAM test emerged as a robust, reliable, and informative health literacy tool to assess risk messages and identify further improvement efforts. Regulators, industry, and public sector organizations involved in communicating health product risk information should consider the use of this test as a best practice to evaluate health literacy burden.
Appendix
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Literature
1.
2.
3.
4.
5.
6.
Nutbeam D. Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promot Int. 2000;15(3):259–67.CrossRef
7.
Neilsen-Bohlman L, Panzer AM, Kindig DA. What is health literacy? In: Committee on Health Literacy, editor. Health literacy: a prescription to end confusion. London: National Academies Press; 2004.
8.
9.
10.
Pleasant A. Health literacy: an opportunity to improve individual, community and global health. New Dir Adult Contin Edu. 2011;130:43–53.CrossRef
11.
12.
Baker D, Wolf MS, Feinglass J, Thompson JA, Gazmararian JA, Huang J. Health literacy and mortality among elderly persons. Arch Intern Med. 2007;167(14):1503–9.PubMedCrossRef
13.
14.
15.
Pleasant A, McKinney J. Coming to consensus on health literacy measurement: an online discussion and consensus-gauging process. Nurs Outlook. 2011;59:95–106.PubMedCrossRef
16.
Weintraub D, Maliski S, Fink A, Choe S, Litwin MS. Suitability of prostate cancer education materials: applying a standardized assessment tool to currently available materials. Pat Edu Coun. 2004;55(2):275–80.CrossRef
17.
Hoffmann T, Mckenna K. Analysis of stroke patients’ and carers’ reading ability and the content and design of written materials: recommendations for improving written stroke information. Pat Edu Coun. 2006;60:286–93.CrossRef
18.
Rees C, Ford J, Sheard C. Patient information leaflets for prostate cancer: which leaflets should healthcare professionals recommend? Pat Edu Coun. 2003;49(3):263–72.CrossRef
19.
20.
Wu AD, Begoray DL, Macdonald M, Wharf-Higgins J, Frankish J, Kwan B, et al. Developing and evaluating a relevant and feasible instrument for measuring health literacy of Canadian high school students. Health Promot Int. 2010;25(4):444–52.PubMedCrossRef
21.
Beyer DR, Lauer MS, Davis S. Readability of informed-consent forms. N Engl J Med. 2003;348(22):2262–3.PubMedCrossRef
22.
Kaphingst KA, Rudd R, DeJong W, Daltroy LH. Literacy demands of product information intended to supplement television direct-to-consumer prescription drug advertisements. Pat Edu Coun. 2004;55:293–300.CrossRef
23.
Helitzer D, Hollis C, Cotner J, Oestreicher N. Health literacy demands of written health information materials: an assessment of cervical cancer prevention materials. Cancer Control. 2009;16(1):70–8.PubMed
24.
25.
Zarcadoolas C. The simplicity complex: exploring simplified health messages in a complex world. Health Promot Int. 2010;26:338–50.PubMedCrossRef
26.
Redish JC, Selzer J. The place of readability formulas in technical communications. Tech Commun. 1985;32(4):46–52.
27.
Doak C, Doak LG, Root JH. Assessing Suitability of Materials. In: Belcher M, editor. Teaching patients with low literacy skills. 2nd ed. Philadelphia: J. B. Lippincott Company; 1996.
28.
Shieh C, Hosei B. Printed information materials: evaluation of readability and suitability. J Community Health Nurs. 2008;25(2):73–90.PubMedCrossRef
29.
Befort CA, Thomas JL, Daley CM, Rhode PC, Ahluwalia JS. Perceptions and beliefs about body size, weight, and weight loss among obese African American women: a qualitative inquiry. Health Educ Behav. 2008;35(3):410–26.PubMedCrossRef
30.
Smith EA, Senter RJ. Automated readability index. AMRL TR. 1967:1-14.
31.
Coleman M, Liau T. A computer readability formula designed for machine scoring. J Appl Psychol. 1975;60:283–4.CrossRef
32.
33.
McLaughlin H. SMOG grading—a new readability formula. J Read. 1969;12(8):639–46.
34.
Gunning R. The technique of clear writing. Michigan: McGraw-Hill; 1968.
35.
Fry E. A readability formula that saves time. J Read. 1968;11:513–6.
36.
Benjamin R. Reconstructing readability: recent developments and recommendations in the analysis of text difficulty. Educ Psychol Rev. 2011;24(1):63–88.CrossRef
37.
DeWalt AD, Broucksou KA, Hawk V, Brach C, Rudd R, Callahan L. Developing and testing the health literacy universal precautions toolkit. Nurs Outlook. 2011;59(2):85–94.PubMedCrossRef
38.
Houts PS, Doak C, Doak LG, Loscalzo MJ. The role of pictures in improving health communication: a review of research on attention, comprehension, recall and adherence. Pat Edu Coun. 2006;61(2):173–90.CrossRef
Metadata
Title
Evaluating the Health Literacy Burden of Canada’s Public Advisories: A Comparative Effectiveness Study on Clarity and Readability
Authors
Matthew LeBrun
Jason DiMuzio
Brittany Beauchamp
Susanne Reid
Vicky Hogan
Publication date
01-12-2013
Publisher
Springer International Publishing
Published in
Drug Safety / Issue 12/2013
Print ISSN: 0114-5916
Electronic ISSN: 1179-1942
DOI
https://doi.org/10.1007/s40264-013-0117-8

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