Abstract
With the Internet becoming a growing source of information on genetics, genetic counselors and other health-care providers may be called upon to guide their patients to appropriate material, which is written at a suitable reading level for the individual and contains quality information. Given that many health-related Web sites are written at a high school or higher reading level, without direction from a genetic counselor or health-care provider, many Internet users may currently be turning to health-related Web sites that they do not understand. Additionally, Internet users may not know how to evaluate the quality of information they find, which could lead to them access inaccurate or irrelevant information. To aid in the process of finding and designing Web sites that are appropriate for patients, the current article provides guidelines for assessing readability and quality of health-related content. Additionally, a demonstration of an assessment is provided. Finally, limitations of these assessments are discussed.
Similar content being viewed by others
References
Bailin, A., & Grafstein, A. (2001). The linguistic assumptions underlying readability formulae: A critique. Language & Communication, 21, 285–301. doi:10.1016/S0271-5309(01)00005-2.
Bath, P. A., & Bouchier, H. (2003). Development and application of a tool designed to evaluate web-sites providing information on Alzheimer’s disease. Journal of Information Science, 29, 279–297. doi:10.1177/01655515030294005.
Bormuth, J. R. (1969). Development of readability analysis. Reading Research Quarterly, 1, 79–132. doi:10.2307/747021.
Case, D., Johnson, J., Andrews, J., Allard, S., & Kelly, K. (2004). From two-step flow to the internet: The changing array of sources for genetics information seeking. Journal of the American Society for Information Science and Technology, 55, 660–669. doi:10.1002/asi.20000.
Cotugna, N., Vickery, C. E., & Carpenter-Haefele, K. M. (2005). Evaluation of literacy level of patient education pages in health-related journals. Journal of Community Health, 30, 213–219. doi:10.1007/s10900-004-1959-x.
Dale, E., & Chall, J. S. (1995). Readability revised: The new Dale–Chall readability formula. Brookline: Brookline Books.
Davis, T. C., Michielutte, R., Askov, E. N., Williams, M. W., & Weiss, B. D. (1998). Practical assessment of adult literacy in health care. Health Education & Behavior, 25, 613–624. doi:10.1177/109019819802500508.
Doak, C. C., Doak, L. G., & Root, J. H. (1996). Teaching patients with low literacy skills (2nd ed.). Philadelphia: J.B. Lippincott.
Eysenbach, G., Powell, J., Kuss, O., & Sa, E. R. (2002). Empirical studies assessing the quality of health information for consumers on the world wide web: A systematic review. Journal of the American Medical Association, 287, 2691–2700. doi:10.1001/jama.287.20.2691.
Fisher, K., Naumer, C., Durrance, J., Stromski, L., & Christiansen, T. (2005). Something old, something new: Preliminary findings from an exploratory study about people’s information habits and information grounds, Information Research, (paper 223).
Flesch, R. (1948). A new readability yardstick. The Journal of Applied Psychology, 32, 221–233. doi:10.1037/h0057532.
Ford, P., Caylor, J., & Sticht, T. (1992). The FORCAST readability formula. Pennsylvania State University Nutrition Center, Bridge to Excellence Conference.
Friedman, D. B., & Hoffman-Goetz, L. (2006). A systematic review of readability and comprehension instruments used for print and web-based cancer information. Health Education & Behavior, 33, 352–373. doi:10.1177/1090198105277329.
Friedman, D. B., & Hoffman-Goetz, L. (2007). An exploratory study of older adults’ comprehension of printed cancer information: Is readability a key factor. Journal of Health Communication, 12, 423–437. doi:10.1080/10810730701438658.
Friedman, D. B., Hoffman-Goetz, L., & Arocha, J. F. (2004). Readability of cancer information on the internet. Journal of Cancer Education, 19, 117–122. doi:10.1207/s15430154jce1902_13.
Fry, E. (1968). A readability formula that saves time. Journal of Reading, nnn, 513–578.
Gunning, R. (1952). The technique of clear writing. New York: McGraw-Hill.
Guttmacher, A. E. (2001). Human genetics on the web. Annual Review of Genomics and Human Genetics, 2, 213–233. doi:10.1146/annurev.genom.2.1.213.
Harland, J., & Bath, P. (2007). Assessing the quality of websites providing information on multiple sclerosis: Evaluating tools and comparing sites. Health Informatics Journal, 13, 207–221. doi:10.1177/1460458207079837.
Hochhauser, M. (2002). The effects of HIPAA on research consent forms. Patient Care Management, 17, 6–7.
