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”.

http://www.universityworldnews.com/article.php?story=20150303151720394

The serious business of gamification

If you’re interested in changing behaviour in your workplace, helping employees or customers to develop new skills, or spurring innovation, you may want to consider the approach known as gamification. If that scares you – given that the word is ugly and sounds as if you would just be encouraging staff to play video games – Brian Burke, a vice-president at technology research firm Gartner Inc., says you should relax.

Gamification is actually not about playing games. Games are about entertainment. Gamification is serious stuff, using game mechanics such as badges and awards to digitally engage and motivate people to achieve their goals.

“It’s not entertainment. It’s motivation,” Mr. Burke said in an interview.

He points to the Boy Scouts, which has long used badges to motivate youngsters, and Weight Watchers, which uses a points system and social encouragement to nudge dieters. Both are examples of gamification from the days before the term was even coined. “It provides them with the encouragement, motivation, and clear path to achieve a goal,” he said.

Mr. Burke stresses that when using gamification, it is vital that the emphasis not be on organizational goals but on motivating people to achieve their own goals. When those personal objectives are aligned with the organizational goals, you can hit the gamification jackpot.

Behavioural change is the most common use for gamification. It comes in handy because new habits must be created to change behaviour, and gamification can excite us to adopt those practices.

In his book Gamify, Mr. Burke notes that Spanish bank BBVA used gamification to encourage customers to use its online services. The BBVA Game, which has 80,000 users, rewards players for completing challenges that educate them about Web banking, encouraging them to use the service. Points are awarded, which can lead to prizes. It has led to a 5-per-cent increase in BBVA’s Web-banking users, who spend 60 per cent more time on the site. Because online banking can be easier than going to a branch, the game is aligned with customers’ needs. But it’s also aligned with BBVA’s needs, because it reduces costs.

Samsung Electronics focused on customers with its social loyalty program, dubbed Samsung Nation. Customers are rewarded with points, levels and badges for watching product videos or commenting on Samsung products. The program has doubled the number of items placed in online shopping carts.

A key to success for behavioural change is to increase complexity over time. The BBVA Game starts by encouraging customers to watch instructional videos and then try simple operations such as checking an account balance. As users become more confident with the help of coaching, they move to more complex tasks such as paying bills.

Gamification can also help people to build their skills. Learning new skills often requires a repetitive process of lectures and practice, which gamification can handle. Or if the skill is best learned in an experiential way – such as being presented with a problem to solve – gamification can provide a vehicle for collaboration with others.

There have long been games that can teach new skills, such as Where in the World is Carmen Sandiego? (a series of video and computer games and TV shows designed to stimulate kids’ interest in geography, cultures and history). But Mr. Burke says those are games first, and skill-builders second. Gamification puts the skill-building first.

U.S. organizations such as Capital BlueCross are using it to educate members on the complexities of health care. The U.S. Department of Health and Human Services applied a gamified solution to educate health-care practitioners on best practices about privacy and security.

A key element of design is to create theory-practice loops. Players are provided with instruction, a challenge, and feedback on their efforts. “Gamification breaks the learning process into small, achievable steps and provides constant feedback and encouragement throughout the process,” Mr. Burke writes in his book.

To spur innovation, gamification can encourage people to submit innovative ideas, evaluate proposals and then collaborate to refine the idea into reality. Quirky, a crowdsourcing product-development company that has more than 6,000 inventors as members and has launched more than 400 new products since 2009, uses gamification in this way.

Mr. Burke says the process can be captivating. During his research he found himself hooked as he submitted a name for an anti-theft rucksack – one of 1,400 possible choices – and watched his suggestion bounce up and down in the Quirky rankings.

While he is an enthusiast, Mr. Burke warns that the biggest challenge facing companies is to understand the limitations as well as the opportunities of gamification. “A lot of organizations are pursuing opportunities that are unlikely to be successful with gamification,” he said. Faced with a problem, they throw some points at it and hope a solution will materialize. But you need to figure out how a point system might work, how to employ collaboration, and whether what you are designing can hold for the long term as well as short term.

But if you get it right, he believes you can harness the power of game design to great benefit for your organization.

Harvey Schachter is a Battersea, Ont.-based writer specializing in management issues. He writes Monday Morning Manager and management book reviews for the print edition of Report on Business and an online work-life column Balance. E-mail Harvey Schachter

http://www.theglobeandmail.com/report-on-business/careers/management/the-serious-business-of-gamification/article18020562/