Neurology patient education materials: do our educational aids fit our patients' needs?

The purpose of this study was to assess the suitability of various neurology patient education brochures, as well as neurology information on the World Wide Web, to determine whether they were appropriate for patients with low literacy. A convenience sample of 520 patients in university-based public and private neurology clinics participated. In this cross-sectional study, the patients' reading levels were assessed by using the Rapid Estimate of Adult Literacy in Medicine. Forty-three patient education materials were assessed for reading level by using the Fog Index and for suitability characteristics (including content, type and relevance of graphics, layout, type size and fonts, and motivating qualities) by using the Suitability Assessment of Materials. The mean education level of patients was 12th grade; however, the mean reading level was 7th-8th grade. Of the assessed materials, 91% were written at a 9th-grade level or above, even though only 58% of patients read at a 9th-grade level. Only 14% of the materials were considered to have superior suitability, whereas 58% were adequate, and 28% were determined not suitable. Thus, the available neurology patient education aids are not matched to the patient population or to the average U.S. reading levels. Ideally, information needs to be written at a 9th-grade level or below. Instructional graphics, simpler words, patient interaction, and cultural sensitivity improve material suitability.