Abstract

Background: Health literacy, as defined by the World Health Organisation, encompasses the skills and resources necessary for individuals and communities to access, understand, evaluate, and utilise health-related information and services to make informed decisions. Lower health literacy is linked to increased risk of chronic health conditions, premature mortality, and higher rates of risky health behaviours.

Reading age is a key component of health literacy and often associated with socio-economic status. Many adults in England have a reading age of 9-11 years, while approximately one in six have a reading age as low as 5-7 years. Those with low health literacy struggle to comprehend medical information, leading to more frequent healthcare utilisation, reduced preventive care and poorer health outcomes.

To address this a pilot intervention modifying the reading age of healthcare materials was conducted and evaluated in South Tyneside Sunderland Foundation Trust in the North East of England, ranked amongst the most deprived areas, according to the Index of Multiple Deprivation (IMD).

Methods: The study employed a pre-post mixed-methods approach to assess modified appointment letters and leaflets, adjusted to a reading age of 9, guided by the Normalisation Process Theoretical framework. Stakeholders' views on existing healthcare materials were qualitatively explored before the intervention launch, likewise the intervention's effects were qualitatively examined after its launch. Quantitative analysis evaluated the impact of lowering the reading age of patient healthcare information on appointment attendance and procedure cancellations. The participant sample included professional staff, clinicians, and service users from two specialties within STSFT.

Results and conclusion: Preliminary qualitative and quantitative findings give an overall interpretation of the acceptability and perceived impact of modifying healthcare information, highlighting the effectiveness of the intervention on improving DNA’s and appointment cancellation rates, to aid the development of a sustainable intervention and policy initiatives. Indicating that adapting healthcare materials' reading age may be a cost-effective way to improve health outcomes and reduce inequalities, especially among vulnerable groups. Given the rising localised and national health inequality rates, there's pressing need for preventative measures, underscoring the significance of further investigating the intervention's feasibility in larger cohorts.