Health Literacy
Vol. 3, No.1 2024


Research and practice of health care information that is easy to understand and act upon: readability and PEMAT

Tsuyoshi Okuhara

Department of Health Communication, School of Public Health, The University of Tokyo

Readability, Understandability, and Actionability of Health-care Information

Tsuyoshi Okuhara

Department of Health Communication, School of Public Health, The University of Tokyo

Readability is the determination, by systemic formulae, of the reading comprehension level a person must have to understand written materials. Japanese and international readability evaluation studies have shown that health-care information is often difficult for citizens and patients to read. A series of processing fluency studies showed that readers are more likely to like, trust, and act on information that they subjectively find easy to read. However, in our randomized controlled study examining the impact of readability on behavior-related outcomes, we found no significant differences in most outcomes between text qualified as easy or difficult to read. While readability is an important prerequisite for better health-care information provision, it is one of the factors in ease of understanding and resultantly taking action by citizens and patients. To provide health-care information that is easy to understand and act upon, it is important to improve both what to communicate (i.e., what content is conveyed) and how to communicate (e.g., ease of viewing, reading, and understanding).

Domestic and International Activities for Easy-to-read Medical Information

Shinsuke Hayama 1)2)

1) Slow Communication Japan,2) National Cancer Center Japan

Japan’s Act for Eliminating Discrimination against Persons with Disabilities, enforced in April 2016, obligates administrative organs to provide reasonable accommodation for persons with disabilities. From April 2024, private businesses will also be required to do so. “Reasonable accommodation” includes giving written or oral explanation in an easy-to-understand manner for people with intellectual disabilities; medical professionals must also take such measures as necessary. This article introduces easy-to-read pamphlets from the United Kingdom, Sweden, South Korea, Taiwan, and Japan to be used as references. These pamphlets were prepared mainly by private organizations dealing with persons with disabilities, in collaboration with medical organizations. It is also important for medical institutions to create their own easy-to-read materials to disseminate up-to-date and well-reasoned information on medical care. Preparing easy-to-read documents requires awareness of three major points: using easy-to-understand words and sentences, using clear layout, and effectively organizing information. This article presents seven points to apply toward making words and sentences easier, focusing on the points that are easy to put into practice, along with examples of their use.

Practical Use of Japanese Version of the Patient Education Materials Assessment Tool

Emi Furukawa

Department of Health Communication, The University of Tokyo Graduate School of Medicine

Patient education materials, such as pamphlets, websites, online videos, and apps, should be easy to understand and act upon regardless of the audience’s health literacy. The Patient Education Materials Assessment Tool (PEMAT) is an instrument developed by the Agency for Healthcare Research and Quality to systematically evaluate materials’ understandability and actionability. We developed a Japanese version of PEMAT in 2021, based on the original version and adapted to Japan’s linguistic and cultural context. PEMAT has three main advantages over other existing tools for evaluating materials’ quality: (1) the ability to measure actionability, which traditional tools have not assessed ? i.e., the likelihood that patients and the general public will be able to practice the behaviors recommended in the materials; (2) the ability to evaluate health and medical information in various media, including printed materials, websites, and videos; and (3) reliability and validity being verified, that is, quality evaluation of materials being ensured based on a certain level of evidence. The Japanese version of PEMAT lets healthcare professionals improve on materials or select more patient-friendly materials.

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