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Readability Assessment of Web-based Patient Education Materials Related to Neuraxial Labor Anesthesia and Analgesia
Abstract Number: T-53
Abstract Type: Original Research
Introduction: The Internet is increasingly utilized as a source of health care information. Web-based patient education materials (PEMs) should be written at a reading level appropriate for the average patient. The US Department of Health and Human Services recommends that PEMs be written at or below the 6th grade reading level. This study aimed to assess the content and readability of neuraxial labor anesthesia and analgesia-related web-based PEMs written by US academic obstetric anesthesia divisions.
Methods: A list of US academic medical centers with obstetric anesthesia divisions was compiled (n=122). A search for web-based PEMs was conducted using the names of these institutions along with search terms such as: obstetric anesthesia, labor analgesia, labor epidural, spinal anesthesia, and health information. Links to PEMs from external websites were excluded. The readability of PEMs was assessed with three commonly used indices: Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and Gunning Frequency of Gobbledygook (Gunning FOG). The scores reflect the grade level required to comprehend the material. Readability scores were compared to national recommendations using a one-sided t-test. P < 0.05 was considered significant. A scoring matrix was developed to assign one point to PEMs that addressed specific content domains, including descriptions of the procedures, risks, benefits, adverse effects, contraindications, and alternative analgesic modalities.
Results: PEMs were identified on the websites of 78 US academic medical centers. The average FKGL, SMOG, and Gunning FOG scores were all higher than the recommended 6th grade reading level (Table 1). The most commonly addressed complications were unintentional dural puncture, postdural puncture headache, and hypotension (85%). The least addressed complication was epidural failure (8%). Contraindications were discussed by 13% of PEMs, and alternative modalities were discussed by 64%.
Conclusions: The majority of web-based PEMs that we identified were written above the recommended 6th grade reading level. Furthermore, while most PEMs explained the benefits of neuraxial analgesia, information about adverse effects, contraindications, and alternatives was not consistently presented. Previous work has shown that patients have significant misunderstandings regarding labor analgesia, therefore the content and readability of PEMs should be improved to enhance patient understanding.