title: Improving health literacy: a Web application for evaluating text-to-speech engines.
abstract: The Internet is increasingly used as a medium for gathering and exchanging health information exchange. Healthcare professionals and organizations need to consider barriers that may exist within their patient-oriented Web applications. One approach to making the Web more accessible for those with lower health literacy may be to supplement textual content with audio annotation using text-to-speech engines, allowing for the creation of a virtual surrogate reader. One challenge is that with numerous text-to-speech engines on the market, objective measures of quality are difficult to obtain. To facilitate comparisons of text-to-speech engines, we developed an open-source Web application that measures user reaction times, subjective quality ratings, and accuracy in completing tasks across different audio files created by text-to-speech engines. Our research endeavor was successful in building and piloting this Web application; significant differences were found for subjective ratings of quality across three text-to-speech engines priced at different levels. However, no significant differences were found with reaction times or accuracy between these text-to-speech engines. Future avenues of research include exploring more complex tasks, usability issues related to implementing text-to-speech features, and applied health promotion and education opportunities among vulnerable populations.
authors.affiliation: School of Nursing, University of Washington, Seattle, USA. swolpin@u.washington.edu
authors.forename: Seth
authors.initials: S
authors.lastname: Wolpin
authors.forename: Donna L
authors.initials: DL
authors.lastname: Berry
authors.forename: Ann
authors.initials: A
authors.lastname: Kurth
authors.forename: William B
authors.initials: WB
authors.lastname: Lober
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001292:Attitude to Computers; D003194:Computer-Assisted Instruction / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006266:Health Education; D057220:Health Literacy / Q000379:methods*; D006293:Health Promotion; D006801:Humans; D020407:Internet / Q000295:instrumentation / Q000458:organization & administration*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D049250:Speech Recognition Software / Q000592:standards; D014584:User-Computer Interface; D035862:Vulnerable Populations