Understandability, actionability, and readability of online patient education materials about diabetes mellitus

The purpose of this study was to assess the understandability, actionability, and readability of online diabetes education materials.

This was a descriptive study that identified printable diabetes education materials through an online search. Materials were included from the following sources: national organizations with materials approved by expert panels, corporations with materials subject to FDA approval, and not-for-profit organizations with inter-professional advisory boards to approve materials. Topics included were basic knowledge of diabetes, hypoglycemia, insulin, and blood sugar goals. Materials were excluded if they were non-printable, contained active links, had a publication date prior to January 2011, were greater than 2 pages in length, or were pediatric focused. Understandability and actionability of the patient education materials were evaluated using the Patient Education Materials Assessment Tool (PEMAT). Descriptive statistics and inter-rater reliability analysis using the kappa statistic were utilized. Readability was assessed using the Flesch-Kincaid Grade Level and Simple Measure of Gobbledygook (SMOG) formula. Pearson correlation coefficient was calculated to assess the relationship between reading grade level and PEMAT scores. In total, 25 websites were identified, 5 of which met the inclusion criteria; 13 patient education materials were included, PEMAT scoring revealed that 4 of these met the criteria for understandability and only 1 met the criteria for actionability. There was no correlation found between PEMAT scores and reading grade levels (Pearson correlation coefficient = -0.30, p = 0.325).

The majority of diabetes patient education materials reviewed scored poorly using the PEMAT. Future development of diabetes patient education materials should be designed with the goal of increasing understandability and actionability.