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Reading Levels of US, Global COVID-19 Websites Too High For Many

8/18/2020

A review of 18 US and international public health and governmental websites with COVID-19 information for the public—including those of the World Health Organization and the US Centers for Disease Control and Prevention (CDC)—has found that all exceeded the recommended reading level and used sentence structures and technical terminology that would hinder understanding.  The review, published today in JAMA Network Open, used five common readability formulas and health readability guidelines to evaluate the websites of three public health agencies and 15 official governmental sites of countries with English-language guidelines and at least 5,000 confirmed coronavirus cases as of Apr 5.  The American Medical Association, the National Institutes of Health, and the CDC recommend that public health information be written at an eighth-grade reading level or lower.  All 149 web pages evaluated were written at levels above the eighth grade by at least one metric, and 141 (95%) were written above that level by all five metrics. Of the 149 pages, 145 (97%) used sentence structures too complex to be understood by eighth-grade readers.  Of the CDC pages reviewed, the median Flesh-Kincaid grade level was 11, median syllables per word were 1.7, median words per sentence were 15.6, and 67 pages contained at least one difficult-to-understand term (median number of difficult terms, 11).  All US states' websites evaluated were written above the eighth-grade level and used substantially more difficult terms than those of the CDC. Nine of the 10 states with the highest illiteracy rates had information exceeding a 10th-grade reading level.  The authors said that CDC resources' lower level of complexity may reflect the influence of governmental oversight mandating that public information be easily understood.



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