Implementation of an organisation-wide health literacy approach to improve the understandability and actionability of patient information and education materials: A pre-post effectiveness study

Objective: Limited examples exist globally of coordinated, organisation-wide health literacy approaches to systematically improve the understandability and actionability of patient health information. Even fewer have been formally evaluated. The aim of this study was to use the Patient Education Materials Assessment Tool (PEMAT) to evaluate the effectiveness of an organisation-wide, evidence-based approach to improve the understandability and actionability of patient information materials in regional health service in New South Wales, Australia. Methods: Two independent raters (blinded to the document version) evaluated pre- and post-implementation versions of 50 randomly-selected patient information materials using the PEMAT, with differences in understandability and actionability analysed using paired samples tests. Results: Mean (+/- SD) overall scores for understandability increased significantly by 5% (95% CI 2-8; p = 0.002) up to 77%+/- 10%, and mean actionability (+/- SD) increased significantly by 4% (95% CI 0-8; p = 0.046) up to 56%+/- 22%. Conclusion: These results demonstrate that organisation-wide approaches with standardised processes for staff to prepare, review and store written patient information and education materials can be successfully implemented to address the impacts and risks of low health literacy. Practice implications: The success of this approach provides a framework for other health organisations to work in partnership with patients to make health information more understandable and actionable. (C) 2019 Published by Elsevier B.V.