Are printed health information brochures readable and suitable as a health information source?

Printed materials can be an important source for health information, but are they readable and suitable? This study, including two phases, evaluated the reading level and suitability of printed health information brochures.

Methods: In phase I, the Smog Readability Formula (SRF) was used to assess the reading level of 21 brochures collected from a county health department, hospitals/clinics, grocery/drug stores, and fire/police departments of five different towns in a Midwest state. In phase II, in addition to SRF, the Suitability Assessment of Materials Scale (SAMS) was added to evaluate another15 brochures from a Healthy Start program. Each brochure was assessed by at least two evaluators. The inter-rater agreement rate ranged from 73% to 95%.

Instruments: SRF calculates the reading level based on the number of words with three or more syllables in the brochure. SAMS includes 22 assessment items in six areas: content, literacy demand, graphics, layout and typography, learning stimulation and motivation, and cultural appropriateness. Each item is scored from 0 to 2. SAMS produces a final percentage score that corresponds to either superior (70-100%), adequate (40-69%) or not suitable (0-39%).

Results: Brochure topics ranged from runny nose, hypertension to cancer (phase I) and pregnancy (phase II). The reading levels for the brochures were 10.1 (range: 6-13) in phase I and 8.4 (range: 7-11) in phase II. Only 14% of the brochures in phase I and 53% in phase II met the recommended 6th to 8th grade reading level. Brochures with a high reading level were produced by hospitals/clinics, non-profit organizations, pharmaceuticals, or public agencies. All brochures in phase II were either adequate (40%) or superior (60%); however, areas rated high as not suitable included no summary statement in the brochure (64%), high reading grade level (42%), and no interaction to stimulate readers (34%).

Conclusions/Implications: Brochures collected from the community were more likely to have a higher reading level than those from the Healthy Start program. The majority of the brochures, however, exceeded the recommended reading level. Both private and public sectors need to develop policies in producing and selecting appropriate brochures better suited for the public.