P3‐644: READABILITY AND IMPLICATIONS FOR HEALTH LITERACY: A LOOK AT ONLINE PATIENT‐ORIENTED DISEASE INFORMATION BY ALZHEIMER'S DISEASE RESEARCH CENTERS

The Institute of Medicine (IOM) defines health literacy as “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.” The average adult reads at an eighth or ninth grade level, with older adults reading at lower levels. The National Institutes of Health (NIH) promotes using plain language appropriate for all health literacy levels. Most NIH-sponsored Alzheimer's Disease Research Centers (ADRCs) have websites with online material for Alzheimer's disease patients and caregivers. The NIH website (https://www.nia.nih.gov/health/alzheimers-disease-research-centers was used to access websites for each ADRC. Websites were evaluated for content addressing four topics: “What is Alzheimer's?” (WH) warning signs (WS), stages (S), and treatment (T). Flesch-Kincaid Grade level (FK) and Flesch Reading Ease index (FRE; 0-100, 0 = most difficult) were calculated for each topic. Two commonly referenced websites, the National Institute for Aging (NIA; https://www.nia.nih.gov/health/alzheimers) and the Alzheimer's Association (AA; https://www.alz.org/) were similarly evaluated. Of 31 ADRCs, 18 (58.1%) websites had content directly addressing at least one topic. 2 websites addressed all four topics, and 5 provided no content or links. 17 websites addressed WH (mean FK 12.7, FRE 34.3), 11 addressed WS (mean FK 9.5, FRE 45.1), 6 websites addressed S (mean FK 11, FRE 42.3), and 13 addressed T (mean FK 13.7, FRE 30.4). 6 websites (19.4%) linked to the NIA and/or the AA, both of which provided content for all topics; the NIA was most readable for WH (FK 10.7, FRE 49.2) and S (FK 8.8, FRE 46.2). The AA was most readable for WS (FK 7.9, FRE 56.6) and T (8.6, 58.5). The readability of basic disease information on ADRC websites uniformly exceeded the average health literacy level of patients and caregivers. Mean FRE scores all fell into the “difficult” range, requiring a high school to college reading level. Community-oriented resources (AA, NIA) came closer to average literacy levels in some topics of interest, but still fell short. ADRC websites should consider simplifying their language to meet the health literacy needs of their target population.