Readability formulas: Cautions and criteria

https://doi.org/10.1016/0738-3991(91)90017-YGet rights and content

Abstract

Health care practitioners are being confronted with the uneven fit between the reading skill level of patients and the reading difficulty level of health-based literature. Readability formulas are being used to obtain a seemingly precise measure of the latter. However, excess emphasis placed on readability scores may cause the practitioner to overlook other important factors in the reading process. This paper examines the readability formula process, discusses other factors which contribute to the readability of healthbased literature and raises some cautions for the patient educator manager responsible for matching patient and text.

References (26)

  • RD Powers

    Emergency department patient literacy and the readability of patient-directed materials

    Ann Emergency Med

    (1988)
  • GR Miller et al.

    A set of thirty-six prose passages calibrated for complexity

    J Verb Learn Verb Behav

    (1967)
  • JW Pichert et al.

    Readability formulas may mislead you

    Patient Educ Courts

    (1985)
  • KC Cadenhead

    Reading level: a metaphor that shapes practice

    Phi Delta Kappa

    (1987)
  • KC Stevens

    Readability formulae and McCall-Crabbs Standard Test Lessons in Reading

    Read Teach

    (1980)
  • CD Meade et al.

    Improving patient comprehension of literature on smoking

    Am J Publ Health

    (1989)
  • LD Streiff

    Can clients understand our instruction?

    Image: J Nurs Scholar

    (1986)
  • JD Mariner et al.

    Consent forms readability, and comprehension: the need for new assessment tools

    Law Med Health

    (1985)
  • AB Zion et al.

    Level of reading difficulty in ACOG patient education pamphlets

    Obstet Gynecol

    (1989)
  • MA Aquino

    The validity of the Miller-Coleman readability scale

    Read Res Q

    (1969)
  • RR Flesch

    A new readability yardstick

    J Appl Psychol

    (1948)
  • R Gunning

    The FOG index after twenty years

    J Bus Commun

    (1968)
  • E Fry

    Fry's readability graph: clarifications, validity and extension to level 17

    J Read

    (1977)
  • Cited by (219)

    • Readability of the Most Commonly Accessed Online Patient Education Materials Pertaining to Surgical Treatments of the Spine

      2021, World Neurosurgery
      Citation Excerpt :

      It has been found to overestimate the readability of patient education materials in some cases owing to its lower level of expected comprehension criteria.18 Other problems with readability formulas are that they are exclusively based on the length and structure of a sentence and do not account for other factors that affect understanding, such as illustrations, page layout, grammatical errors, and motivation of the reader.22,38,39 Finally, the present study only used a singular search engine, Google, and thus could not account for the patients who would use another search engine and might encounter different health-related articles.

    • Simple contents and good readability: Improving health literacy for LEP populations

      2020, International Journal of Medical Informatics
      Citation Excerpt :

      Health information should be judged beyond just the readability of the text. One of the biggest critiques of readability formulas is that it does not take the patient into consideration [33,43]. The Centers for Medicare and Medicaid Services [44] recommends that readability formulas be used in meaningful ways, with a clear understanding of what each formula is measuring.

    • Family partnerships: Implications from the digital world

      2023, Meaningful and Active Family Engagement: IEP, Transition and Technology Integration in Special Education
    View all citing articles on Scopus
    View full text