Reading Ability of Parents Compared With Reading Level of Pediatric Patient Education Materials
1 Departments of Pediatrics, Internal Medicine, Louisiana State University Medical Center School of Medicine, Shreveport, LA
2 Departments of Family Medicine, Louisiana State University Medical Center School of Medicine, Shreveport, LA
3 Departments of Preventive Medicine and Pediatrics, Kansas University School of Medicine, Wichita, KA
4 Departments of Pediatrics, Louisiana State University Medical Center School of Medicine, Shreveport, LA
5 Departments of Internal Medicine, Louisiana State University Medical Center School of Medicine, Shreveport, LA
Objectives. To test the reading ability of parents of pediatric outpatients and to compare their reading ability with the ability necessary to read commonly used educational materials; to compare individual reading grade levels with the levels of the last grade completed in school; and to further validate a new literacy screening test designed specifically for medical settings.
Design. Prospective survey.
Setting. Pediatrics outpatient clinic in a large, public university, teaching hospital.
Participants. Three hundred ninety-six parents or other caretakers accompanying pediatric outpatients.
Measurements. Demographics and educational status were assessed using a structured interview. Reading ability was tested using the Rapid Estimate of Adult Literacy in Medicine (REALM) and the Wide Range Achievement Test-Revised2. Written educational materials were assessed for readability levels with a computer program (Grammatik IV).
Results. The mean score on the REALM for all parents placed them in the seventh to eighth grade reading range, despite the mean self-reported last grade completed in school being 11th grade 5th month. Wide Range Achievement Test-Revised2 scores correlated well with REALM scores (0.82). Eighty percent of 129 written materials from the American Academy of Pediatrics, the Centers for Disease Control, the March of Dimes, pharmaceutical companies, and commercially available baby books required at least a 10th grade reading level. Only 25% of 60 American Academy of Pediatrics items and 19% of all materials tested were written at less than a ninth grade level, and only 2% of all materials were written at less than a seventh grade level.
Conclusion. This study demonstrates that parents' self-reported education level will not accurately indicate their reading ability. Testing is needed to screen at-risk parents for low reading levels. In a public health setting, a significant amount of available parent education materials and instructions require a higher reading level than most parents have achieved. In such settings, all materials probably should be written at less than a high school level if most parents are to be expected to read them. The REALM can easily be used in busy public health clinics to screen parents for reading ability.
Submitted on March 22, 1993Accepted on September 1, 1993
CiteULike 
Connotea 
Del.icio.us 
Digg 
Facebook 
Reddit 
Technorati 
Twitter What's this?
This article has been cited by other articles:
|
|
 |
|
  L. M. Sanders, S. Federico, P. Klass, M. A. Abrams, and B. Dreyer Literacy and Child Health: A Systematic Review Arch Pediatr Adolesc Med, February 1, 2009; 163(2): 131 - 140. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Badarudeen and S. Sabharwal Readability of Patient Education Materials from the American Academy of Orthopaedic Surgeons and Pediatric Orthopaedic Society of North America Web Sites J. Bone Joint Surg. Am., January 1, 2008; 90(1): 199 - 204. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Stebbing, I. C K Wong, R. Kaushal, and A. Jaffe The role of communication in paediatric drug safety Arch. Dis. Child., May 1, 2007; 92(5): 440 - 445. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. M. Sanders, V. T. Thompson, and J. D. Wilkinson Caregiver Health Literacy and the Use of Child Health Services Pediatrics, January 1, 2007; 119(1): e86 - e92. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. B. Friedman and L. Hoffman-Goetz A Systematic Review of Readability and Comprehension Instruments Used for Print and Web-Based Cancer Information Health Educ Behav, June 1, 2006; 33(3): 352 - 373. [Abstract] [PDF]
|
|
|
|
|
|
C. L. Arnold, T. C. Davis, J. O. Frempong, S. G. Humiston, A. Bocchini, E. M. Kennen, and M. Lloyd-Puryear Assessment of Newborn Screening Parent Education Materials Pediatrics, May 1, 2006; 117(5/S1): S320 - S325. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. R. Hargrave, U. A. Hargrave, and E. Bouffet Quality of health information on the Internet in pediatric neuro-oncology Neuro-oncol, April 1, 2006; 8(2): 175 - 182. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. S. Wolf, J. A. Gazmararian, and D. W. Baker Health Literacy and Functional Health Status Among Older Adults Arch Intern Med, September 26, 2005; 165(17): 1946 - 1952. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. T. McCray Promoting Health Literacy J. Am. Med. Inform. Assoc., March 1, 2005; 12(2): 152 - 163. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. V. Raman, R. M. Jacobson, and G. A. Poland A Parent-Driven, Computer-Based Vaccine Information System: Addressing Variability in Information Needs for the Varicella Vaccine Mayo Clin. Proc., February 1, 2005; 80(2): 187 - 192. [Abstract] [PDF]
