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Published in: BMC Public Health 1/2021

Open Access 01-12-2021 | Intoxication | Research

Readability levels and thematic content analysis of online and printed lead poisoning informational materials

Authors: Harriet Okatch, Ebony Pitts, Emily Ritchey, Kylie Givler, Madeline Kuon

Published in: BMC Public Health | Issue 1/2021

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Abstract

Background

Lead poisoning prevention efforts include preparing and disseminating informational materials such as brochures and pamphlets to increase awareness of lead poisoning, lead exposures and lead poisoning prevention. However, studies have demonstrated that patient education materials for diseases and health conditions are prepared at a reading level that is higher than the recommended 7th–8th grade reading level. This study, therefore, aims to assess the reading levels of lead poisoning informational materials.

Methods

Lead poisoning materials (N = 31) were accessed from three states; Michigan, New York and Pennsylvania. The readability levels of the materials were assessed using the Flesh Kincaid Grade Level readability test. The Kruskal-Wallis test was conducted to determine if the readability levels differed between the materials obtained from the different states. Thematic content analyses were carried out to assess the inclusion of four themes; definition of lead poisoning, risk factors and exposures, testing and referral and prevention covering 12 subtopics. The Wilcoxon rank sum test was used to examine if there was a difference in the number of subtopics by readability level (dichotomized to >8th grade and < 8th grade).

Results

The median readability level of the informational materials was 6.7 (IQR: 5.1–8.1). However, there was variability in the readability levels of the materials (range 3.5 to 10.6); materials obtained from Michigan had the highest median reading level of 8.1 (IQR: 6.9–9.0) followed by Pennsylvania. Heterogeneity was observed in the content of the materials. Most of the materials (80%) from Michigan focused on water as a source of lead poisoning, whereas materials from New York and Pennsylvania focused on lead-based paint and other sources. The materials prepared at >8th grade reading level contained fewer topics than materials prepared at <8th grade reading level.

