Readability of patient education materials for bariatric surgery

Introduction Bariatric surgery is a successful treatment for obesity, but barriers to surgery exist, including low health literacy. National organizations recommend patient education materials (PEM) not exceed a sixth-grade reading level. Difficult to comprehend PEM can exacerbate barriers to bariatric surgery, especially in the Deep South where high obesity and low literacy rates exist. This study aimed to assess and compare the readability of webpages and electronic medical record (EMR) bariatric surgery PEM from one institution. Methods Readability of online bariatric surgery and standardized perioperative EMR PEM were analyzed and compared. Text readability was assessed by validated instruments: Flesch Reading Ease Formula (FRE), Flesch Kincaid Grade Level (FKGL), Gunning Fog (GF), Coleman-Liau Index ( CL), Simple Measure of Gobbledygook (SMOG), Automated Readability Index (ARI), and Linsear Write Formula (LWF). Mean readability scores were calculated with standard deviations and compared using unpaired t-tests. Results 32 webpages and seven EMR education documents were analyzed. Webpages were overall difficult to read compared to standard/average readability EMR materials (mean FRE 50.5 +/- 18.3 vs. 67.4 +/- 4.2, p = 0.023). All webpages were at or above high school reading level: mean FKGL 11.8 +/- 4.4, GF 14.0 +/- 3.9, CL 9.5 +/- 3.2, SMOG 11.0 +/- 3.2, ARI 11.7 +/- 5.1, and LWF 14.9 +/- 6.6. Webpages with highest reading levels were nutrition information and lowest were patient testimonials. EMR materials were sixth to ninth grade reading level: FKGL 6.2 +/- 0.8, GF 9.3 +/- 1.4, CL 9.7 +/- 0.9, SMOG 7.1 +/- 0.8, ARI 6.1 +/- 1.0, and LWF 5.9 +/- 0.8. Conclusion Surgeon curated bariatric surgery webpages have advanced reading levels above recommended thresholds compared to standardized PEM from an EMR. This readability gap may unintentionally contribute to barriers to surgery and affect postoperative outcomes. Streamlined efforts are needed to create materials that are easier to read and comply with recommendations. [GRAPHICS] .

Automated summary

This study assessed and compared the readability of online webpages and electronic medical record (EMR) patient education materials (PEM) for bariatric surgery. The results showed that webpages had lower readability levels compared to the recommended reading level, while EMR materials met the recommended reading level. This readability gap may impact barriers to surgery and postoperative outcomes.