Saturday, March 21, 2015

Health websites too hard to understand, studies say

Prepared by medical experts, many health websites that are supposed to provide information about physical and mental problems people may be facing, have been found to be too difficult for lay people to comprehend. 

Researchers in Europe, North America and Australia have independently found that the readability of online health information is generally written above the average reading ability of adults the information is intended to help. 

Yet researchers say the internet has been shown to be an effective medium to deliver health information and boost health literacy of the wider population, including people with lower income and less education, as well as minority groups. Provided, that is, the information is actually comprehensible to its intended audience. 

Australian researchers say that with an ageing population and increasing demand for self-management of chronic diseases to minimise health costs, combined with diversified health services and treatment choices, health literacy is considered “an essential life skill” in the 21st century.

Reading ability

Based on the assessment of the reading ability of adult Americans, the US Department of Health recommended that health information should be written at or below the sixth-grade level – the level of an 11-12 year-old child with six years of US education. 

Studies in the US and Europe, however, have found that the readability of online health information is above the average reading ability of adults. One study that reviewed 352 health websites worldwide, reported the average reading grade level was 12.3.

This meant an adult would have had to complete more than 12 years of schooling to fully understand the material. The study also found that none of the websites met the recommended reading level of grade 6. 

Australian study

In the latest study, researchers at Deakin University in Melbourne found Australian websites were too difficult for the average person to read, especially those dealing with dementia and obesity – two of the conditions becoming more prevalent in Australia.

Dr Matthew Dunn and Christina Cheng, researchers with Deakin’s school of health and social development, evaluated the readability of Australian online health information to see if it matched the average reading level of Australians. 

The results of the study, published in the Australian and New Zealand Journal of Public Health, suggest that health websites are pitched above the average Australian reading level, making them an ineffective way to provide health information to the community.

“With around 16 million Australians active online and almost 80% of them seeking out health information, the internet is clearly an important way to help people understand and make decisions about their health,” Dunn said.

“But the limited availability of easy-to-read health materials suggests that many Australians are not benefiting from the convenience of the internet. The low readability also raises concern that many readers may misinterpret the information which could lead to inappropriate healthcare decisions.”

Dunn told University World News that although the results could not be transposed to online health sites in other countries, “the literature does suggest that we would expect the same results elsewhere”. 

“I don't think it's necessarily academic writing or jargon that is obscuring meaning. I think it is the case that the language we use around health and health issues can be complex,” he said. 

“We need to be mindful that a large segment of the population don't have science degrees or even did science at school. So we need to consider how we can write this information in accessible ways without losing the meaning.”

For the study, the researchers reviewed the content of 251 web pages, representing 137 websites, relating to 12 common health conditions – bowel cancer, breast cancer, prostate cancer, heart disease, anxiety, depression, diabetes, asthma, arthritis, back pain, obesity and dementia. 

To determine readability, the pages were assessed against the recommended benchmark of year 8 reading level. The results showed that only 2.4% of pages were considered ‘easy to read’ and only 0.4% were below a grade 8 school reading level.

“None of the mean grade levels of the 12 health conditions matched the grade 8 benchmark, with information on dementia and obesity found to be the most difficult to read,” Dunn said.

“That dementia and obesity information is among the most difficult to read is cause for concern. The growing prevalence of these two conditions means it is essential that easy-to-read health information is available to meet the needs of those most at risk of developing obesity or dementia.”

A lost opportunity

The researchers believe a great opportunity to provide valuable health information to Australians is being lost: “The flexible and interactive nature of the internet has provided health professionals with a tool that has great potential to increase the health literacy of the general population,” Dunn said.

“However, the opportunity to make best use of the internet for relaying health information will be lost if agencies do not assess their websites for readability and make the necessary changes so that a larger proportion of the population can understand their information.”

In their paper, the researchers say advances in communication technology have transformed the ways consumers access health information, understand their conditions and make healthcare decisions. 

“Providing health information is a fundamental task of health education and health literacy is a major outcome. It is purported that health literacy is linked to general literacy skills which involve an individual's capacity to read, write, speak and solve everyday problems,” they write. “Hence, good and comprehensible health information is an integral part of developing health literacy.”

Dunn said studies had found that 44% of Australians had low literacy skills, making it paramount that health information be presented at a readability level to accommodate the wide range of literacy skills among the general population.

“Internet users’ ability to read health information online may also be affected by their internet behaviours and vice versa. For instance, most web users spend about 10 seconds to two minutes on a web page before deciding to read on. If consumers find the health information difficult to understand, particularly in the opening paragraphs, they may abandon the web page.”

He said the limited availability of easy-to-read health materials indicated that many Australians were not benefiting from the convenience of the internet. The low readability of the information available also raised concern that many readers could misinterpret the information which could lead to “inappropriate healthcare decisions”.