Readability of online Spanish patient education materials in dermatology

Decreased health literacy is associated with worse outcomes for a variety of dermatologic conditions. Hispanic adults have the lowest average health literacy of any racial or ethnic group in the United Sates. Although patients are increasingly using online patient education materials (PEMs) for dermatologic care, limited information exists regarding the readability of these resources. The objective of this study is to evaluate the readability of online Spanish language PEMs in dermatology. Online Spanish language PEMs relevant to dermatology were gathered from the United States National Library of Medicine (USNLM) MedlinePlus health library and top Google, Yahoo, and Bing search results for "Spanish patient education dermatology." Spanish text was analyzed for readability using two validated programs: Spanish Lexile Analyzer and Índice Flesch-Szigriszt (INFLESZ). Pearson's correlation coefficient was used to examine the association between the two readability measures. ANOVA without post hoc correction was performed to determine variability between PEMs. A total of 254 Spanish language PEMs were collected and analyzed from nine online sources. The average article length was 601 words. The average Lexile measure was 1005 L (SD = 144 L) and the average INFLESZ score was 64.60 (SD = 7.53). Readability scores equated to an 8-10th grade reading level and was varied based on the source of information (p < 0.001). Online Spanish language PEMs related to dermatology are generally written at a reading level that exceeds national recommendations and may reduce comprehension for Hispanic patients. Targeted initiatives to address and improve online health information for Spanish-speaking patients are warranted.