3572 - The MEDaphor Project: Comparing Readability and Access of Novel Cancer Education Materials for Patients with Limited Health Literacy

M. D. Tibbs, M. Schiaffino, and J. A. Hattangadi-Gluth; Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA

Purpose/Objective(s): A cancer diagnosis presents significant challenges in managing access to care, receiving care, and following up appropriately. Up to one-half of adults in the United States have limited health literacy, a known predictor of poorer outcomes. Racial and ethnic minorities, elderly, and low income populations have disproportionately low health literacy rates, which exacerbates inequities in healthcare. Despite recommendations for health educational material to be written at a 6th to 8th grade reading level, often available materials are written at 9th to 12th grade reading levels. Multimodality educational resources, such as narrated videos, provide improved learning and engagement in complex topics such as cancer care. We hypothesize that our novel educational scripts (MEDaphor) that explain cancer biology and treatments will score significantly lower (easier to read) than currently available children and adult education video scripts. Materials/

Methods: We developed novel scripts which use a story-based metaphor in order to demonstrate concepts of cancer biology and treatments including surgery, chemotherapy, and radiation. We evaluated our video scripts as well as scripts of videos currently available for both children and adult education using the Flesch-Kincaid Grade Level score and Simple Measure of Gobbledygook (SMOG) Index. Analysis was performed with R using ANOVA and Tukey’s Test for multiple comparisons.
Results: The MEDaphor cancer biology and cancer treatments scripts had a Flesch-Kincaid Grade Level score of 5.8 and 6.1, respectively. The SMOG Index was 5th grade for both MEDaphor scripts. These scores were significantly different compared to scores from children and adult video scripts (ANOVA, p=0.041, p=0.028). Adult video Flesch-Kincaid Grade Level scores were significantly higher than our script (Tukey, p=0.048), and both children and adult video SMOG scores were significantly higher than our script (Tukey, p=0.034 and p=0.039 respectively). See table for data.
Conclusion: Our novel patient education materials meets current recommendations for reading levels in commonly used readability formulas. Our scripts readability scores are at a significantly lower grade level compared to currently available educational video resources for both children and adults. Ongoing development of our educational resource include translating the script into multiple languages, obtaining direct patient feedback via focus groups, and developing illustrations for multimedia learning. Our future plan is to develop these scripts into accessible, multimedia educational resources that empower patients with low health literacy.

Abstract 3572 – Table 1

Resource	Flesch-Kincaid	SMOG
MEDaphor: Biology	5.8	5.0
MEDaphor: Treatments	6.1	5.0
Kid 2 Kid (children)	6.3	9.5
Imaginary Friend Society (children)	6.1	9.8
What is Cancer?	8.7	9.0
What is Radiation Therapy?	10.9	10.1