June 2015
Volume 56, Issue 7
ARVO Annual Meeting Abstract  |   June 2015
Improving Patient Education Materials about Glaucoma with Attention to Low Health Literacy
Author Affiliations & Notes
  • Andrew M. Williams
    Michigan State University College of Human Medicine, Grand Rapids, MI
    Ophthalmology, Duke Eye Center, Durham, NC
  • Jullia Ann Rosdahl
    Ophthalmology, Duke Eye Center, Durham, NC
  • Kelly W Muir
    Ophthalmology, Duke Eye Center, Durham, NC
  • Footnotes
    Commercial Relationships Andrew Williams, None; Jullia Rosdahl, None; Kelly Muir, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 1392. doi:
  • Views
  • Share
  • Tools
    • Alerts
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Andrew M. Williams, Jullia Ann Rosdahl, Kelly W Muir; Improving Patient Education Materials about Glaucoma with Attention to Low Health Literacy. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1392.

      Download citation file:

      © ARVO (1962-2015); The Authors (2016-present)

  • Supplements

Purpose: Poor health literacy is associated with worse health-related outcomes in glaucoma. We revised our department’s glaucoma patient education materials using evidence-based guidelines about writing for patients with low health literacy. The purpose of this study was to assess whether our revisions improved the handouts’ suitability for a low health literacy population using a validated scoring tool for patient education materials.

Methods: Evidence-based guidelines for writing easy-to-read patient education materials were applied to revise 12 patient education handouts on various glaucoma topics that are commonly distributed at our academic glaucoma practice. The original and revised versions of the handouts were scored in random order by two glaucoma specialists. Handouts were scored using the Suitability Assessment of Materials (SAM) instrument, which systematically assesses the suitability of health information materials for patients with low health literacy. The Flesch-Kincaid Grade Level (FKGL) was also calculated for the original and revised documents. Paired t test was used for analysis.

Results: SAM scores between the two evaluators were significantly correlated (p<0.01, n=24). The mean (± standard deviation) SAM score improved from 60±7% (adequate) for the original versions (n=12) to 88±4% (superior) for the revised handouts (n=12) (p<0.00001). Eleven of the 17 SAM criteria significantly improved after revision, including: making the purpose evident, focusing content on behaviors, inclusion of a summary, reading grade level, use of active voice, use of common vocabulary, layout, typography, use of subheadings, improving motivation by subdividing tasks, and matching logic, language, and experience to the intended reader (p<0.05 for all). Readability improved from an average of a tenth-grade reading level (FKGL=10.0±1.6) to a sixth-grade reading level (FKGL=6.4±1.2) upon document revision (p<0.00001).

Conclusions: By revising our glaucoma handouts using guidelines on writing easy-to-understand material, the suitability of the documents for patients with low health literacy improved. The average reading level decreased from the tenth-grade level to the sixth-grade level after revision. A similar systematic approach could improve the readability of other ophthalmic educational materials. Future research could examine how improved materials affect clinical outcomes.


This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.