Evaluating Readability, Understandability, and Actionability of Online Printable Patient Education Materials for Cholesterol Management: A Systematic Review

Background Dyslipidemia management is a cornerstone in cardiovascular disease prevention and relies heavily on patient adherence to lifestyle modifications and medications. Numerous cholesterol patient education materials are available online, but it remains unclear whether these resources are suita...

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Main Authors: Chaitanya Bhatt, Ethan Lin, Laura E. Ferreira‐Legere, Cynthia A. Jackevicius, Dennis T. Ko, Douglas S. Lee, Kathryn Schade, Sharon Johnston, Todd J. Anderson, Jacob A. Udell
Format: Article
Language:English
Published: Wiley 2024-04-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
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Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.123.030140
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author Chaitanya Bhatt
Ethan Lin
Laura E. Ferreira‐Legere
Cynthia A. Jackevicius
Dennis T. Ko
Douglas S. Lee
Kathryn Schade
Sharon Johnston
Todd J. Anderson
Jacob A. Udell
author_facet Chaitanya Bhatt
Ethan Lin
Laura E. Ferreira‐Legere
Cynthia A. Jackevicius
Dennis T. Ko
Douglas S. Lee
Kathryn Schade
Sharon Johnston
Todd J. Anderson
Jacob A. Udell
author_sort Chaitanya Bhatt
collection DOAJ
description Background Dyslipidemia management is a cornerstone in cardiovascular disease prevention and relies heavily on patient adherence to lifestyle modifications and medications. Numerous cholesterol patient education materials are available online, but it remains unclear whether these resources are suitable for the majority of North American adults given the prevalence of low health literacy. This review aimed to (1) identify printable cholesterol patient education materials through an online search, and (2) evaluate the readability, understandability, and actionability of each resource to determine its utility in practice. Methods and Results We searched the MEDLINE database for peer‐reviewed educational materials and the websites of Canadian and American national health organizations for gray literature. Readability was measured using the Flesch–Kincaid Grade Level, and scores between fifth‐ and sixth‐grade reading levels were considered adequate. Understandability and actionability were scored using the Patient Education Materials Assessment Tool and categorized as superior (>80%), adequate (50%–70%), or inadequate (<50%). Our search yielded 91 results that were screened for eligibility. Among the 22 educational materials included in the study, 15 were identified through MEDLINE, and 7 were from websites. The readability across all materials averaged an 11th‐grade reading level (Flesch–Kincaid Grade Level=11.9±2.59). The mean±SD understandability and actionability scores were 82.8±6.58% and 40.9±28.60%, respectively. Conclusions The readability of online cholesterol patient education materials consistently exceeds the health literacy level of the average North American adult. Many resources also inadequately describe action items for individuals to self‐manage their cholesterol, representing an implementation gap in cardiovascular disease prevention.
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spelling doaj-art-e9307eaccbae48fa8f6a6ceddd6f17a32025-08-20T02:26:37ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-04-0113810.1161/JAHA.123.030140Evaluating Readability, Understandability, and Actionability of Online Printable Patient Education Materials for Cholesterol Management: A Systematic ReviewChaitanya Bhatt0Ethan Lin1Laura E. Ferreira‐Legere2Cynthia A. Jackevicius3Dennis T. Ko4Douglas S. Lee5Kathryn Schade6Sharon Johnston7Todd J. Anderson8Jacob A. Udell9Department of Medicine University of Toronto Toronto Ontario CanadaDepartment of Medicine University of Toronto Toronto Ontario CanadaICES Toronto Ontario CanadaICES Toronto Ontario CanadaDepartment of Medicine University of Toronto Toronto Ontario CanadaDepartment of Medicine University of Toronto Toronto Ontario CanadaFaculty of Arts and Social Science Huron University College London Ontario CanadaInstitut du Savoir Montfort, Department of Family Medicine University of Ottawa Ottawa Ontario CanadaLibin Cardiovascular Institute, Cumming School of Medicine, University of Calgary Alberta CanadaDepartment of Medicine University of Toronto Toronto Ontario CanadaBackground Dyslipidemia management is a cornerstone in cardiovascular disease prevention and relies heavily on patient adherence to lifestyle modifications and medications. Numerous cholesterol patient education materials are available online, but it remains unclear whether these resources are suitable for the majority of North American adults given the prevalence of low health literacy. This review aimed to (1) identify printable cholesterol patient education materials through an online search, and (2) evaluate the readability, understandability, and actionability of each resource to determine its utility in practice. Methods and Results We searched the MEDLINE database for peer‐reviewed educational materials and the websites of Canadian and American national health organizations for gray literature. Readability was measured using the Flesch–Kincaid Grade Level, and scores between fifth‐ and sixth‐grade reading levels were considered adequate. Understandability and actionability were scored using the Patient Education Materials Assessment Tool and categorized as superior (>80%), adequate (50%–70%), or inadequate (<50%). Our search yielded 91 results that were screened for eligibility. Among the 22 educational materials included in the study, 15 were identified through MEDLINE, and 7 were from websites. The readability across all materials averaged an 11th‐grade reading level (Flesch–Kincaid Grade Level=11.9±2.59). The mean±SD understandability and actionability scores were 82.8±6.58% and 40.9±28.60%, respectively. Conclusions The readability of online cholesterol patient education materials consistently exceeds the health literacy level of the average North American adult. Many resources also inadequately describe action items for individuals to self‐manage their cholesterol, representing an implementation gap in cardiovascular disease prevention.https://www.ahajournals.org/doi/10.1161/JAHA.123.030140cholesteroldyslipidemiapatient educationstatins
spellingShingle Chaitanya Bhatt
Ethan Lin
Laura E. Ferreira‐Legere
Cynthia A. Jackevicius
Dennis T. Ko
Douglas S. Lee
Kathryn Schade
Sharon Johnston
Todd J. Anderson
Jacob A. Udell
Evaluating Readability, Understandability, and Actionability of Online Printable Patient Education Materials for Cholesterol Management: A Systematic Review
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
cholesterol
dyslipidemia
patient education
statins
title Evaluating Readability, Understandability, and Actionability of Online Printable Patient Education Materials for Cholesterol Management: A Systematic Review
title_full Evaluating Readability, Understandability, and Actionability of Online Printable Patient Education Materials for Cholesterol Management: A Systematic Review
title_fullStr Evaluating Readability, Understandability, and Actionability of Online Printable Patient Education Materials for Cholesterol Management: A Systematic Review
title_full_unstemmed Evaluating Readability, Understandability, and Actionability of Online Printable Patient Education Materials for Cholesterol Management: A Systematic Review
title_short Evaluating Readability, Understandability, and Actionability of Online Printable Patient Education Materials for Cholesterol Management: A Systematic Review
title_sort evaluating readability understandability and actionability of online printable patient education materials for cholesterol management a systematic review
topic cholesterol
dyslipidemia
patient education
statins
url https://www.ahajournals.org/doi/10.1161/JAHA.123.030140
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