title: Assessment of printed patient-educational materials for chronic kidney disease.
abstract: BACKGROUND
  Awareness of chronic kidney disease (CKD) is suboptimal among patients with CKD, perhaps due to poor readability of patient education materials (PEMs). We reviewed the suitability and readability of common PEMs that focused on 5 content areas: basics of CKD, risk factors for CKD development, risk factors for CKD progression, complications of CKD and self-management strategies to improve kidney health.
  
  
  METHODS
  Three reviewers (nephrologist, primary care physician, patient) used the Suitability Assessment of Materials to rate PEMs on message content/stimulation of learning, typography, visuals and layout and determined literacy level. Mean ratings were calculated for each PEM by content area and overall (superior = 70-100; adequate = 40-69; inadequate = <40). Linear regression was used to determine the impact of literacy level on mean rating.
  
  
  RESULTS
  We reviewed 69 PEMs from 19 organizations, divided into 113 content area sections. Most (79%) PEM sections were 'adequate' (mean rating, 58.3%). Inclusion of patient-centered content and opportunities for patient interaction were associated with 'superior' ratings. Mean ratings (SD) were similar across content areas: basics of CKD, 58.9% (9.1); risk factors for CKD development, 57.0% (12.3); risk factors for CKD progression, 58.5% (12.0); CKD complications, 62.3% (15.7), and self-management strategies, 62.2% (12.3). ≤6th grade literacy level (vs. >6th grade) was associated with an 11.7 point higher mean rating.
  
  
  CONCLUSIONS
  Most PEMs for kidney disease were adequate. Outstanding PEMs shared characteristics of patient centeredness, a low literacy level, and patient interaction. Providers should be aware of strengths and limitations of PEMs when educating their patients about CKD.
authors: Division of Nephrology, University of California San Francisco, San Francisco, CA, USA. Delphine.tuot@ucsf.edu
authors: Delphine S
authors: DS
authors: Tuot
authors: Elizabeth
authors: E
authors: Davis
authors: Alexandra
authors: A
authors: Velasquez
authors: Tanushree
authors: T
authors: Banerjee
authors: Neil R
authors: NR
authors: Powe
mesh_terms: D032882:Comprehension; D018450:Disease Progression; D058015:Health Communication / Q000379:methods*; D057220:Health Literacy; D006293:Health Promotion / Q000379:methods; D006801:Humans; D009398:Nephrology / Q000379:methods; D010353:Patient Education as Topic / Q000379:methods*; D011364:Professional Practice; D012044:Regression Analysis; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis* / Q000628:therapy*; D012307:Risk Factors
references: Patient Educ Couns. 2008 Aug;72(2):342-9
references: 18450409
references: Am J Health Behav. 2011 Jan-Feb;35(1):118-28
references: 20950164
references: N Engl J Med. 2004 Sep 23;351(13):1296-305
references: 15385656
references: Nephrol Dial Transplant. 2013 Jan;28(1):129-37
references: 23222414
references: J Cardiovasc Nurs. 2012 Nov-Dec;27(6):485-94
references: 21743339
references: J Gen Intern Med. 2004 Aug;19(8):835-42
references: 15242468
references: JAMA. 2002 Nov 20;288(19):2469-75
references: 12435261
references: Arch Intern Med. 1998 Jan 26;158(2):166-72
references: 9448555
references: Top Stroke Rehabil. 2012 Sep-Oct;19(5):417-22
references: 22982829
references: Health Promot Pract. 2010 Jan;11(1):44-53
references: 18403749
references: JAMA. 2011 Apr 27;305(16):1695-701
references: 21521851
references: Clin J Am Soc Nephrol. 2009 Jan;4(1):195-200
references: 19056617
references: J Health Commun. 2010 Jul;15(5):487-501
references: 20677054
references: J Am Soc Nephrol. 2001 Aug;12(8):1713-1720
references: 11461944
references: Nephrol News Issues. 2004 Oct;18(11):76, 78-9, 81-4
references: 15551616
references: J Am Soc Nephrol. 2010 Nov;21(11):1979-85
references: 20671215
references: JAMA. 2002 Oct 16;288(15):1909-14
references: 12377092
references: Health Aff (Millwood). 2001 Nov-Dec;20(6):64-78
references: 11816692
references: Ann Intern Med. 2011 Jul 19;155(2):97-107
references: 21768583
references: Pediatrics. 2012 May;129(5):e1269-74
references: 22492766
references: Public Health Rep. 2006 May-Jun;121(3):245-54
references: 16640146
references: Nephrol Nurs J. 2008 Mar-Apr;35(2):147-55; quiz 156
references: 18472683
references: Patient Educ Couns. 2012 Aug;88(2):184-8
references: 22459637
references: Patient Educ Couns. 2008 Dec;73(3):448-55
references: 18755566
references: Clin J Am Soc Nephrol. 2011 Aug;6(8):1838-44
references: 21784832
references: J Am Soc Nephrol. 2005 Jan;16(1):180-8
references: 15563563
references: Res Social Adm Pharm. 2013 Sep-Oct;9(5):503-16
references: 22835706
references: Am J Kidney Dis. 2013 Jul;62(1):73-80
references: 23352380
references: J Korean Acad Nurs. 2011 Jun;41(3):333-43
references: 21804342
references: Semin Dial. 2003 Mar-Apr;16(2):157-64
references: 12641881
references: Ann Intern Med. 2005 Mar 1;142(5):342-51
references: 15738453
references: Thorax. 2011 Jan;66(1):26-31
references: 21037270
references: Am J Obstet Gynecol. 2012 May;206(5):431.e1-5
references: 22542120
references: Arch Intern Med. 2011 Mar 14;171(5):453-9
references: 21403042
references: J Am Soc Nephrol. 2003 Jul;14(7 Suppl 2):S114-6
references: 12819314
references: Kidney Int. 2011 Dec;80(12):1344-51
references: 21832984
references: Patient Educ Couns. 2009 Aug;76(2):174-80
references: 19560895
references: Ann Intern Med. 2004 May 4;140(9):721-8
references: 15126256
references: Am J Health Behav. 2007 Sep-Oct;31 Suppl 1:S69-78
references: 17931139
references: Adv Chronic Kidney Dis. 2010 May;17(3):225-36
references: 20439091
references: JAMA. 2002 Jul 24-31;288(4):475-82
references: 12132978
references: Ann Allergy Asthma Immunol. 2010 Jul;105(1):12-9
references: 20642198