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BACKGROUND Poor sleep hygiene persists in college students today, despite its heavy implications in adolescent development and academic performance. While previous literature has explored sleep patterns in undergraduates at a broad scale, no studies have exclusively assessed undergraduate medical students or pre-medicine (pre-med) college students. A gap also exists in knowledge of how students perceive their sleep patterns compared to their actual patterns. OBJECTIVE This study aims to address two research questions (RQs). What are the sleep patterns of pre-med college students (RQ1)? Would the proposed study protocol be feasible to examine the perception of sleep quality and promote sleep behavioral changes in pre-med college students (RQ2)? METHODS To analyze RQ1, a survey was conducted on pre-med students in a medical science baccalaureate program in a research one university in the Midwest United States to investigate their sleep habits and understand their demographics. To examine RQ2, five students were recruited from the survey pool to evaluate feasibility of the proposed protocol in addressing perception of sleep quality and changes. RESULTS Based on the 103 survey responses, pre-med students slept an average of 7.1 hours per night. A quarter of the participants had a poor sleep quality (PSQI≥5), although there was with no significant differences in proportions of Good (PSQI≥5) vs. Poor sleepers across cohorts. When students perceived no problem at all in their sleep quality, 50% were defined as having poor sleep quality. A larger proportion of students who perceived sleep quality as only a slight problem, still had 25% students presenting poor sleep quality. High stress levels were generally associated with poor sleep quality. The protocol evaluation revealed Fitbit as a beneficial tool in raising sleep awareness. Participants highlighted Fitbit elements that aid in comprehension, as well as room for improvement in the protocol. CONCLUSIONS Poor sleep quality experienced by unaware pre-med students points to a need to raise sleep awareness and develop effective interventions. Future work should refine the study protocol based on lessons learned and health behavior theories and use Fitbit as an informatics solution to promote healthy sleep behaviors.

BACKGROUND Patient education materials (PEMs) can be vital sources of information for the general population. However, despite American Medical Association (AMA) and National Institute of Health (NIH) recommendations to make PEMs easier to read for patients with low health literacy, they often do not adhere to these recommendations. The readability of online PEMs in the Obstetrics and Gynecology (OB/GYN) field, in particular, has not been thoroughly investigated. OBJECTIVE The study sampled online OB/GYN PEMs and aimed to examine agreeability across traditional readability measures (RMs), adherence of online PEMs to AMA and NIH recommendations, and whether readability level of online PEMs varied by publication source and medical topic. METHODS A total of 1,576 online OB/GYN PEMs were collected via three major search engines. Ninety-three were excluded due to shorter content (less than 100 words), yielding 1,483 PEMs for analysis. Each PEM was scored by four traditional readability measures (TRMs), including Flesch-Kincaid Grade Level (FKGL), Gunning-Fog Index (GFI), Simple Measure of Gobbledygook (SMOG), and the Dale-Chall (DCL). The PEMs were categorized based on publication source and medical topic by two research team members. The readability scores of the categories were compared statistically. RESULTS Results indicated that the four TRMs did not agree with each other, leading to the use of an averaged readability (composite) score for comparison. The composite scores across all online PEMs were not normally distributed and had a median at the 11th grade. Governmental PEMs had the lowest readability level amongst source categorization and PEMs about menstruation had the highest readability. CONCLUSIONS This study found that online OB/GYN PEMs did not meet the AMA and NIH readability recommendations and would be difficult to read and comprehend for patients with low health literacy. Both findings connected well to the literature. This study highlights the need to improve the readability of OB/GYN PEMs to help patients make informed decisions. While research has been done to create more sophisticated readability measures for medical and health documents. Once validated, these tools need to be utilized by online content creators of health education materials.

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