Low health literacy is a massive problem in the UK, Europe and United States. The medical community in general has an ongoing problem with low patient adherence to treatments, and this is one problem that could be effectively tackled with better patient support materials. ‘Better’ in this case means support materials that patients with lower health literacy can understand more readily.
Creating support materials that give plenty of information as well as comprehensive instructions or advice on living with a condition can be a difficult undertaking. Medical writers’ natural language will include terms outside general education levels, and a fine line exists between simplification and dumbing down.
There are, however, ways to assess how readable support materials are, and make complex language simpler. By using shorter, everyday words, comprehension levels also rise. Patients may be able to read the information, but if the words and phrases are too long they may still struggle to understand.
- Cut the number of long words and sentences: You can use readability formulas to help identify sections of text that might give difficulty. Based on sentence length and number of syllables in words, they return a readability score. While helpful, they don’t give the whole picture, however, so use them in conjunction with other methods.
- Use active language: Using an active writing style naturally makes sentences shorter and more immediate.
- Here’s an example of passive voice: Life changing diseases such as type 2 diabetes are often caused by obesity.
- Here’s the same sentence in active voice: Obesity may cause type 2 diabetes, a life changing condition.
Sometimes long medical names can make patient support materials appear more complex than they actually are. One way of discovering whether medical terms are complicating a text is to remove them before testing. If the text is still at too high a reading level, revise it by replacing long words with shorter ones. Plain, everyday language is nearly always more direct than academic phrasing.
Easy ways to test the readability of support materials
Several accepted methods or scales exist to assess readability:
- The Fry Readability Graph
- The Gunning FOG readability test
- The Flesch-Kincaid readability test
- The SMOG (Simple Measure of Gobbledygook) readability formula
Some word processors also have built-in features that help measure the readability of patient support materials. Alternatively, try dedicated software or online readability testing tools. It helps if you choose one method, then stick with it throughout the drafting process.
Test patient support materials on patients
Tools, automated language checkers, and applied formulas can only ever provide guidelines. One of the very best ways of discovering whether support materials are easy to read and understand is to test them on the people who’ll use them.
Knowing your intended audience is an initial part of planning any written material. When you’re producing patient-centric materials, consider how well you know the end user:
- How much do they already know about their condition?
- What is their attitude to the disease or illness?
- How well do they accept or interpret new ideas?
- What barriers may they encounter when trying to follow through on the advice given in support materials?
Usability testing focus groups or discussions with individuals in the target audience should take place before the first draft, and continue through every subsequent draft.
Plain language is important in-patient support materials, but so too is the layout and presentation of the document. Just including more white space or a larger font could improve reading levels and comprehension, and therefore raise health literacy levels among target groups.