title: Online patient resources for hernia repair: analysis of readability.
abstract: BACKGROUND
  The limited functional health literacy of a significant portion of the adult US population negatively affects their access to appropriate online health information about hernia repair surgery. The National Institutes of Health and American Medical Association recommend that patient-directed content should be written at a sixth-grade reading level. This study aims to evaluate readability of the most frequently used Internet resources for patient information about hernia repair relative to average American literacy.
  
  
  METHODS
  A web search for "hernia repair surgery" was performed, and the top 12 Web sites were identified. Relevant articles (n=102) with patient-directed content immediately available from the main sites were downloaded. The 12 most popular consumer magazines in circulation were also identified, and using the same method, the first 10 articles were downloaded from each magazine's Web site for comparison. Readability was assessed using 10 established analyses. A t-test was used to compare the average grade level of hernia repair and magazine articles for each readability test.
  
  
  RESULTS
  Web-based information about hernia repair had an overall average reading grade level of 13.6. All 102 articles were above the recommended sixth-grade reading level; these were significantly more difficult to read than the comparison group of articles from popular magazines.
  
  
  CONCLUSIONS
  Online patient-directed information about hernia repair uniformly exceeds the recommended reading level and may be too difficult to be understood by a large portion of the US population.
authors.affiliation: Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
authors.forename: Christina R
authors.initials: CR
authors.lastname: Vargas
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
authors.forename: Danielle J
authors.initials: DJ
authors.lastname: Chuang
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts. Electronic address: blee3@bidmc.harvard.edu.
authors.forename: Bernard T
authors.initials: BT
authors.lastname: Lee
mesh_terms: D032882:Comprehension; D006295:Health Resources; D059685:Herniorrhaphy; D006801:Humans; D020407:Internet
keywords: Hernia; Hernia repair surgery; Online resources; Readability