Addressing the information needs of the lay reader: how much is enough?

Article type
Authors
Parker S, Carrick S
Abstract
Background: The Cochrane Collaboration is dedicated to making current and accurate information about the effects of healthcare readily available via Systematic Reviews (SR) published on The Cochrane Library (CLIB). With a wealth of research information relating to breast cancer now on the CLIB, effective knowledge translation of the results of these reviews are required for the non-expert reader. The synopses appended to systematic reviews are designed to summarise the review results for consumers using a language style and format that enhances accessibility and aids browsing on the CLIB1. This initiative reflects a general trend towards the development of health information resources that are easy to read and which address the information needs of the lay reader.

It is the responsibility of individual Cochrane Review Groups (CRGs) to develop the synopses in conjunction with their reviewers. To do this they require a good understanding of the rationale for the development of the synopses, including the minimum standard of quality and content required. The Cochrane Breast Cancer Group (CBCG) has never formally assessed the breast cancer synopses but anecdotal feedback from consumers suggests they are seen as too lay. Objectives: To undertake a preliminary assessment of the accessibility (readability) of breast cancer synopses and the overall usefulness to consumers. This will inform our future practice.

Method: - The literature relating to the assessment of the readability of health literature was reviewed. The SMOG formula (a tool for testing readability of written health information where the text is less than 30 sentences in length) was chosen to estimate the US reading grade for each breast cancer synopses.

- Consumers (n=20) affiliated with the CRG were invited to participate. Recruitment was extended using snowball sampling. Each participant was asked to review the synopses and complete a Likert style questionnaire regarding readability, usefulness, placement within the review and level of information provided.

- The placement of the synopses within the review when browsing the CLIB was also reviewed.

Results: Eighteen of 19 published breast cancer reviews contained a synopsis. The mean word count of the breast cancer synopses was 120 (range 100-133) which complies with Cochrane guidelines (75-125 words), but which falls short of the 300- 500 words recommended for testing readability with many tools. The mean number of polysyllabic (3 or more syllables) words per 30 sentences was 79.72 (range 60-105), and the mean US reading grade for comprehension was 11.8 (range 10-14). Based on an Australian audience this equates to the reading age required to comprehend a weekly women's magazine or tabloid newspaper3.

Conclusions: Preliminary results suggest our synopses are readable for a very lay audience. Their short length and placement at the bottom of the review suggests they are unlikely to aid browsing of the CLIB. Standard readability scales provide little information about the level of comprehension, or the appropriateness of the information provided. The results from the consumer evaluation will enable us to offer suggestions as to how the synopses should be written and how much information should be included.

References: 1. The Cochrane Manual 2. Hawe P, Degeling D, Hall J. Evaluating Health promotion: A Health Workers Guide. Artarmon: MacLennan & Petty Pty. Ltd.; 1990. p.135. 3. Hawe P, Degeling D, Hall J. Evaluating Health promotion: A Health Workers Guide. Artarmon: MacLennan & Petty Pty. Ltd.; 1990. p. 71.