212758 How Accessible was Information about H1N1? Literacy Assessments of CDC Guidance Documents for Different Audiences

Wednesday, November 11, 2009: 12:35 PM

Rajiv N. Rimal, PhD , Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Lisa Lagasse, MHS , Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Katherine Clegg Smith, PhD , Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
J. Douglas Storey, PhD , Communication Science & Research, The Health Communication Partnership, Center for Communication Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Elizabeth Rhoades , Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Daniel J. Barnett, MD, MPH , Department of Environmental Health Sciences, Johns Hopkins University, Baltimore, MD
Saad Omer, MPH PhD , Rollins School of Public Health, Global Health, Emory University, Atlanta, GA
Jonathan Links, PhD , Environmental Health Sciences, Johns Hopkins School of Public Health, Baltimore, MD
Background. High reading level of health documents can render them inaccessible to many. We examined readability of H1N1 guidance documents produced by the CDC. We hypothesized (a) readability of information for technical audiences would be higher than for lay audiences and (b) information produced earlier in the outbreak would have higher scores.

Methods. All CDC H1N1 guidance documents (N=100) (April 28-July 20, 2009) were assessed for Flecsh-Kincaid (FK) readability. Six target audience groups were identified: technical personnel; primary distributive audience (e.g., health departments); secondary distributive audience (e.g., schools); laypersons; the media; and multiple audiences. Time period was divided into three groups: first week, second week, and thereafter.

Results. Across documents, the average FK grade level was 8.6 (range: 3-13). We found a significant main-effect for target audience, F(5,82)=29.7, P<.001, no effect for time, and a time-by-audience interaction, F(10,82)=4.4, P<.05. Reading level of material for the primary audience was highest (M=11.2), followed by technical personnel (M=10.9) and local institutions (M =9.5). Messages for the media had lowest grade level (M=5.9), followed by messages for laypersons (M=6.3), and those for multiple audiences (M=8.5). Over time, literacy level of messages for the media increased; that for technical audiences decreased.

Discussion. Readability of CDC's guidance documents varied, appropriately, by the intended audience. Documents for the media (followed by laypersons) were written at the lowest and those for primary audiences at the highest grade levels. Over time, this difference converged. Analyses of additional, interpretive methods (amount of white space, graphical aids, size, etc.) are ongoing.

Learning Objectives:
1) Identify the importance of writing health information that is accessible to audiences with low health literacy skills 2) Compare the readability of H1N1 guidance documents across different target audiences

Keywords: Health Literacy, Health Communications

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was involved in the primary task of writing for this abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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