Health literacy and the Internet: a study on the readability of Australian online health information

Objective: Almost 80% of Australian Internet users seek out health information online so the readability of this information is important. This study aimed to evaluate the readability of Australian online health information and determine if it matches the average reading level of Australians. Methods: Two hundred and fifty‐one web pages with information on 12 common health conditions were identified across sectors. Readability was assessed by the Flesch‐Kincaid (F‐K), Simple Measure of Gobbledygook (SMOG) and Flesch Reading Ease (FRE) formulas, with grade 8 adopted as the average Australian reading level. Results: The average reading grade measured by F‐K and SMOG was 10.54 and 12.12 respectively. The mean FRE was 47.54, a ‘difficult‐to‐read’ score. Only 0.4% of web pages were written at or below grade 8 according to SMOG. Information on dementia was the most difficult to read overall, while obesity was the most difficult among government websites. Conclusions and implications: The findings suggest that the readability of Australian health websites is above the average Australian levels of reading. A quantifiable guideline is needed to ensure online health information accommodates the reading needs of the general public to effectively use the Internet as an enabler of health literacy.     

How do people interpret information about colorectal cancer screening: observations from a think‐aloud study

Background

The English NHS Bowel Cancer Screening Programme biennially invites individuals aged 60–74 to participate in screening. The booklet, ‘Bowel Cancer Screening: The Facts'' accompanies this invitation. Its primary aim is to inform potential participants about the aims, advantages and disadvantages of colorectal cancer screening.

Objective

To provide detailed commentary on how individuals process the information contained within ‘The Facts’ booklet.

Design, setting and participants

This study comprised of 18 interviews with individuals aged 45–60 and used a ‘think‐aloud’ paradigm in which participants read aloud the booklet. Participant utterances (verbal statements made in response to researcher‐led prompts) were transcribed and analysed using a combination of content and thematic analysis.

Results

A total of 776 coded utterances were analysed (mean = 43.1 per person; range = 8–95). While overall comprehension was satisfactory, several problem areas were identified such as the use of complex unfamiliar terminology and the presentation of numerical information. Specific sections such as colonoscopy risk information evoked negative emotional responses. Participants made several suggestions for ways in which comprehension might be improved.

Conclusion

Public perceptions of the NHS Bowel Cancer Screening Programme information materials indicated that specific aspects of the booklet were difficult to process. These materials may be an appropriate target to improve public understanding of the aims, benefits and disadvantages of colorectal cancer screening. These findings will contribute to a broader NIHR‐funded project that aims to design a supplementary ‘gist‐based’ information leaflet suitable for low literacy populations.     

自贡市贡井区居民健康素养水平干预效果

目的根据2011和2013年自贡市贡井区居民健康素养监测结果,对自贡市居民健康素养水平进行评估,发现居民健康素养的薄弱点,为明确今后健康素养促进工作的重点提供科学依据。方法采用多阶段分层整群随机抽样的方法在两年中对自贡市贡井区共817名居民进行健康素养监测,对比分析2011和2013年两年的素养监测结果。结果 2011和2013年该市居民有3个认知率低于40%的薄弱点:对艾滋病的正确传播途径的认知(2011年为25.2%,2013年为30.1%),对被动吸烟引发的疾病的认知(2011年为6.0%,2013年20.8%)对煤气中毒的正确做法的认知(2011年为24.6%,2013年为7.9%),其中煤气中毒的正确做法认知率明显降低,且差异有统计学意义(P0.05)。结论虽然居民健康素养水平有所提高,但某些方面仍显不足,今后该市健康教育工作应重点针对这3个薄弱点,从而针对性地采取长期、科学、有效的健康教育干预策略。     

Sagittal spine shape literacy in the general adult population,assessed by a novel,simple graphical tool

[Purpose] The sagittal shape of the spine is associated with back-pain, balance and quality of life. We developed, evaluated and report the responses of a graphical tool to assess sagittal spine shape knowledge (literacy). [Participants and Methods] Two hundred and fifty adults were randomly assigned, in a cross-sectional crossover study, to free-hand draw and select the “ideal” sagittal spine shape. We evaluated the inter and intra-rater reliability and agreement between tests and the sagittal and lordotic spine literacy between the drawing and selection test versions. [Results] Drawing test inter- and intra-rater agreement was 79% and 80% respectively. Drawing vs. selection agreement was 43%. More participants drew than selected the correct spine (30% vs. 21%) (p<0.001) and lumbar lordosis shape (56% vs. 42%) (p<0.001). Test order did not affect spine shape literacy scores. A significantly poorer literacy trend was observed with spine pain presence (p=0.02). [Conclusion] We developed a reliable method to evaluate spine shape literacy and established that only 21% and 42% of our sample demonstrated correct sagittal spine and lordotic spine shape literacy, respectively. The low literacy scores suggests that consideration of including spine shape literacy in health literacy and self-management programs may be warranted, especially in ageing populations.     

An examination of technologies in complementary medicine education and practice: The perceptions and experiences of naturopathy students,faculty and educational leaders

ObjectivesLittle is known about the education of future CM practitioners. The objective is to explore the perceptions and experiences of students, faculty and professional leaders toward technologies in complementary medicine education and practice.Design and settingQualitative focus groups and one-on-one semi-structured interviews were conducted in CM educational organizations and institutions in North America (United States / Canada) and Australia involving seven focus groups (29 naturopathic students), and 30 one-on-one interviews (faculty, educational and professional leaders of the naturopathic profession).ResultsData analysis identified five issues reported. These related to perceptions of; the shortfalls of CM classroom technology, the value of technology within CM clinical practice, learning technologies in the classroom, addressing equity concerns as a consequence of learning technology use, and the need to develop technology literacy skills amongst students and faculty.ConclusionThis is the first study to examine the perceptions of students, faculty and professional leaders toward technologies in CM education and practice within an education setting. CM students exhibited complex attitudes and adoption patterns to technology. CM students were critical of faculty who have perceived low levels of digital literacy. The technology issue that students in our study found most challenging was PowerPoint use in the classroom. There is an urgent need to establish a strategic research agenda and modelling around this important area of health care education in order to ensure a well-educated, effective workforce able to deliver the best outcomes for the patients and communities they serve.