How readable are Australian multilingual diabetes patient education materials? An evaluation of national English-language source texts

Multilingual patient education materials (PEMs) in Australia are normally prepared initially in English (source text) and then translated into other languages. The aim of this study was to evaluate whether the source texts for publicly available multilingual diabetes PEMs in Australia were written at the reading level recommended by health literacy guidelines (eighth-grade reading level).

Nonexperimental descriptive study.

All publicly accessible multilingual fact sheets on diabetes self-management from the Diabetes Australia and National Diabetes Services Scheme websites were collected. Readability was analysed using five different readability indices: Flesch Kincaid Grade Level (FKGL), Gunning Fog Score (GFS), Coleman Liau Index (CLI), Simplified Measure of Gobbledygook Index (SMOG) and Automated Readability Index (ARI). The average number of syllables per word and the average number of words per sentence were also calculated.

The average reading grade level of included PEMs was above Grade 10 (mean 10.4; standard deviation [SD] 0.9). The average number of syllables per word was 1.5 (SD 0.1), and the average number of words per sentence was 17 (SD 0.9).

English-language source texts for national multilingual diabetes PEMs examined in this study were written at a readability level significantly higher than that recommended in health literacy guidelines. This was likely due to the use of polysyllabic words and complex medical terms, which are especially problematic when they are not defined. Improving readability of English-language source texts may help to ensure that the translated PEMs are more readable and accessible to their target readers. In conjunction with addressing other features that can make written materials easier to understand, this may help to better support diabetes self-management.