title: Development of injury prevention materials for people with low literacy skills.
abstract: OBJECTIVE
  Children living in low income urban environments are at high risk for preventable injuries, which result in thousands of Pediatric Emergency Department (PED) visits every year. The development and evaluation of written injury prevention materials used in a PED-based intervention trial are presented. The purpose is to describe the development of injury prevention materials for people with low literacy skills, and explain literacy and comprehension abilities among a sample of parents from the PED.
  
  
  METHODS
  Materials were developed using rules of plain language and with consideration of the needs of a low literacy population. Materials were assessed using the Flesch-Kincaid and Suitability Assessment of Materials. Literacy and comprehension abilities in a PED sample were tested using the Rapid Estimate of Adult Literacy in Medicine (REALM) and the Cloze.
  
  
  RESULTS
  REALM results for n=59 parents sampled from the PED indicated that 27% (n=16) read below 9th grade reading level. Cloze results demonstrate that materials were appropriate for 71% (n=21) when written for 8th grade reading level and 80% (n=23) when rewritten for 6th grade reading level.
  
  
  CONCLUSIONS
  Others designing similar interventions can use these methods to develop interventions for low literacy populations.
  
  
  CONCLUSIONS
  When developing injury prevention materials for use with PED populations, health professionals should consider reading ability, reading level, content, and design of materials.
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. trifilel@ccri.net
authors.forename: Lara B
authors.initials: LB
authors.lastname: Trifiletti
authors.forename: Wendy C
authors.initials: WC
authors.lastname: Shields
authors.forename: Eileen M
authors.initials: EM
authors.lastname: McDonald
authors.forename: Allen R
authors.initials: AR
authors.lastname: Walker
authors.forename: Andrea C
authors.initials: AC
authors.lastname: Gielen
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D001294:Attitude to Health; D015142:Baltimore; D002648:Child; D002669:Child Welfare; D032882:Comprehension; D004522:Educational Status; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D006266:Health Education / Q000592:standards*; D006304:Health Status; D006801:Humans; D020380:Needs Assessment / Q000458:organization & administration*; D010290:Parents / Q000193:education* / Q000523:psychology; D010372:Pediatrics; D010865:Pilot Projects; D011204:Poverty Areas; D011932:Reading; D017751:Safety Management; D012660:Semantics; D011795:Surveys and Questionnaires; D013664:Teaching Materials / Q000592:standards*; D014947:Wounds and Injuries / Q000517:prevention & control*