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Academic and community hernia center websites in the United States fail to meet healthcare literacy standards of readability

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Abstract

Background

Health literacy is considered the single best predictor of health status. Organizations including the American Medical Association (AMA) and the National Institutes of Health (NIH) have recommended that the readability of patient education materials not exceed the sixth-grade level. Our study focuses on the readability of self-designated hernia centers websites at both academic and community organizations across the United States to determine their ability to dispense patient information at an appropriate reading level.

Methods

A search was conducted utilizing the Google search engine. The key words “Hernia Center” and “University Hernia Center” were used to identify links to surgical programs within the United States. The following readability tests were conducted via the program: Flesch–Kincaid Grade Level (FKGL), Gunning Fox Index (GFI), Coleman–Liau Index (CLI), Simple Measure of Gobbledygook (SMOG), and Flesch Reading Ease (FRE) score.

Results

Of 96 websites, zero (0%) had fulfilled the recommended reading level in all four tests. The mean test scores for all non-academic centers (n = 50) were as follows: FKGL (11.14 ± 2.68), GFI (14.39 ± 3.07), CLI (9.29 ± 2.48) and SMOG (13.38 ± 2.03). The mean test scores [SK1] for all academic programs (n = 46) were as follows: FKGL (11.7 ± 2.66), GFI (15.01 ± 2.99), CLI (9.34 ± 1.91) and SMOG (13.71 ± 2.02). A one-sample t test was performed to compare the FKGL, GFI, CLI, and SMOG scores for each hernia center to a value of 6.9 (6.9 or less is considered an acceptable reading level) and a p value of 0.001 for all four tests were noted demonstrating statistical significance. The Academic and Community readability scores for both groups were compared to each other with a two-sample t test with a p value of > 0.05 for all four tests and there were no statistically significant differences.

Conclusion

Neither Academic nor Community hernia centers met the appropriate reading level of sixth-grade or less. Steps moving forward to improve patient comprehension and/or involving with their care should include appropriate reading level material, identification of a patient with a low literacy level with intervention or additional counseling when appropriate, and the addition of adjunct learning materials such as videos.

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Authors and Affiliations

  1. Division of Bariatric, Foregut, and Advanced Gastrointestinal Surgery, Renaissance School, Medicine at Stony Brook University, Stony Brook, NY, USA

    S. Docimo Jr., K. Seeras, A. Pryor & K. Spaniolas

  2. Henry Ford Macomb, Detroit, MI, USA

    R. Acho

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  1. S. Docimo Jr.
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  2. K. Seeras
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Correspondence to S. Docimo Jr..

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Conflict of interest

Dr.’s Seeras, and Acho have no conflicts of Interest. Dr. Pryor receives consulting fees from Ethicon, Medtronic, Stryker, and Gore as well as honoraria from Baranova and Obalon. Dr. Spaniolas receives honorarium from Gore. Dr. Docimo receives consulting fees from Boston Scientific and Medronic.

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No humans or animal rights were violated during this study.

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IRB exemption was indicated considering it is a review article of websites and no patient information was obtained to complete this study.

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Docimo Jr., S., Seeras, K., Acho, R. et al. Academic and community hernia center websites in the United States fail to meet healthcare literacy standards of readability. Hernia 26, 779–786 (2022). https://doi.org/10.1007/s10029-022-02584-z

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