Research Priorities for Readability Assessment of Health Information: A Modified eDelphi Study

Readability assessments are routinely used in health contexts to evaluate and revise written health information. However, there are many research gaps, as well as a lack of consensus and limited guidelines regarding how to conduct readability assessments. This study uses an eDelphi methodology to identify and gain expert consensus on research priorities to determine the role of readability assessment in health literate document design. Panelists participated in two rounds of online surveys to rate the importance of 25 candidate research questions pertaining to five broad categories (the effect of readability on outcomes, readability in practice, conducting readability analyses, grade reading level thresholds, and readability and translation). We analyzed responses for consensus (70% agreement), with research questions not achieving consensus re-fielded in subsequent rounds. Two survey rounds were completed by 35 and 30 participants, respectively. Of the 31 research questions rated in at least one round, 20 (65%) achieved consensus and were considered a research priority. Four of the top five research priorities related to understanding the effect of improving readability on cognitive, behavioral and health-related outcomes. Another top priority was understanding the role of AI in improving readability. Consensus demonstrated a need to understand the effect of improving readability on cognitive, behavioral and health-related outcomes. By identifying a list of research priorities, these findings provide a clear and actionable list of future directions.