Readability of publicly available mental health information: A systematic review

• Published in: Patient education and counseling 2023-06, Vol.111, p.107682-107682, Article 107682
• Main Authors: Boutemen, Laura, Miller, Ann Neville
• Format: Article
• Language: English
• Subjects: Comprehension; Health Literacy; Humans; Internet; Leaflets; Mental Health; Mental health information; Readability; Reading; Systematic Review; Websites
• ISSN: 0738-3991; 1873-5134
• DOI: 10.1016/j.pec.2023.107682

Relatively little research has examined the health literacy demand of public communication (e.g. websites, pamphlets, and posters) about mental disorders. This study describes characteristics of existing research and summarizes what is known about the readability of such information. A search of eight data bases yielded 33 studies that met inclusion criteria. Studies were screened for relevance at each stage and then coded for key characteristics and appraised for quality by both authors working independently. Grade-level readability scores as measured by the Flesch-Kincaid, SMOG, and other indices ranged from 6th to 17th grade. Most Flesch Reading Ease scores fell within the 30–50 range. Results of accessibility measures were inconsistent. With the recommended readability level for health communication set at sixth grade, most publicly available information about mental disorders uses vocabulary and sentence structure that is too complex for the general public. Mixed evidence indicated that accessibility issues are also problematic. Developers of health information need to decrease health literacy demand in written mental health information to ensure patients and their families may benefit from this information. •Most mental health information on websites and in pamphlets and books is written at a level that is too high for the average reader.•The majority of studies reviewed use grade-level readability formulas which provide no information beyond sentence-length and word-length counts.•We know little about application of broader recommendations for plain language such as design, organization, and syntactical issues.•Nearly half of studies evaluated were low quality, especially in reporting of selection procedures. Additional rigor is needed in future research.