Skip to main content

Advertisement

SpringerLink
Log in

Colorectal cancer screening patient education materials—how effective is online health information?

  • Original Article
  • Published:
International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Patients screened for colorectal cancer (CRC) frequently turn to the Internet to improve their understanding of tests used for detection, including colonoscopy, flexible sigmoidoscopy, fecal occult blood test (FOBT), and CT colonography. It was of interest to determine the quality and readability levels of online health information.

Methods

The screening tools were googled, and the top 20 results of each test were analyzed for readability, accessibility, usability, and reliability. The 80 articles excluded scientific literature and blogs. We used ten validated readability scales to measure grade levels, and one-way ANOVA and Tukey’s honestly statistical different (HSD) post hoc analyses to determine any statistically significant differences among the four diagnostic tests. The LIDA tool assessed overall quality by measuring accessibility, usability, and reliability.

Results

The 80 articles were written at an 11.7 grade level, with CT colonography articles written at significantly higher levels than FOBT articles, F(3, 75) = 3.07, p = 0.033. LIDA showed moderate percentages in accessibility (83.9 %), usability (73.0 %), and reliability (75.9 %).

Conclusions

Online health information about CRC screening tools are written at higher levels than the National Institute of Health (NIH) and American Medical Association (AMA) recommended third to seventh grade levels. More patients could benefit from this modality of information if it were written at a level and quality that would better facilitate understanding.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Siegel R, Ma J, Zou Z, Jemal A (2014) Cancer statistics, 2014. CA Cancer J Clin 64(1):9

    Article  PubMed  Google Scholar 

  2. Charnock D. (1998) The DISCERN handbook: quality critera for consumer health information on treatment choices

  3. Cherla DV, Sanghvi S, Choudhry OJ, Liu JK, Eloy JA (2012) Readability assessment of internet-based patient education materials related to endoscopic sinus surgery. Laryngoscope 122(8):1649–1654. doi:10.1002/lary.23309

    Article  PubMed  Google Scholar 

  4. Coleman M, Liau TL (1975) A computer readability formula designed for machine scoring. J Appl Psychol 60:2

    Article  Google Scholar 

  5. Colaco M, Svider PF, Agarwal N, Eloy JA, Jackson IM (2012) Readability Assessment of Online Urology Patient Education Materials. J Urol.

  6. Badarudeen S, Sabharwal S (2008) Readability of patient education materials from the American Academy of Orthopaedic surgeons and pediatric Orthopaedic Society of North America web sites. J Bone Joint Surg Am 90(1):199–204

    Article  PubMed  Google Scholar 

  7. Paasche-Orlow MKTH, Brancati FL (2003) Readability standards for informedconsent forms as compared with actual readability. N Engl J Med 348(8):721–726

    Article  PubMed  Google Scholar 

  8. Badarudeen S, Sabharwal S (2010) Assessing readability of patient education materials: current role in orthopaedics. Clin Orthop Relat Res 468(10):2572–2580. doi:10.1007/s11999-010-1380-y

    Article  PubMed  PubMed Central  Google Scholar 

  9. O’Connor A, Rostom A, Fiset V (1999) Decision aids for patients facing health treatment or screening decisions: systematic review. BMJ 319(7212):731–734

    Article  PubMed  PubMed Central  Google Scholar 

  10. Berland GK, Elliott MN, Morales LS, Algazy JI, Kravitz RL, Broder MS, Kanouse DE, Munoz JA, Puyol J, Lara M, Watkins KE, Yang H, McGlynn EA (2001) Health information on the internet accessibility, Quality, and Readability in English and Spanish. JAMA 285(20):2612–2621

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Sudore R, Mehta K, Simonsick E, Harris T, Newman A, Satterfield S (2006) Limited literacy in older people and disparities in health and healthcare access. J Am Geriatr Soc 54(5):770–776

    Article  PubMed  Google Scholar 

  12. McLaughlin GH (1969) SMOG grading: a new readability formula. J Read 12:8

    Google Scholar 

  13. Baker DW, Wolf MS, Feinglass J, Thompson JA, Gazmararian JA, Huang J (2007) Health literacy and mortality among elderly persons. Arch Intern Med 167(14):1503–1509

