title: Assessment of commonly available education materials in heart failure clinics.
abstract: BACKGROUND
  Health literacy (HL) is an established independent predictor of cardiovascular outcomes. Approximately 90 million Americans have limited HL and read at the fifth grade level or lower. Therefore, we sought to determine the suitability and readability level of common cardiovascular patient education materials (PEM) related to heart failure and heart-healthy lifestyle.
  
  
  RESULTS
  The suitability and readability of written PEMs were assessed using the suitability assessment of materials (SAM) and Fry readability formula. The SAM criteria are composed of the following categories: message content, text appearance, visuals, and layout and design. We obtained a convenience sample of 18 English-written cardiovascular PEMs freely available from major health organizations. Two reviewers independently appraised the PEMs. Final suitability scores ranged from 12% to 87%. Readability levels ranged between 3rd and 15th grade level; the average readability level was 8th grade. Ninety-four percent of the PEMs were rated either superior or adequate on text appearance, but 50% or more of the PEMs were rated inadequate on each of the other categories of the SAM criteria. Only 2 (11%) PEMs had the optimum suitability score of 70% or higher and 5th grade or lower readability level suitable for populations with limited HL.
  
  
  CONCLUSIONS
  Commonly available cardiovascular PEMs used by some major healthcare institutions are not suitable for the average American patient. The true prevalence of suboptimal PEMs needs to be determined because it potentially negatively impacts optimal healthcare delivery and outcomes.
authors: Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors: Kimberli
authors: K
authors: Taylor-Clarke
authors: Queen
authors: Q
authors: Henry-Okafor
authors: Clare
authors: C
authors: Murphy
authors: Madeline
authors: M
authors: Keyes
authors: Russell
authors: R
authors: Rothman
authors: Andre
authors: A
authors: Churchwell
authors: George A
authors: GA
authors: Mensah
authors: Douglas
authors: D
authors: Sawyer
authors: Uchechukwu K A
authors: UK
authors: Sampson
mesh_terms: D002318:Cardiovascular Diseases; D032882:Comprehension; D057220:Health Literacy; D006333:Heart Failure; D006801:Humans; D010353:Patient Education as Topic / Q000379:methods*; D011795:Surveys and Questionnaires