Conclusions

We find that the materials were often prepared at reading levels lower than the recommended 8th grade reading level. However, there is variability in the reading levels and in the content of the materials. While the materials met the general readability guidelines, they did not necessarily meet the needs of specific groups, especially groups at risk.
Literature
2.
go back to reference Centers for Disease Control and Prevention. CDC National Childhood Blood Lead Surveillance Data. 2019. Centers for Disease Control and Prevention. CDC National Childhood Blood Lead Surveillance Data. 2019.
3.
go back to reference Chao J, Kikano GE. Lead poisoning in children. Am Fam Physician. 1993;47(1):113–20.PubMed Chao J, Kikano GE. Lead poisoning in children. Am Fam Physician. 1993;47(1):113–20.PubMed
8.
go back to reference Cherney M, Erdman S, Kuon M, Shupin N, Regis N, Fitzelle-Jones E, et al. Insights into the Slow Uptake of Residential Lead Paint Remediation Funds: A Lancaster, Pennsylvania, Case Study. Int J Environ Res Public Health. 2021;18(2):652.CrossRef Cherney M, Erdman S, Kuon M, Shupin N, Regis N, Fitzelle-Jones E, et al. Insights into the Slow Uptake of Residential Lead Paint Remediation Funds: A Lancaster, Pennsylvania, Case Study. Int J Environ Res Public Health. 2021;18(2):652.CrossRef
10.
go back to reference Okatch H, Cherney M, Mokshefsky B, Kuon M, Scheuring S, Ritchey E, et al. Professionals' Perceptions: "Why is Lead Poisoning Prevalent in Lancaster County?". Int J Environ Res Public Health. 2019;16(13):2281.CrossRef Okatch H, Cherney M, Mokshefsky B, Kuon M, Scheuring S, Ritchey E, et al. Professionals' Perceptions: "Why is Lead Poisoning Prevalent in Lancaster County?". Int J Environ Res Public Health. 2019;16(13):2281.CrossRef
13.
go back to reference Abu-Heija AA, Shatta M, Ajam M, Abu-Heija U, Imran N, Levine D. Quantitative Readability Assessment of the Internal Medicine Online Patient Information on Annals.org. Cureus. 2019;11(3):e4184. Abu-Heija AA, Shatta M, Ajam M, Abu-Heija U, Imran N, Levine D. Quantitative Readability Assessment of the Internal Medicine Online Patient Information on Annals.​org. Cureus. 2019;11(3):e4184.
17.
go back to reference Walsh TM, Volsko TA. Readability assessment of internet-based consumer health information. Respir Care. 2008;53(10):1310–5.PubMed Walsh TM, Volsko TA. Readability assessment of internet-based consumer health information. Respir Care. 2008;53(10):1310–5.PubMed
18.
go back to reference Davis TC, Mayeaux EJ, Fredrickson D, Bocchini JA Jr, Jackson RH, Murphy PW. Reading ability of parents compared with reading level of pediatric patient education materials. Pediatrics. 1994;93(3):460–8.PubMed Davis TC, Mayeaux EJ, Fredrickson D, Bocchini JA Jr, Jackson RH, Murphy PW. Reading ability of parents compared with reading level of pediatric patient education materials. Pediatrics. 1994;93(3):460–8.PubMed
19.
go back to reference Kirsch IS, Jungeblut A, Jenkins L, Kolstad A. Adult literacy in America. In: Improvement USDoEOoERa, editor. Third Edition ed 2002. Kirsch IS, Jungeblut A, Jenkins L, Kolstad A. Adult literacy in America. In: Improvement USDoEOoERa, editor. Third Edition ed 2002.
21.
go back to reference Centers for Disease Control and Prevention. Scientific and technical information simply put. 1999. Centers for Disease Control and Prevention. Scientific and technical information simply put. 1999.
22.
go back to reference Doak CC, Doak LG, Root JH. Teaching patients with low literacy skills. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 1995. Doak CC, Doak LG, Root JH. Teaching patients with low literacy skills. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 1995.
26.
go back to reference New York City Department of Health and Mental Hygiene. Report to the New York CIty Council on Progress in Prevennting Childhood Lead Poisoning in New York City. 2018. New York City Department of Health and Mental Hygiene. Report to the New York CIty Council on Progress in Prevennting Childhood Lead Poisoning in New York City. 2018.
29.
go back to reference National Assessment of Adult Literacy. A first look at the literacy of America’s Aults in teh 21st Century. U. S Department of Education; 2006. National Assessment of Adult Literacy. A first look at the literacy of America’s Aults in teh 21st Century. U. S Department of Education; 2006.
34.
go back to reference Hore P, Alex-Oni K, Sedlar S, Nagin D. A Spoonful of Lead: A 10-Year Look at Spices as a Potential Source of Lead Exposure. J Public Health Manag Pract. 2019;25 Suppl 1, Lead Poisoning Prevention:S63-S70. Hore P, Alex-Oni K, Sedlar S, Nagin D. A Spoonful of Lead: A 10-Year Look at Spices as a Potential Source of Lead Exposure. J Public Health Manag Pract. 2019;25 Suppl 1, Lead Poisoning Prevention:S63-S70.
36.
go back to reference Centers for Disease C, Prevention. Lead poisoning associated with ayurvedic medications--five states, 2000–2003. MMWR Morb Mortal Wkly Rep. 2004;53(26):582–4. Centers for Disease C, Prevention. Lead poisoning associated with ayurvedic medications--five states, 2000–2003. MMWR Morb Mortal Wkly Rep. 2004;53(26):582–4.
37.
go back to reference Centers for Disease Control and Prevention. Childhood lead poisoing from commerically manufactured french ceramic dinnerware-New York City, 2003. MMWR Morb Mortal Wkly Rep. 2004;53(26):3. Centers for Disease Control and Prevention. Childhood lead poisoing from commerically manufactured french ceramic dinnerware-New York City, 2003. MMWR Morb Mortal Wkly Rep. 2004;53(26):3.
38.
go back to reference Centers for Disease Control and Prevention. Brief Report: Lead poisoning from ingestion of a toy necklace-Oregon 2004. MMWR Morb Mortal Wkly Rep. 2004;53(23):3. Centers for Disease Control and Prevention. Brief Report: Lead poisoning from ingestion of a toy necklace-Oregon 2004. MMWR Morb Mortal Wkly Rep. 2004;53(23):3.
Metadata
Title
Readability levels and thematic content analysis of online and printed lead poisoning informational materials
Authors
Harriet Okatch
Ebony Pitts
Emily Ritchey
Kylie Givler
Madeline Kuon
Publication date
01-12-2021
Publisher
BioMed Central
Keyword
Intoxication
Published in
BMC Public Health / Issue 1/2021
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-021-11944-w

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