Unnecessarily difficult: Physical activity resources for adults are loaded with jargon

June 8, 2018, Oregon State University
Unnecessarily difficult: Physical activity resources for adults are loaded with jargon
Written resources can enhance and support health behavior changes and are considered a fundamental component of health promotion efforts. If they are not easy to read, they are less useful and access inequities will continue to persist. Credit: Oregon State University

Web page articles and other written materials designed to encourage physical activity are often too difficult to be easily read and understood by most U.S. adults, limiting their effectiveness, new research from Oregon State University shows.

Written resources can enhance and support health behavior changes and are considered a fundamental component of health promotion efforts. If they are not easy to read, they are less useful and access inequities will continue to persist, said Brad Cardinal, a kinesiology professor in the College of Public Health and Human Sciences at OSU.

"If we think it's an important message, we should make it as broadly accessible as possible," he said.

Easily-read resources using plain, simple language are more likely to have a positive impact. They also are more likely to promote health literacy, or the knowledge, motivation, confidence and skill to obtain and apply accurate health information. Those with higher health literacy are more likely to engage in preventive health behaviors, including , said Cardinal, a national expert on the benefits of physical .

"When people access the web and try to read something about exercise or health that is above their comfort level, they can easily become confused. Taken to extremes, misunderstandings could result in unnecessary pain or injury," he said. "But someone with stronger reading skills and higher health literacy could read the same thing and use the information to be successful."

Cardinal and OSU doctoral candidate Jafrā D. Thomas recently published two papers on the topic. The first paper, a readability review of more than 150 written resources, was published in the Sociology of Sport Journal.

The second, an analysis of 14 past studies of readability of physical activity resources, was just published in the journal Quest. Thomas is lead author of both papers; Brian Flay, professor emeritus in OSU's College of Public Health and Human Sciences, is also a co-author on the second paper.

In the first paper, Thomas and Cardinal reviewed 163 articles and downloadable documents on popular health promotion websites such as WebMD.com, Heart.org and CDC.gov. They grouped the articles based on their sources: government, professional association, voluntary health agency or commercial, and used several readability formulas to measure the reading grade level of each .

They found that more than 50 percent of the materials, which included a range of topics such as physical activity and exercise ideas, technical instruction and management of specific health conditions, were written above an eighth-grade reading level, the maximum recommended for accessibility. Only 2.5 percent were written for optimal reading levels, which is fifth-grade or lower.

In the second paper, Thomas, Flay and Cardinal examined 14 studies published between 1992 and the present, which when combined, had reviewed more than 800 written health educational resources on topics such as physical activity, physical fitness or sports medicine.

The average reading level across the studies was greater than 10th-grade, more than two full levels above the maximum recommended eighth-grade reading level. There was no difference in the reading level of resources produced by the government and those by non-government agencies.

The findings suggest that despite the efforts underway by officials and policymakers to improve the readability of health resources, through efforts such as the 2010 Plain Writing Act, the problem continues to persist, Cardinal said.

"The goal of such resources, regardless of who produced or disseminated them, should be to assure they are readable," he said. "This is the minimum way of trying to assure they are accessible for the widest possible audience."

The findings in both papers underscore the important role readability plays in reaching target audiences, and in particular underrepresented audiences such as those for whom English is a second language or those with less formal education, said Thomas.

"People with more education tend to participate more in physical activities, in part because they have more access to resources," he said. "When resources aren't readable, they are likely to favor people with more education and could contribute to disparities in rates."

Public officials and policymakers can do their part by creating and following readability policies; checking readability of materials using tools already embedded in word-processing programs or that are free online; and running materials past focus groups to check for and comprehension, Thomas said.

"Approach the work with an inclusive mindset," he said. "Strive to keep things plain and simple and don't be afraid to give people options and ask them what they prefer."

Explore further: Readability of online health information for patients with pancreatic cancer

More information: Jafrā D. Thomas et al, Are Physical Activity Resources Understandable as Disseminated? A Meta-Analysis of Readability Studies, Quest (2018). DOI: 10.1080/00336297.2018.1463269

Related Stories

Readability of online health information for patients with pancreatic cancer

May 4, 2016
Online information on pancreatic cancer overestimates the reading ability of the overall population and lacks accurate information about alternative therapy, according to a study published online by JAMA Surgery.

Patient information too high for patients' literacy

June 1, 2015
More than 90 per cent of educational materials written for kidney disease patients is higher than an average patient's literacy, according to a new study published in the June issue of the National Kidney Foundation's American ...

Only 5 percent of prostate cancer websites written below high school reading level, study finds

October 29, 2012
Ninety million American adults read below high school levels, so the National Institutes of Health recommends that patient-education materials be written at the fourth-through-sixth grade level.

Literacy level an issue in laryngectomy-related patient ed

August 22, 2017
(HealthDay)—Current laryngectomy-related patient education materials are too difficult for an average American adult to understand, according to a study published online Aug. 16 in Head & Neck.

Improving readability of discharge instructions leads to fewer patient follow-up calls

October 26, 2017
The National Institutes of Health and the American Medical Association recommend that health information should be written at a sixth grade level in order to be effectively understood by an average adult. However, disparities ...

Recommended for you

Students more likely to eat school breakfast when given extra time, new study finds

August 18, 2018
Primary school students are more likely to eat a nutritional breakfast when given 10 extra minutes to do so, according to a new study by researchers at Virginia Tech and Georgia Southern University.

Like shark attack and the lottery, unconscious bias influences cancer screening

August 17, 2018
What do shark attack, the lottery and ovarian cancer screening having in common? It turns out our judgments about these things are all influenced by unconscious bias.

Phantom odors: One American in 15 smells odors that aren't there, study finds

August 16, 2018
Imagine the foul smell of an ash tray or burning hair. Now imagine if these kinds of smells were present in your life, but without a source. A new study finds that 1 in 15 Americans (or 6.5 percent) over the age of 40 experiences ...

US drug overdose deaths surge amid fentanyl scourge

August 16, 2018
US drug overdose deaths surged to nearly 72,000 last year, as addicts increasingly turn to extremely powerful synthetic opioid fentanyl as the supply of prescription painkillers has tightened.

Parental life span predicts daughters living to 90 without chronic disease or disability

August 15, 2018
Researchers at the University of California San Diego School of Medicine report that women whose mothers lived to at least age 90 were more likely to also live to 90, free of serious diseases and disabilities.

Eating breakfast burns more carbs during exercise and accelerates metabolism for next meal

August 15, 2018
Eating breakfast before exercise may "prime" the body to burn carbohydrates during exercise and more rapidly digest food after working out, University of Bath researchers have found.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.