Extending the use of health literacy assessment instruments

Extending the use of health literacy assessment instruments

Summary

Brenda L. MacArthur, George Mason University;
Thomas J. Roccotagliata, George Mason University
Clayton Sinyai, The Center of Construction Research and Training

This study validates the SAM and CCI for use in health-related contexts other than patient education. Additionally, the results offer important implications for how health-safety training materials are assessed for general readability/suitability.

Abstract

Extending the use of health literacy assessment instruments: A case for suitability assessment of materials and clear communication

Health education materials are distributed to the public daily, and it is assumed that they will be able to read and understand it. Health communication researchers advocate for improving the public’s health literacy. An array of research examines how providers can improve health literacy through communication with patients, but less research examines how we assess the suitability of printed materials that are so frequently distributed. The present study fills this gap in health literacy literature by examining two common tools for assessing health-related educational materials. The Suitability Assessment of Materials (SAM) created by researchers at the John Hopkins School of Medicine allows healthcare providers to assess the suitability of printed materials they provide to their patients. Materials are rated as Superior, Adequate, or Not Suitable. The Clear Communication Index (CCI) developed by the Centers for Disease Control and Prevention assess all communication materials, regardless of the channel/modality. With this tool, materials are identified as Suitable or Not Suitable. Because the SAM was created in the provider-patient context and the CCI encompasses a more comprehensive public health approach to assessing health educational materials, the purpose of the present study was to (1) compare their performance, and (2) extend/validate the use of these tools in other health-related contexts. This study specifically examined their performance in assessing health safety materials for construction workers.

A total of 115 health-safety materials were scored on the SAM and CCI. The sample represented 16 companies, and more than half of the sample represented 4 companies: CWPR (n = 25), J.J. Keller (n = 23), OSHA (n = 21), and NIOSH (n = 6). After achieving inter-coder reliability, two researchers scored the materials on the SAM and CCI. Overall, the CCI yielded lower ratings than the SAM. The CCI rated 6% of the sample as suitable, versus 62% superior and 36% adequate on the SAM. It is possible that the CDC set stricter guidelines for what they considered suitable or the differences may be a function of the SAM offering an additional “adequate” score. Second, the materials created by nonprofit organizations earned the highest scores on both instruments, while commercially produced materials earned the lowest. Finally, while the SAM and CCI are beneficial tools for assessing construction health safety materials, certain CCI criteria should be adapted from CDC’s original context for use in other contexts.

This study validates the SAM and CCI for use in health-related contexts other than patient education. Additionally, the results offer important implications for how health-safety training materials are assessed for general readability/suitability. The quality of these assessments has direct implications for construction workers’ health and safety. Information should be presented at a level that the target population can read and understand. If these materials aren’t assessed, or the tools used to assess them are flawed, consumers may be at increased risk for injuries on the job. From a broader perspective, this study holds important implications for where construction companies should obtain health safety information. Materials created by nonprofits and state/local governments are most suitable.

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