The Consumers' Perspective: Text Features and Readability of Consumer Health Text.

Rosemblat G, Logan R

Mednet 2007: Germany. 12 Oct 2007


Background: The increasing number of consumers seeking health information online can foster a mismatch between the ability to understand written health information and the readability level of consumer health text. Previous research suggests that textual features (e.g.: discourse, style), significantly affect consumer understanding. In an earlier study, health communication experts identified textual factors that contribute to readability, such as the ability to convey the main point and consumers' familiarity with vocabularies. The current study sought to compare these earlier assessments with indirect measures of readability that consumers encountered with the same text. The degree that consumer readability assessments were consistent with significant variables previously identified by experts was investigated. Objective: This pilot study assessed how consumers evaluated the influence of specific linguistic and stylistic features on the perceived readability of health texts. Methods: An external contractor conducted the study following an NLM-designed protocol, using a quasi-experimental, within-subjects design. Consumers (n=48) with diverse demographics and health literacy levels were recruited. Variables previously perceived as significant for readability were reevaluated. Four identical passages used in were reexamined: two with a lower and two with a higher readability score, as measured by an NLM-developed Readability Analyzer. Several grounded instruments (E.g., Cloze test), were used to assess consumers' readability and comprehension, and convergence with earlier findings. We sought to isolate the effects of vocabulary knowledge on performance, and measure how accurately participants perceived the main idea of each text. The Statistical Package for the Social Sciences (SPSS) was used to analyze the results. Conclusion: In this study, vocabulary familiarity was also perceived as a significant contributor to readability, while author's ability to communicate the main point was not. The relationship between factual statements within difficult articles and poor Cloze scores allows us to draw the inference that the way vocabulary is used and elements are located in a passage influence readability assessments. Thus, this study also suggests that context of use is just as important as vocabulary familiarity: familiar terms used in unfamiliar ways (E.g., figurative uses) hinder readability. Overall, a consumer perspective contributes to an understanding of how vocabulary and main point contribute to readability. Complete abstract at

Rosemblat G, Logan R. The Consumers' Perspective: Text Features and Readability of Consumer Health Text. 
Mednet 2007: Germany. 12 Oct 2007