Reading Grade Level and Readability of Printed Cancer Education Materials

Judy Singh

ONF 2003, 30(5), 867-870. DOI: 10.1188/03.ONF.867-870

Purpose/Objectives: To analyze cancer brochures to estimate their reading level and assess their readability.

Design: Quantitative.

Sample: 10 cancer brochures published by various cancer organizations.

Methods: SMOG was used to estimate reading grade level of the brochures; the Readability Assessment Instrument (RAIN) was used to analyze the brochures in terms of 14 variables that affect comprehension. Interrater reliability was computed for reading grade level and readability level.

Main Research Variables: Reading grade level and readability.

Findings: Reading grade level of the brochures ranged from 9-15. The RAIN analysis showed that the number of variables incorporated across the 10 brochures ranged from 12-14, and the number of variables reaching readability criteria ranged from 6-8.

Conclusions: Cancer education materials are written at levels that may be too high for the average reader. These materials also may be difficult to understand because of the way they are written. Materials need to be written so that they match the reading levels of patients with cancer and the general public and incorporate more of the variables that affect comprehension so that readers can understand them easily.

Implications for Nursing: Nurses use written education materials to inform patients about their cancer diagnoses. They can conduct a comprehensive analysis of cancer brochures using SMOG and RAIN and then, if needed, use this information to revise the brochures so that they can be understood easily. If possible, patients who are going to be using the materials should be involved in the revision process.

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    References

    Adkins, A., & Singh, N. (2001). Reading level and readability of patient education materials in mental health. Journal of Child and Family Studies, 10, 1-8.

    Adkins, A.D., Singh, N.N., McKeegan, G.F., Lanier, A.E., & Oswald, D.P. (2002). Behavior treatment programs, readability and treatment outcomes. Research in Developmental Disabilities, 23, 253-265.

    American Brain Tumor Association. (1992). About Meningioma. Des Plaines, IL: Author.

    American Cancer Society. (1987). Facts on cancer of the larynx. Atlanta, GA: Author.

    American Cancer Society. (1987). Talking with your doctor. Atlanta, GA: Author.

    American Cancer Society. (1990). Finding a lump in your breast. Atlanta, GA: Author.

    American Cancer Society. (1992). What you should know about melanoma. Atlanta, GA: Author.

    Association for Brain Tumor Research. (1985). About medulloblastoma. Des Plaines, IL: Author.

    Channing Bete Co. Inc. (1989). About Cancer. South Deerfield, MA: Author.

    Cooley, M.E., Moriarty, H., Berger, M.S., Selm-Orr, D., Coyle, B., & Short, T. (1995). Patient literacy and the readability of written cancer educational materials. Oncology Nursing Forum, 22, 1345-1351.

    Davis, T.C., Crouch, M.A., Wills, G., Miller, S., & Abdehou, D.M. (1990). The gap between patient reading comprehension and readability of patient education materials. Journal of Family Practice, 31, 533-538.

    Estey, A., Musseau, A., & Keehn, L. (1994). Patient's understanding of health information: A multihospital comparison. Patient Education and Counseling, 24, 73-78.

    Flesch, R. (1948). A new readability yardstick. Journal of Applied Psychology, 32, 221-233.

    Fry, E.B. (1968). A readability formula that saves time. Journal of Reading, 11, 513-516, 578.

    Glazer, H.R., Kirk, L.M., & Bosler, F.E. (1996). Patient education pamphlets about prevention, detection, and treatment of breast cancer for low literacy women. Patient Education and Counseling, 27, 185-189.

    Kirkpatrick, M.F., & Mohler, C. (1999). Using the readability assessment instrument to evaluate patient medication leaflets. Drug Information Journal, 33, 557-563.

    Leukemia and Lymphoma Society of America. (1992). Chronic lymphocytic leukemia. White Plains, NY: Author.

    McLaughlin, G.H. (1969). SMOG grading-A new readability formula. Journal of Reading, 12, 639-646.

    National Institutes of Health. (1985). Progress against cancer of the skin. Bethesda, MD: Author.

    National Institutes of Health. (1990). What you need to know about cancer of the stomach. Bethesda, MD: Author.

    Richardson, J.S., & Morgan, R.F. (1994). Reading to learn in the content areas. Belmont, CA: Wadsworth.

    Singh, J. (1995). The readability of educational materials written for parents of children with attention-deficit hyperactivity disorder. Journal of Child and Family Studies, 4, 207-218.

    Singh, J. (2000). Readability of HIV/AIDS education materials. AIDS Education and Prevention, 12, 214-224.

    Singh, J. (2003). RAIN: Readability Assessment Instrument Manual (2nd ed.). Midlothian, VA: ONE Research Institute.

    U.S. Department of Education. (1986). Digest of education statistics (1985-86). Washington, DC: Office of Education Research and Improvement, U.S. Department of Education Center for Statistics.