    Article  PubMed  Google Scholar 

  14. Chall JS (1995) Readability revisited: the new Dale-Chall readability formula. Brookline Books Cambridge, MA

    Google Scholar 

  15. Brown JB, Weston WW, Stewart MA (1989) Patient-centred interviewing part II: finding common ground. Can Fam Physician 35:153–157

    CAS  PubMed  PubMed Central  Google Scholar 

  16. Bouton ME, Shirah GR, Nodora J, Pond E, Hsu CH, Klemens AE, et al. (2012) Implementation of educational video improves patient understanding of basic breast cancer concepts in an undereducated county hospital population. J Surg Oncol 105(1):48–54. doi:10.1002/jso.22046

    Article  PubMed  Google Scholar 

  17. Agarwal N, Chaudhari A, Hansberry DR, Tomei KL, Prestigiacomo CJ (2013) A comparative analysis of neurosurgical online education materials to assess patient comprehension. J Clin Neurosci. doi:10.1016/j.jocn.2012.10.047

    Google Scholar 

  18. Agarwal N, Sarris C, Hansberry DR, Lin MJ, Barrese JC, Prestigiacomo CJ (2013) Quality of patient education materials for rehabilitation after neurological surgery. NeuroRehabilitation 32(4):817–821. doi:10.3233/nre-130905

    PubMed  Google Scholar 

  19. Eloy JA, Li S, Kasabwala K, Agarwal N, Hansberry DR, Baredes S, et al. (2012) Readability assessment of patient education materials on major otolaryngology association websites. Otolaryngol Head Neck Surg. doi:10.1177/0194599812456152

    Google Scholar 

  20. Hansberry DR, Agarwal N, Gonzales SF, Baker SR (2013) Are we effectively informing patients? A quantitative analysis of online patient education resources from the American Society of Neuroradiology. Am J Neuroradiol.in press.

  21. Hansberry DR, Kraus C, Agarwal N, Baker SR, Gonzales SF (2013) Health literacy in vascular and interventional radiology: a comparative analysis of online patient education resources. CardioVasc Int Radiol. in press.

  22. Hansberry DR, Agarwal N, Shah R, Schmitt PJ, Baredes S, Setzen M, et al. (2013) Analysis of the readability of patient education materials from surgical subspecialties. Laryngoscope. doi:10.1002/lary.24261

    Google Scholar 

  23. Hansberry DR, Suresh R, Agarwal N, Heary RF, Goldstein IM (2013) Quality assessment of online patient education resources for peripheral neuropathy. J Peripher Nerv Syst 18(1):44–47. doi:10.1111/jns5.12006

    Article  PubMed  Google Scholar 

  24. Kasabwala K, Agarwal N, Hansberry DR, Baredes S, Eloy JA (2012) Readability assessment of patient education materials from the American Academy of otolaryngology—head and neck surgery foundation. Otolaryngol Head Neck Surg 147(3):466–471. doi:10.1177/0194599812442783

    Article  PubMed  Google Scholar 

  25. Misra P, Agarwal N, Kasabwala K, Hansberry DR, Setzen M, Eloy JA (2012) Readability analysis of healthcare-oriented education resources from the american academy of facial plastic and reconstructive surgery (AAFPRS). Laryngoscope. doi:10.1002/lary.23574

    PubMed  Google Scholar 

  26. Agarwal N, Feghhi DP, Gupta R, Hansberry DR, Quinn JC, Heary RF, et al. (2014) A comparative analysis of minimally invasive and open spine surgery patient education resources. J Neurosurg Spine 21(3):468–474. doi:10.3171/2014.5.SPINE13600

    Article  PubMed  Google Scholar 

  27. Agarwal N, Hansberry DR, Singh PL, Heary RF, Goldstein IM (2014) Quality assessment of spinal cord injury patient education resources. Spine 39(11):E701–E7E4. doi:10.1097/BRS.0000000000000308

    Article  Google Scholar 

  28. Hansberry DR, Ramchand T, Patel S, Kraus C, Jung J, Agarwal N, et al. (2014) Are we failing to communicate? Internet-based patient education materials and radiation safety. Eur J Radiol 83(9):1698–1702. doi:10.1016/j.ejrad.2014.04.013

    Article  PubMed  Google Scholar 

  29. National Institutes of Health (2007) How to write easy to read health materials. http://www.nlm.nih.gov/medlineplus/etr.html. Accessed July 29, 2014.

