Hi Kelli,

I see your point about the audio portion helping with comprehension of the information on the Medline Plus tutorials. However, these tutorials are labeled on the Medline site as "easy-to-read" when they are actually written at high school to high college level. They should be labeled as regular modules with voice. Using these modules for instruction in literacy programs (my former professional field) is fine but the high reading level would be a barrier to most people who don't have help to read them. 

We have this situation because we don't have guidelines for reading ease and easy navigability for health websites. For example, reading level is not even mentioned in the NCI's book "Research-Based Web Design and Usability Guidelines" available at usability.gov. 

Speaking of reading level, many people think that medical terms will skew results on readability formulas. What they really do is to accurately reflect the difficulty of the text. If "laparoscopy" is in a document 10 times, that means the inexperienced readers who have to "sound it out" each time they come to it, will have to do so 10 times. That means 10 interruptions in their reading flow. It means 10 interruptions in the process of trying to build understanding of the content. The high reading score reflects that difficulty quite accurately. Strong readers like most of us on this list can "sound out" a word one time and then have it in our sight word vocabulary (we can immediately recognize it from sight the next time we see it) from that point forward. Less skilled readers must "sound out" a new word at least dozens of times before it moves into their sight word vocabulary. As writers we should try to avoid using the medical or technical terms many times as we present the content. You can "teach" it separately in a call out box or sidebar for those who can learn it quickly without having the word be a barrier to understanding of the concepts in the flowing text. 

My two cents worth, 

Audrey 

Audrey Riffenburgh, M.A., President
Plain Language Works (formerly Riffenburgh & Associates)
Specialists in Health Literacy & Plain Language since 1994
Albuquerque, New Mexico, USA 
E-mail: ar at plainlanguageworks.com
Founding Member, The Clear Language Group, www.clearlanguagegroup.com
Co-founder, Health Literacy Institute, www.healthliteracyinstitute.net



  ----- Original Message ----- 
  From: Ham, Kelli 
  To: Audrey Riffenburgh ; The Health and Literacy Discussion List 
  Sent: Friday, August 22, 2008 11:24 AM
  Subject: [HealthLiteracy 2259] Re: CAUTION in printing out Medline tutorials!


  Hi Audrey,

   

  Thanks for pointing out the "easy to read" issue with the tutorials.  The tutorials themselves are easier to understand, because of the combined use of text, images and the voice.  The key here is the notion of understanding, rather than reading level.   I have talked to folks who are using these in literacy programs, with the learner listening as they read the text, then going back without the sound to read the slide.  Still, I wonder if there is any publicly available results from usability studies or focus groups with low-level readers on these materials.  I agree that the reading level of the printed version isn't at a true easy to read level, but it still is useful to know that it exists and will work for some patients and consumers.   

   

  Regarding reading level tests - medical terms in any text will likely throw off the final readability score.  If the word 'laparoscopy' appears several times in a text, it is a five-syllable word that will skew the results.  The same is true for many other terms, even common words such as diabetes.   It would be interesting to see how the scores differ without the necessary medical terms.   At any rate, thanks for the reminder to think critically about what is being labeled as "easy-to-read".

   

  Best regards,

   

  Kelli

   

  Kelli Ham

  Consumer Health Coordinator

  NN/LM Pacific Southwest Region

  UCLA Louise M. Darling Biomedical Library

  310-825-1984

   

  From: healthliteracy-bounces at nifl.gov [mailto:healthliteracy-bounces at nifl.gov] On Behalf Of Audrey Riffenburgh
  Sent: Friday, August 22, 2008 10:28 AM
  To: The Health and Literacy Discussion List
  Subject: [HealthLiteracy 2258] CAUTION in printing out Medline tutorials!

   

  Hello, everyone, 

   

  Please remember that the Medline Plus tutorials are not written in easy-to-read language. I can't figure out how they can possibly be listed that way on the site. They may be "easy" to listen to because a voice reads the text for the viewer. However, the version that is available for print is not in plain language. For example, I just did a reading level analysis on the laparoscopy tutorial's text and it scored grade level 14 (SMOG formula). That's college level, NOT easy! 

