Objectives/Hypothesis
Evaluate the reading difficulty of Spanish patient education materials using the validated Índice Flesch-Szigriszt (INFLESZ) and Spanish Lexile Analyzer, and to identify relationships between English and Spanish readability formulas.
Study Design
Cross-sectional analysis.
Methods
All otolaryngology-related patient education articles written in Spanish from the health libraries of the top 10 US News & World Report–ranked hospitals, top 10 Doximity-ranked otolaryngology residencies, the American Academy of Otolaryngology–Head and Neck Surgery website, and the US National Library of Medicine online section on ears, nose and throat were collected. Reading difficulty was assessed using the INFLESZ and Spanish Lexile Analyzer. Additional readability assessments included the traditional English tools: Flesch-Kincaid Grade Level, Flesch Reading Ease Score, and the Simple Measure of Gobbledygook score.
Results
A total of 497 articles were reviewed. The average INFLESZ score for all articles was 57.75, which is considered normal and requires the reading ability of a student who finished Escuela Secundaria Obligatoria or 10th grade equivalent in the United States. The average Spanish Lexile measure for all articles was 1062L, equivalent to a reading level between the 6th and 12th grade. English readability tools calculated a more difficult reading level compared to Spanish tools when performed on the same text.
Conclusions
Current Spanish patient education materials in otolaryngology may be too difficult for the average Spanish-speaking reader to understand. Future improvements may be warranted to improve the readability of educational materials and increase health literacy.
Level of Evidence
NA Laryngoscope, 2017
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