Assessment of printed lung cancer surgery patient education materials in the United States

Well-designed patient education materials (PEMs) increase health literacy, which has been linked to better surgical patient outcomes. The quality of lung cancer surgery PEMs is unknown, however. Here we assessed printed lung cancer surgery PEMs for readability, understandability, actionability, and accessibility.

Various lung cancer programs throughout the United States were contacted for their lung cancer surgery PEMs. The readability of the received materials was calculated using 6 readability tests. Four thoracic surgeon-advanced practice practitioner dyads scored the PEMs for understandability, actionability, and accessibility using the Patient Education Material Assessment Tool and the Accessibility Assessment Tool, with the recommended minimum threshold of 70%. One-sample t tests were performed to compare each parameter against its recommended threshold.

Out of 34 institutions contacted, 18 (52.9%) provided PEMs. The average reading level of the PEMs ranged from 7th grade to 11th grade, significantly exceeding the recommended 6th grade health literacy threshold (P < .01). Although mean understandability (73.7 ± 13.2%) and actionability (70.2 ± 17.8%) scores were not significantly different from the minimum threshold, and the mean accessibility score (81.8 ± 13.5%) was significantly higher than the threshold (P < .05), there was wide variation in the scores. Most PEMs scored well in organization and writing but lacked other features that can enhance patient understanding, such as visual aids and summaries.

PEMs are written at reading levels that are too advanced for patients. Although PEMs scored well in understandability, actionability, and accessibility, analysis of individual items revealed the need for improvement, including the use of shorter sentences, more visual aids and summaries, and expansion of language translations.