  30. Dollahite J, Thompson C, McNew R (1996) Readability of printed sources of diet and health information. Patient Educ Couns 27(2):123–134

    Article  CAS  PubMed  Google Scholar 

  31. The Minervation validation instrument for healthcare websites (LIDA tool) [database on the Internet]2007. Accessed: September 2012

  32. 2007. MTLIMvifhcw.

  33. Health literacy: report of the Council on Scientific Affairs (1999) Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs, American Medical Association. JAMA. 281(6):552–7.

  34. Covering kids & families. Health literacy style manual 2005.

  35. Simply put—a guide for creating easy-to-undestand materials. 3 ed. Atlanta, Georgia: US Department of Health and Human Services—Centers for Disease Control and Prevention (CDC); 2009.

  36. Agarwal N, Hansberry D, Sabourin V, Tomei K, Prestigiacomo C (2013) A comparative analysis of the quality of patient education materials from medical specialties. JAMA Intern Med:1–2. doi:10.1001/jamainternmed.2013.6060

  37. Cotugna N, Vickery CE, Carpenter-Haefele KM (2005) Evaluation of literacy level of patient education pages in health-related journals. J Community Health 30(3):213–219

    Article  PubMed  Google Scholar 

  38. D’Alessandro DM, Kingsley P, Johnson-West J (2001) The readability of pediatric patient education materials on the world wide web. Arch Pediatr Adolesc Med 155(7):807–812

    Article  PubMed  Google Scholar 

  39. Davis TC, Williams MV, Marin E, Parker RM, Glass J (2002) Health literacy and cancer communication. CA Cancer J Clin 52(3):134–149

    Article  PubMed  Google Scholar 

  40. Diaz JAGR, Ng JJ, Reinert SE, Friedmann PD, Moulton AW (2002) Patients’ use of the internet for medical information. J Gen Intern Med 17:180–185

    Article  PubMed  PubMed Central  Google Scholar 

  41. Doak CC, Doak LG, Friedell GH, Meade CD (1998) Improving comprehension for cancer patients with low literacy skills: strategies for clinicians. CA Cancer J Clin 48(3):151–162

    Article  CAS  PubMed  Google Scholar 

  42. Albright J, de Guzman C, Acebo P, Paiva D, Faulkner M, Swanson J (1996) Readability of patient education materials: implications for clinical practice. Appl Nurs Res 9(3):139–143

    Article  CAS  PubMed  Google Scholar 

  43. Baker DW, Parker RM, Williams MV, Clark WS, Nurss J (1997) The relationship of patient reading ability to self-reported health and use of health services. Am J Public Health 87(6):1027–1030

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgments

There were no sources of funding and support. There were no additional contributors to the study, and all authors contributed substantially to the study design, data accrual, analysis, and interpretation of the work, drafting and revision of the manuscript, and final approval of the version to be published.

Author contributions

ESJ, AMJ, PA, and DRH were involved with the manuscript study concept and design. ESJ, AMJ, and PJT were involved with acquisition of data. DRH and PJT were responsible for statistical analysis and interpretation of data. ESJ, AMJ, and PA drafted the manuscript. CD and SC provided critical revision of the manuscript for important intellectual content.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA

    Elizabeth Sheena John

  2. Department of Gastroenterology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA

    Elizabeth Sheena John & Sita Chokhavatia

  3. Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA

    Ann M. John

  4. Department of Radiology, Jefferson University Hospital, Philadelphia, PA, USA

    David R. Hansberry

  5. Department of Radiology, Rutgers New Jersey Medical School, Newark, NJ, USA

    Prashant J. Thomas

  6. Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    Prateek Agarwal

  7. Department of Gastroenterology, Cooper University Hospital, Camden, NJ, USA

    Christopher Deitch

Authors
  1. Elizabeth Sheena John
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ann M. John
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. David R. Hansberry
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Prashant J. Thomas
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Prateek Agarwal
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Christopher Deitch
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sita Chokhavatia
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Elizabeth Sheena John.

Ethics declarations

Disclosures

None of the authors have any disclosures.

Grant funding

N/A

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

John, E.S., John, A.M., Hansberry, D.R. et al. Colorectal cancer screening patient education materials—how effective is online health information?. Int J Colorectal Dis 31, 1817–1824 (2016). https://doi.org/10.1007/s00384-016-2652-0

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00384-016-2652-0

Keywords

Search

Navigation