The readability of online breast cancer risk assessment tools

Abstract

Numerous breast cancer risk assessment tools that allow users to input personal risk information and obtain a personalized breast cancer risk estimate are available on the Internet. The goal of these tools is to increase screening awareness and identify modifiable health behaviors; however, the utility of this risk information is limited by the readability of the material. We undertook this study to assess the overall readability of breast cancer risk assessment tools and accompanying information, as well as to identify areas of suggested improvement. We searched for breast cancer risk assessment tools, using five search terms, on three search engines. All searches were performed on June 12, 2014. Sites that met inclusion criteria were then assessed for readability using the suitability assessment of materials (SAM) and the SMOG readability formula (July 1, 2014–January 31, 2015). The primary outcomes are the frequency distribution of overall SAM readability category (superior, adequate, or not suitable) and mean SMOG reading grade level. The search returned 42 sites were eligible for assessment, only 9 (21.4 %) of which achieved an overall SAM superior rating, and 27 (64.3 %) were deemed adequate. The average SMOG reading grade level was grade 12.1 (SD 1.6, range 9–15). The readability of breast cancer risk assessment tools and the sites that host them is an important barrier to risk communication. This study demonstrates that most breast cancer risk assessment tools are not accessible to individuals with limited health literacy skills. More importantly, this study identifies potential areas of improvement and has the potential to heighten a physician’s awareness of the Internet resources a patient might navigate in their quest for breast cancer risk information.Electronic supplementary materialThe online version of this article (doi:10.1007/s10549-015-3601-2) contains supplementary material, which is available to authorized users.

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“…Our readability results are consistent with previous studies, which have found high readability levels for other breast cancer-related topics such as risk assessment and treatment. 20,65,75 Our results clearly highlight the need for more plain-language dissemination of research about environmental risk factors. 76 …”

“…16 A major report recommendation was to identify effective strategies for communicating accurate and reliable breast cancer risk information to diverse audiences given that individuals possess different literacy and numeracy skills and may prefer different formats for receiving and responding to health-related information. 17–19 Prior research has examined the format and readability of breast cancer risk assessment tools 20,21 , however, important research questions persist regarding messaging about the link between breast cancer and environmental exposures.…”

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