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Readability and Actionability of Patient Education Materials on Preeclampsia
Abstract Number: T-23
Abstract Type: Original Research
Background: Preeclampsia is a leading cause of maternal morbidity and mortality worldwide. The most vulnerable populations affected by preeclampsia often have low understanding of the disease. Patients are increasingly using the internet as a source of health information. the increased reliance on web-based materials, multiple studies have found that online patient education materials (PEMs) are written above the 6th grade reading level recommended by the U.S. Department of Health and Human Services. The objective of this study was to evaluate the readability, content, and quality of PEMs addressing preeclampsia.
Methods: The websites of the 240 U.S. academic medical centers with obstetric and gynecology (OB/Gyn) residency programs were searched for PEMs. Readability was assessed using three validated indices: Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and Gunning Frequency of Gobbledygook (FOG). A scoring matrix was developed by an expert panel to evaluate 31 content domains of the PEMs focusing on the risk factors, signs/symptoms, and adverse outcomes of preeclampsia. Website quality was assessed using the Patient Education Materials Assessment Tool for Print (PEMAT-P). The PEMAT evaluates two components, the understandability of the content, and the actionability; defined as what actions should be taken based on the information presented. Websites with fewer than 30 sentences were excluded from analysis. Website content and quality were scored by two reviewers. Discrepancies were resolved by a third reviewer.
Results: One hundred fourteen websites with PEMs were identified. Five PEMs were excluded due to inadequate sentence length. The mean readability levels of all PEMs were higher than the recommended 6th grade reading level using all indices (P<0.001 for all). There was significant variability in the content of PEMs (Table 1). PEMAT-P scores were consistent with good website understandability (median 92%, interquartile range [IQR]: 92-94%); however actionability was poor (median 40%, IQR 0-40%.
Conclusions: The mean readability of Web-based PEMs addressing preeclampsia was above the recommended 6th grade reading level. Furthermore, while most PEMs explained the many of the risk factors, signs and symptoms and adverse outcomes of preeclampsia, the actionability of the PEMs was quite low. Thus, the content, readability, and actionability of PEMs on preeclampsia should be improved.