Article Text

  1. O. O. Desalu,
  2. C. L. Arnold,
  3. P. F. Bass,
  4. T. C. Davis
  1. Louisiana State University Health Sciences Center-Shreveport, Shreveport, LA


Background In 1999 the American Academy of Pediatrics recommended that universal newborn hearing screening (UNHS) be part of the standard of care for all newborns. Despite the availability of written UNHS materials in most states, parent awareness of UNHS remains low. The Institute of Medicine recently reported that 90 million Americans have trouble understanding and using health information and that most patient information is unnecessarily complex.

Purpose To determine the reading level and user friendliness of available UNHS parent education materials regarding initial screening and retesting.

Methods Seventy-six English language materials were evaluated for reading level using the Flesch Reading Ease Formula and user friendliness using a checklist modified from established models. The checklist contained 23 specific criteria grouped into 5 categories: layout, illustrations, message clarity, manageable information (information limited and focused on parents "need to know "), and cultural appropriateness. Each brochure was evaluated individually by three research assistants and each criterion scored according to the amount of improvement needed—little/none, some, or much—to make the brochure user friendly.

Results The average reading level of the materials was 10th-12th grade, 27% were written at college level, and none were written at the recommended 6th grade level. Most brochures had some user-friendly attributes such as cultural appropriateness (82%), adequate font size (71%), and clear illustrations (80%). Most brochures needed some improvement in layout, clarity of the message, and providing a manageable amount of information. Criteria that needed most work were ample white space (37%), limiting paragraphs to 4-5 lines (44%), and focusing on parents' "need to know " (24%).

Conclusion States have made a good start in developing UNHS materials. Materials could be improved by lowering the reading level to at least a 7th to 8th grade level, making them more parent centered, and limiting the amount of information given. All materials must focus on what parents need to know and do in a timely manner.

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