title: Literacy assessment of family health history tools for public health prevention.
abstract: OBJECTIVE
  This study aimed to systematically identify and evaluate the readability and document complexity of currently available family history tools for the general public.
  
  
  METHODS
  Three steps were undertaken to identify family history tools for evaluation: (a) Internet searches, (b) expert consultation, and (c) literature searches. Tools identified were assessed for readability using the Simple Measure of Gobbledygook (SMOG) readability formula. The complexity of documents (i.e., forms collecting family history information) was assessed using the PMOSE/IKIRSCH document readability formula.
  
  
  RESULTS
  A total of 78 tools were identified, 47 of which met the criteria for inclusion. SMOG reading grade levels for multimedia-based tools ranged from 10.1 to 18.3, with an average score of 13.6. For print-based tools, SMOG ranged from 8.7 to 14.1, with an average score of 12.0. Document complexity ranged from very low complexity (level 1 proficiency) to high complexity (level 4 proficiency).
  
  
  CONCLUSIONS
  The majority of tools are written at a reading grade level that is beyond the 8th grade average reading level in the United States. The lack of family history tools that are easy to read or use may compromise their potential effectiveness in identifying individuals at increased risk for chronic diseases in the general population.
authors.affiliation: Boston University School of Public Health, Boston, MA 02118, USA. clwang@bu.edu
authors.forename: C
authors.initials: C
authors.lastname: Wang
authors.forename: R E
authors.initials: RE
authors.lastname: Gallo
authors.forename: L
authors.initials: L
authors.lastname: Fleisher
authors.forename: S M
authors.initials: SM
authors.lastname: Miller
mesh_terms: D005190:Family; D057220:Health Literacy; D006801:Humans; D008487:Medical History Taking; D011314:Preventive Health Services / Q000458:organization & administration*; D011634:Public Health