Felicia Hill-Briggs|Kristina P. Schumann|Ogechi N. Dike
Five-step Methodology for Evaluation and Adaptation of Print Patient Health Information to Meet the &lt;5th Grade Readability Criterion
Welch Foundation|Johns Hopkins Medicine|Johns Hopkins University|University of Maryland, Baltimore County|Johns Hopkins Medicine|Johns Hopkins University|Johnson University
background setting declining us literacy new policies include use clear communication lowliteracy accessibility practices patients reliable methods adapting health information meet criteria remain pressing need objectives report method validation study 1 method replication study 2 procedures outcomes 5step method evaluating adapting print health information meet current lowliteracy criterion 5th grade readability materials sets 18 11 publicly disseminated patient education documents developed university affiliated medical center measures three lowliteracy criteria strategically targeted efficient systematic evaluation text modification meet 5th grade reading level sentence length 15 words writing active voice use common words multisyllabic words 23 syllables minimized avoided interrater reliability document evaluations determined results training methodology resulted interrater reliability 099100 study 1 098100 study 2 original documents met none targeted low literacy criteria study 1 following lowliteracy adaptation mean reading grade level decreased 10418 3806 p00001 consistent achievement criteria words per sentence passive voice syllables per word study 2 demonstrated similar achievement target criteria resulting decrease mean reading grade level 11018 4603 p00001 conclusions 5step methodology proved teachable efficient targeting limited set modifiable criteria effective reliable achieving 5th grade readability