An Exploratory Study of Older Adults' Comprehension of Printed Cancer Information: Is Readability a Key Factor?

Abstract

Printed cancer information often is written at or beyond high school reading levels, despite lower average literacy abilities of the public. The objectives of this exploratory study were twofold: (1) to evaluate older adults' comprehension of breast (BC), prostate (PC), and colorectal (CC) cancer information; and (2) to determine if comprehension of BC, PC, and CC information varies according to text readability. Comprehension of printed cancer resources was evaluated with 44 community-dwelling older adults using the Cloze procedure and recall questions. Participants' comprehension scores were compared with Simple Measure of Gobbledegook (SMOG) readability scores (<grade 13 vs. grade 13+). Overall, older adults had satisfactory comprehension of cancer information as measured by Cloze (.86 +/- .01) and recall (.71 +/- .02). For CC information written at grade 13, however, a significant negative correlation between readability and Cloze comprehension was found (r(s) = -.44, SE = .17, p = .019), indicating poorer participant comprehension at higher readability levels. Comprehension of BC or PC information did not vary by readability level. Though readability plays a role in older adults' understanding of cancer information, cancer type and content are also important factors that influence comprehension. Use of plain language is recommended for CC resources.

Should We Be Afraid of Simple Messages? The Effects of Text Difficulty and Illustrations in People With Low or High Health Literacy

“…Although the use of readability levels to test for comprehensibility is often recommended in low health literacy interventions (Hill-Briggs, Schumann, & Dike, 2012), research has shown that in cancer communication, readability and comprehensibility are not always related (Friedman & Hoffman-Goetz, 2007). Therefore we primarily chose to pretest the messages extensively for difficulty.…”

Nutrition and Health Literacy: A Systematic Review to Inform Nutrition Research and Practice

“…Of these, 11 focused on traditional print materials (7,(29)(30)(31)(32)(33)(34)(35)(36)(37)(38) and five examined Internet-based information (39)(40)(41)(42)(43). Participants' level of health literacy (specifically reading ability) was also assessed in one print (32) and one Internet study (40).…”

“…Three studies (39,42,43) focused on general nutrition and dietary guidance, and two targeted cancer prevention (40,41). The readability of information on Web sites reviewed ranged from a mean grade level of 8.8 (42) to some college (39,41,43).…”

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“…PCPs indicated lack of information about PrCA screening among AA patients was a barrier to communicating with them about the screening process. Developing plain language and culturally appropriate resources about PrCA screening could be beneficial for AA communities and patients as they face the screening decision and help empower them to engage in shared decision making with PCPs [27]. …”