Readability Level of Spanish Language Online Health Information: A Systematic Review

Introduction: Because there is limited online health information in Spanish and it is critical to raise health literacy among Spanish-speaking people, it is essential to assess the readability level of Spanish material. Method: This systematic review included all articles published up to January 3, 2024, and used the CINAHL, MEDLINE, and PubMed databases. The objective was to include the body of knowledge on published articles on the readability levels of Spanish-language, web-based health information intended for lay audiences. Results: There were 27 articles in the final review. Within these articles, 11 tools were used in the Spanish language text. Of the tools, INFLESZ was the most frequently used and the FRY formula, Flesch-Szigriszt Index, and Flesch Formula Index were least used. Most materials (85.2%) reported readability levels of online Spanish information above the 8^th grade reading level. Conclusions: The findings show the lack of internet-based Spanish language health information and materials at a recommended (e.g., 5^th to 8^th grade) reading level. More research is needed to determine which readability tests are more accurate for calculating the readability of Spanish web health information.