   

  These tutorial modules are also organized according to the "medical model" which means the disease description first, etiology of disease, etc. and eventually--maybe--getting to useful action messages. Moreover, the illustrations that are inserted in the print-outs are not labeled and not placed near the text they supposedly support. 

   

  So remember to look carefully at materials you offer to patients.  There are more and more materials available that are called "easy" or "plain language" but truly are neither. Since we don't yet have standard definitions of terms and standard guidelines on what makes something "easy" for the majority of the public, we should remember to think before we use materials. 

   

  Audrey Riffenburgh, M.A., President
  Plain Language Works (formerly Riffenburgh & Associates)
  Specialists in Health Literacy & Plain Language since 1994
  Albuquerque, New Mexico

  Founding Member, The Clear Language Group, www.clearlanguagegroup.com
  Co-founder, Health Literacy Institute, www.healthliteracyinstitute.net

   

   

  ----- Original Message ----- 

    From: Ham, Kelli 

    To: The Health and Literacy Discussion List 

    Sent: Thursday, August 21, 2008 2:11 PM

    Subject: [HealthLiteracy 2252] Re: Easy to read Prostate Cancer info

     

    Hi Caroline,

     

    The very last slide each of the Interactive Tutorials on MedlinePlus will have a button that says "Print Module".  This will be a pdf document that covers the material in the tutorial, although it won't have as many images.

     

    For the Prostate Cancer tutorial, I clicked on Summary and then just clicked through the last few slides to find it.

     

    Hope that helps,

     

    Kelli

     

    Kelli Ham

    Consumer Health Coordinator

    NN/LM Pacific Southwest Region

    UCLA Louise M. Darling Biomedical Library

    310-825-1984

     

    From: healthliteracy-bounces at nifl.gov [mailto:healthliteracy-bounces at nifl.gov] On Behalf Of Marshall, Caroline
    Sent: Thursday, August 21, 2008 10:11 AM
    To: healthliteracy at nifl.gov
    Subject: [HealthLiteracy 2244] Easy to read Prostate Cancer info

     

    Hello all,

     

    I am trying to find some easy to read handouts or brochures for a series of town meetings.  The first meeting is on Prostate Cancer.  I have found plenty of information  but I would like to include some  easy to read handouts.  I have checked MedlinPlus but they offer a video tutorial, this has to be in print. Do any of you know a resource I could use.

     

     

     

    Regards,


    Caroline

     

    ______________________________
    Caroline Marshall
    Health Sciences Librarian

    Horblit Health Sciences Library

     



    Danbury Hospital, 24 Hospital Avenue, Danbury, CT 06810
    V: (203) 739-7419 | F: (203) 739-7568 | caroline.marshall at danhosp.org
    http://www.danburyhospital.org

    This transmittal is intended for a particular addressee(s). If it is not clear that you are the intended recipient, you are hereby notified that you have received this transmittal in error; any review, copying or distribution or dissemination is strictly prohibited. If you suspect that you have received this transmittal in error, please notify Danbury Health Systems immediately by email reply to the sender, and delete the transmittal and any attachments.
    READER BEWARE: Internet e-mail is inherently insecure and occasionally unreliable. Please contact the sender if you wish to arrange for secure communication or to verify the contents of this message.

     


----------------------------------------------------------------------------

    ----------------------------------------------------
    National Institute for Literacy
    Health and Literacy mailing list
    HealthLiteracy at nifl.gov
    To unsubscribe or change your subscription settings, please go to http://www.nifl.gov/mailman/listinfo/healthliteracy
    Email delivered to ar at plainlanguageworks.com



------------------------------------------------------------------------------


  ----------------------------------------------------
  National Institute for Literacy
  Health and Literacy mailing list
  HealthLiteracy at nifl.gov
  To unsubscribe or change your subscription settings, please go to http://www.nifl.gov/mailman/listinfo/healthliteracy
  Email delivered to ar at plainlanguageworks.com
-------------- next part --------------
An HTML attachment was scrubbed...
URL: http://www.nifl.gov/pipermail/healthliteracy/attachments/20080826/5d5cf282/attachment.html 
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/jpeg
Size: 5811 bytes
Desc: not available
Url : http://www.nifl.gov/pipermail/healthliteracy/attachments/20080826/5d5cf282/attachment.jpe