Readability of patient education material in stroke: a systematic literature review

Abstract

Background

Stroke education materials are crucial for the recovery of stroke patients, but their effectiveness depends on their readability. The American Medical Association (AMA) recommends patient education materials be written at a sixth-grade level. Studies show existing paper and online materials exceed patients' reading levels and undermine their health literacy. Low health literacy among stroke patients is associated with worse health outcomes and decreased efficacy of stroke rehabilitation.

Objective

We reviewed the readability of paper (i.e brochures, factsheets, posters) and online (i.e American Stroke Association, Google, Yahoo!) stroke patient education materials, reading level of stroke patients, accessibility of online health information, patients’ perceptions on gaps in stroke information, and provided recommendations for improving readability.

Method

A PRISMA-guided systematic literature review was conducted using PUBMED, Google Scholar, and EbscoHost databases and “stroke”, “readability of stroke patient education”, and “stroke readability” search terms to discover English-language articles. A total of 12 articles were reviewed.

Results

SMOG scores for paper and online material ranged from 11.0 - 12.0 grade level and 7.8 - 13.95 grade level respectively. Reading level of stroke patients ranged from 3rd grade to 9th grade level or above. Accessibility of online stroke information was high. Structured patient interviews illustrated gaps in patient education materials and difficulty with comprehension.

Conclusion

Paper and online patient education materials exceed the reading level of stroke patients and the AMA recommended 6th grade level. Due to limitations in readability, stroke patients are not being adequately educated about their condition.

KEYWORDS:

• Readability
• patient education material
• stroke
• quality
• online health information

Disclosure statement

No potential conflict of interest was reported by the author(s).

Contributors

There were no other contributors to this work.

Prior presentations

The authors report no prior presentations of this work.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.