Making sense of home pregnancy test instructions

To examine readability and related formatting characteristics of English language instructions accompanying home pregnancy tests (HPTs).

We identified 16 HPTs; however, because of duplicate instructions, our final sample included 13 unique sets of HPT instructions (brand names, n = 9; store brand, n = 4). Reading grade level of How to Use and Interpret Results and General Information sections were calculated using the Simple Measure of Gobbledygoop readability formula. Total number of graphics was tallied. Foldout dimension, text point size, and graphic dimensions were measured to the nearest millimeter with a standard ruler. We also assessed layout features, graphic characteristics, presence of a clear message, and presentation of manageable information using the User-Friendliness Tool (UFT).

Reading level ranged from 7th to 10th grade (mean +/- SD 8.5 +/- 0.9) for the How to Use and Interpret Results sections, and the Question and Answer sections ranged from 11th to 14th grade (mean +/- SD 12.1 +/- 0.7). Mean page length was 29.7 +/- 6.6 cm, and average page width was 23.3 +/- 7.0 cm, similar in size to an 8.5 x 11 inch sheet of paper. Graphics were used throughout HPT instructions (range 2-9), and most were similar in size to a U.S. quarter. None of the instructions scored high in all criteria on the UFT.

Readability and formatting characteristics of most HPT instructions do not meet recommended criteria for compliance with plain language guidelines. These findings underscore the need for improved instructions and ultimately improving patients' ability to use HPTs and interpret results with accuracy.