Multiple automated health literacy assessments: Development of the Health Literacy Editor: Presenter(s): Julie Ayre, The University of Sydney, Australia. (April 2023)

• Record Type: Journal Article
• Authors: Muscat, Danielle; Bonner, Carissa; Dunn, Adam; Harrison, Eliza; Dalmazzo, Jason; Mouwad, Dana; Aslani, Parisa; Shepherd, Heather; Mac, Olivia; McCaffery, Kirsten
• Is Part Of: Patient education and counseling. Volume 109(2023)Supplement
• Page Start: 137
• Publication Date: 2023-04
• Subjects: Patient education -- Periodicals; Health counseling -- Periodicals; Health education -- Periodicals; Counseling -- Periodicals; Patient Education -- Periodicals; Éducation des patients -- Périodiques; Counseling -- Périodiques; Éducation sanitaire -- Périodiques; 615.5071
• DOI: 10.1016/j.pec.2022.10.313
• Languages: English
• ISSNs: 0738-3991

Abstract

Abstract : Background: Producing health information that people can easily understand is challenging and time-consuming. Existing guidance is often subjective and lacks specificity. This study outlines the development and user-testing of the Health Literacy Editor. This new automated tool helps users write health information that is easy to understand and that adheres to health literacy guidelines. Methods: Existing health literacy and plain language guidelines were collated. Items amenable to programmable automated assessment were incorporated into the Editor. The prototype was iteratively refined across four rounds of user-testing with health services staff (N=20). After each round, Yardley's (2021) optimisation criteria were applied to collate user feedback. These criteria guided which changes would be implemented. Results: The Editor comprises six assessments: readability, complex language, passive voice, text structure, lexical density/diversity, and person-centred language. These are presented as global scores, with additional, more specific feedback flagged in the text itself. Feedback is provided in real-time such that users can iteratively revise and improve the text. Key changes from user-testing included: making the interface more intuitive, reducing the amount of information presented to first-time users, and creating varying 'levels' of support (e.g. 1-2 sentences, in-depth videos). Evaluations using the System Usability Scale and Technology Acceptance Model, showed high usability (Mean=84.25/100; SD=13.9) and perceived usefulness by health staff (M=8.62/10; SD=1.35). Conclusions: The Health Literacy Editor is an innovative new tool to improve the quality and safety of written health information. It provides objective, immediate feedback on a range of factors, complementing readability with other, less widely used but important objective assessments such as complex and person-centred language. User-testing with health services staff has made the Editor more intuitive and engaging. This is a scalable intervention to support the uptake of health literacy guidelines by health services and providers of health information.