Kaphingst, K. A., Zanfini, C. J., & Emmons, K. M. (2006). Accessibility of web sites containing colorectal cancer information to adults with limited literacy. Cancer Causes & Control, 17, 147–151. doi:10.1007/s10552-005-5116-3.
Kim, P., Eng, T. R., Deering, M. J., & Maxfield, A. (1999). Published criteria for evaluating health related web sites. British Medical Journal, 318, 647–649, Review.
Kincaid, J. P., Fishburne, R. P., Robers, R. L., & Chissom, B. S. (1975). (No. 8–75). Memphis, TN: Naval Air Station: Research Branch Report.
Kunst, H., Groot, D., Latthe, P. M., Latthe, M., & Khan, K. S. (2002). Accuracy of information on apparently credible websites: Survey of five common health topics. British Medical Journal, 324, 581–582. doi:10.1136/bmj.324.7337.581.
Mclaughlin, G. H. (1969). Smog grading—a new readability formula. Journal of Reading, 12, 639–646.
Meric, F., Bernstam, E. V., Mirza, N. Q., Hunt, K. K., Ames, F. C., Ross, M. I., et al. (2002). Breast cancer on the world wide web: Cross sectional survey of quality of information and popularity of websites. British Medical Journal, 324, 577–581. doi:10.1136/bmj.324.7337.577.
National Society of Genetic Counselors.(2008). FAQs about genetic counselors and the NSGC. Retrieved February 25, 2008, from http://www.nsgc.org/about/faq.cfm.
Paasche-Orlow, M. K., Parker, R. M., Gazmararian, J. A., Nielsen-Bohlman, L. T., & Rudd, R. R. (2005). The prevalence of limited health literacy. Journal of General Internal Medicine, 20, 175–184. doi:10.1111/j.1525-1497.2005.40245.x.
Paasche-Orlow, M. K., Taylor, H. A., & Brancati, F. L. (2003). Readability standards for informed-consent forms as compared with actual readability. The New England Journal of Medicine, 348, 721–726. doi:10.1056/NEJMsa021212.
Pew Internet and American Life Project.(2006). Online health search 2006. Retrieved February 25, 2008, from http://www.pewinternet.org/pdfs/PIP_online_Health_2006.pdf.
Powers, R. D., Sumner, W. A., & Kearl, B. E. (1958). A recalculation of four adult readability formulas. Journal of Educational Psychology, 49, 99–105. doi:10.1037/h0043254.
Provost, M., Koompalum, D., Dong, D., & Martin, B. C. (2006). The initial development of the webmedqual scale: Domain assessment of the construct of quality of health web sites. International Journal of Medical Informatics, 75, 42–57. doi:10.1016/j.ijmedinf.2005.07.034.
Raygor, A. L. (1977). The Raygor readability estimate: A quick and easy way to determine difficulty. In P. D. Pearson (Ed.), Reading: Theory, practice, and research (pp. 259–263). Clemson: National Reading Conference.
Redish, J. C., & Selzer, J. (1985). The place of readability formulas in technical communication. Technical Communication, 32, 46–52.
Resta, R., Biesecker, B. B., Bennett, R. L., Blum, S., Estabrooks Hahn, S., Strecker, M. N., et al. (2006). A new definition of genetic counseling: National Society of Genetic Counselors’ task force report. Journal of Genetic Counseling, 15, 77–83. doi:10.1007/s10897-005-9014-3.
Seidman, J. J., Steinwachs, D., & Rubin, H. R. (2003). Design and testing of a tool for evaluating the quality of diabetes consumer-information web sites. Journal of Medical Internet Research, nnn, 5.
Smith, E. A., & Senter, R. J. (1967). Automated readability index. AMRL-TR (6570th Aerospace Medical Research Laboratory), nnn, 1–14.
Spache, G. (1974). Good reading for poor readers. Champaign, IL: Garrard.
Taylor, M. R. G., Alman, A., & David, K. (2001). Use of the internet by patients and their families to obtain genetics-related information. Mayo Clinic Proceedings, 76, 772–776.
U.S. Department of Health and Human Services. (2000). Health people 2010: Understanding and improving health. Retrieved February 1, 2008, from http://www.health.gov/healthypeople/Document/HTML/Volume1/Opening.html.
Weiss, B. D. (1998). Communicating with patients who have limited literacy skills: Report of the national work group on literacy and health. The Journal of Family Practice, 46, 168–176.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Shedlosky-Shoemaker, R., Sturm, A.C., Saleem, M. et al. Tools for Assessing Readability and Quality of Health-Related Web Sites. J Genet Counsel 18, 49–59 (2009). https://doi.org/10.1007/s10897-008-9181-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10897-008-9181-0