Health literacy and the Internet: Evaluating the readability of medical resources on local television websites

BACKGROUND: Patient education materials are often written at high reading levels and difficult to comprehend. The media play a critical role in communicating health messages to the public. Local television stations are posting a large amount of health content on the Web. The difficulty level of this information has not been evaluated. OBJECTIVES: (1) To assess the content of health stories posted on local television websites, and (2) To evaluate readability levels of these health messages. METHODS: Eighty media markets were selected randomly from a stratified sample of Nielsen-defined small, medium, and large market areas. The top three health articles on each market web page were selected for analysis. Readability levels were assessed using SMOG, Flesch-Kincaid (F-K), and Flesch Reading Ease (FRE). RESULTS: A total of 279 articles were found over a two-day search. The majority of stories were national (47.0%) and educational (48.0%) pieces. Fewer articles were breaking news stories (19.7%). More articles focused on both prevention and treatment (30.0%) rather than on prevention (21.8%) or treatment (21.1%) alone. Mean readability was at a senior high school level according to SMOG (Grade 11.8) and F-K (Grade 10.3). Overall FRE was 52.3 implying a ‘fairly difficult' reading style. Readability was considerably more difficult for infectious compared to chronic disease stories. CONCLUSIONS: Health information on television websites is complex. As broadcast news media continue to mobilize viewers toward health content on the Web, they must first consider the difficulty of the information and the literacy abilities of their intended audience.