Abstract
BACKGROUND: Health literacy is an understudied topic among published Spanish resources. Research focused on resources written in English demonstrates that content exceeds the recommended reading level for patients. Given the prevalence of breast reduction procedures and the increase in diverse patients undergoing the procedure in the last few years, this study explores the readability of Spanish information discussing breast reduction surgery by private and academic organizational websites.
METHODS: Using a de-identified Google search engine, we identified the first 20 Spanish websites that provided breast reduction information. Two independent reviewers used the Patient Education and Materials Assessment Tool (PEMAT) and Cultural Sensitivity Assessment Tool (CSAT) to assess understandability, actionability, and cultural sensitivity of each website. The Spanish SMOG readability formula (SOL), Gilliam-Peña-Mountain, the Fry Readability Adaptation for Spanish Evaluation (FRASE), and Crawford assessments were used to assess readability.
RESULTS: Both private- and academic-based websites scored above 70% for understandability but had lower scores for actionability. CSAT scores were just marginally above the threshold. Both private and academic readability assessments revealed consistently high reading grade levels 2 ranging from ninth to eleventh grade, except Crawford scores, which assessed a mean reading level of 6th grade.
CONCLUSION: Websites displaying Spanish content exceed the recommended level for patient educational materials. While the average understandability scores may be satisfactory on some websites, many have room for improvement, specifically regarding actionability. A limited sample size also emphasized the need to advocate for institutions to cater to patients who speak languages other than English. Important Points: Online Spanish resources on breast reduction are often too complex and exceed the recommended reading level for patients. Spanish resources need to be more than simple English translation to promote more cultural sensitivity. There is a significant gap in published online Spanish resources on breast reduction, particularly from academic and private organizations.
LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .