title: Health literacy and the readability of written information for hormone therapies.
abstract: BACKGROUND
  Health education and counseling are important elements of the care provided by clinicians. Counseling efforts may involve helping women to understand their options for symptom management related to various reproductive life transitions. In light of this, the need for information during the menopausal transition is critical for assisting women with their health care decisions. Yet the Institute of Medicine estimates that approximately half the adult population in the United States has difficulty understanding and using health information. The US Food and Drug Administration (FDA) mandates the distribution of written information for estrogen-containing products; however, the readability of information for these pharmaceutical products has not been widely studied. To address this gap, this study examined the readability of written information for FDA-approved prescription menopausal hormone therapies (N = 31).
  
  
  METHODS
  Readability of the written information about hormone therapies from 31 hormone therapy products was assessed using the Flesch Reading Ease and Flesch-Kincaid Grade Level formulas.
  
  
  RESULTS
  The reading level ranged from 6.70 to 12.30, with an average grade level of 9.33 (ninth-grade reading level). All but one of the hormone therapy products evaluated in this study exceeded the recommended sixth-grade reading level for written health information. In addition, only 48% of the written information instructions in the study sample (n = 15) included illustrations.
  
  
  CONCLUSIONS
  Assessment of written information about menopausal hormone therapies showed that the majority of the materials are written at a high reading level. These findings have implications for health literacy and counseling efforts when helping women to understand their options for menopausal symptom management. Midwives, nurses, and other health care providers may need to supplement written information with additional consumer-friendly written information, utilize illustrations, and use verbal instructions more frequently to help support women in evaluating their treatment options.
authors: School of Library and Information Science, Wayne State University, Detroit, MI 48202, USA. dcharbon@wayne.edu
authors: Deborah H
authors: DH
authors: Charbonneau
mesh_terms: D000328:Adult; D032882:Comprehension; D003376:Counseling; D003657:Decision Making; D003695:Delivery of Health Care; D004522:Educational Status; D015914:Estrogen Replacement Therapy; D057220:Health Literacy; D006801:Humans; D008593:Menopause; D011932:Reading; D014481:United States; D014956:Writing