|
|
|
|
 |
|
 A. Harwood and J. E. Harrison How readable are orthodontic patient information leaflets? J. Orthod., September 1, 2004; 31(3): 210 - 219. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. V. Wegner and D. C. Girasek How Readable Are Child Safety Seat Installation Instructions? Pediatrics, March 1, 2003; 111(3): 588 - 591. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. C. Davis, M. V. Williams, E. Marin, R. M. Parker, and J. Glass Health Literacy and Cancer Communication CA Cancer J Clin, May 1, 2002; 52(3): 134 - 149. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Busey, T. R. Schum, and J. R. Meurer Parental Perceptions of Well-Child Care Visits in an Inner-city Clinic Arch Pediatr Adolesc Med, January 1, 2002; 156(1): 62 - 66. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. R. Nath, S. T. Sylvester, V. Yasek, and E. Gunel Development and Validation of a Literacy Assessment Tool for Persons With Diabetes The Diabetes Educator, November 1, 2001; 27(6): 857 - 864. [Abstract] [PDF]
|
|
|
|
 |
|
 E. M. ROGERS, S. C. RATZAN, and J. G. PAYNE Health Literacy: A Nonissue in the 2000 Presidential Election American Behavioral Scientist, August 1, 2001; 44(12): 2172 - 2195. [Abstract] [PDF]
|
|
|
|
|
|
D. M. D'Alessandro, P. Kingsley, and J. Johnson-West The Readability of Pediatric Patient Education Materials on the World Wide Web Arch Pediatr Adolesc Med, July 1, 2001; 155(7): 807 - 812. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. E. ALEXANDER READABILITY OF PUBLISHED DENTAL EDUCATIONAL MATERIALS J Am Dent Assoc, July 1, 2000; 131(7): 937 - 942. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. D. Cabana, B. E. Ebel, L. Cooper-Patrick, N. R. Powe, H. R. Rubin, and C. S. Rand Barriers Pediatricians Face When Using Asthma Practice Guidelines Arch Pediatr Adolesc Med, July 1, 2000; 154(7): 685 - 693. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. M. Taylor and P. A Cameron Discharge instructions for emergency department patients: what should we provide? Emerg. Med. J., March 1, 2000; 17(2): 86 - 90. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. C. Powell, R. R. Tanz, A. Uyeda, M. B. Gaffney, and K. M. Sheehan Injury Prevention Education Using Pictorial Information Pediatrics, January 1, 2000; 105(1): e16 - e16. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Page Glascoe Communicating With Parents Young Exceptional Children, September 1, 1999; 2(4): 17 - 25. [PDF]
|
|
|
|
|
|
A. Kempe, C. Dempsey, and S. R. Poole Introduction of a Recorded Health Information Line Into a Pediatric Practice Arch Pediatr Adolesc Med, June 1, 1999; 153(6): 604 - 610. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Ad Hoc Committee on Health Literacy for the Counci Health Literacy: Report of the Council on Scientific Affairs JAMA, February 10, 1999; 281(6): 552 - 557. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. C. Christensen and G. D. Grace The Prevalence of Low Literacy in an Indigent Psychiatric Population Psychiatr Serv, February 1, 1999; 50(2): 262 - 263. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. C. Davis, R. Michielutte, E. N. Askov, M. V. Williams, and B. D. Weiss Practical Assessment of Adult Literacy in Health Care Health Educ Behav, October 1, 1998; 25(5): 613 - 624. [Abstract]
|
|
|
|
|
|
R. Y. Moon, T. L. Cheng, K. M. Patel, K. Baumhaft, and P. C. Scheidt Parental Literacy Level and Understanding of Medical Information Pediatrics, August 1, 1998; 102(2): e25 - 25. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. A. Dunn, P. E. Shenouda, D. R. Martin, and A. J. Schultz Videotape Increases Parent Knowledge About Poliovirus Vaccines and Choices of Polio Vaccination Schedules Pediatrics, August 1, 1998; 102(2): e26 - 26. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. P. Glascoe The Value of 'Parents' Evaluations of Developmental Status' in Detecting and Addressing Children's Developmental and Behavioral Problems Assessment for Effective Intervention, July 1, 1998; 23(4): 185 - 203. [Abstract] [PDF]
|
|
|
|
|
|
F. P. Glascoe, F. Oberklaid, P. H. Dworkin, and F. Trimm Brief Approaches to Educating Patients and Parents in Primary Care Pediatrics, June 1, 1998; 101 (6): e10 - e10. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. D. Weiss and C. Coyne Communicating with Patients Who Cannot Read N. Engl. J. Med., July 24, 1997; 337(4): 272 - 274. [Full Text]
|
|
|
|
|
|
M. V. Williams, R. M. Parker, D. W. Baker, N. S. Parikh, K. Pitkin, W. C. Coates, and J. R. Nurss Inadequate Functional Health Literacy Among Patients at Two Public Hospitals JAMA, December 6, 1995; 274(21): 1677 - 1682. [Abstract] [PDF]
|
|
|
|
|
|
S. Miles and T. Davis Patients Who Can't Read: Implications for the Health Care System JAMA, December 6, 1995; 274(21): 1719 - 1720. [Abstract] [PDF]
|
|
|
|
 |
|
 C. Klingbeil, M. W. Speece, and H. Schubiner Readability of Pediatric Patient Education Materials: Current Perspectives on an Old Problem Clinical Pediatrics, February 1, 1995; 34(2): 96 - 102. [Abstract] [PDF]
|
|
