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Health literacy: Reducing inequalities in healthcare access through improving the readability of healthcare material in the Northeast of England-a qualitative evaluation

Dunnett, Jo, Trebacz, Anastasia, Holkham, Jack, Baldasera, Chloe, Dawson, Lorna, Swiers, Ryan and Christie-De Jong, Floor (2025) Health literacy: Reducing inequalities in healthcare access through improving the readability of healthcare material in the Northeast of England-a qualitative evaluation. Public Health, 247 (105887). ISSN 0033-3506

Item Type: Article

Abstract

Objectives
Lower health literacy increases the risk of chronic illness, premature mortality, and health-harming behaviours. Leading to higher healthcare utilisation and lower preventive care participation. Many adults in England read at a 9–11-year level making most healthcare materials inaccessible. This study aimed to assess an intervention modifying healthcare materials’ readability in a hospital trust in North-East England by evaluating patient and staff perspectives.
Study design
Guided by the Theoretical Framework of Acceptability, a qualitative design evaluated modified patient leaflets for routine outpatient clinics, adjusted to a reading age of 9–11 years to align with the national average. Stakeholder perspectives on modified and unmodified materials were explored.
Methods
Twenty-five participants (six males, 19 females; aged 18–60, including 12 healthcare providers and 13 service users) with varying health literacy were recruited from four medical specialties in a single hospital trust in the northeast of England. Semi-structured interviews were conducted and analysed using Framework method.
Results
Participants preferred the modified materials for their clarity. Simpler language was perceived as reducing stigma and increasing confidence to engage with healthcare professionals. Service users felt empowered to manage their health, as revised materials were easier to understand. Healthcare providers valued improved readability, anticipating enhanced patient engagement and reduced misunderstandings. Participants emphasised the ethical imperative for accessible healthcare information to reduce inequalities.
Conclusions
Improving readability is welcomed and necessary to reduce structural inequalities. As disparities persist, ensuring accessible healthcare information could be a cost-effective scalable strategy. Further research should assess effectiveness on health outcomes.

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More Information

Uncontrolled Keywords: Health literacy Readability Reading age Patient information Healthcare communication
Depositing User: Floor Christie-De Jong

Identifiers

Item ID: 19303
Identification Number: https://doi.org/10.1016/j.puhe.2025.105887
ISSN: 0033-3506
URI: http://sure.sunderland.ac.uk/id/eprint/19303
Official URL: https://doi.org/10.1016/j.puhe.2025.105887

Users with ORCIDS

ORCID for Jo Dunnett: ORCID iD orcid.org/0009-0006-3243-0058
ORCID for Anastasia Trebacz: ORCID iD orcid.org/0000-0002-0528-6082
ORCID for Jack Holkham: ORCID iD orcid.org/0009-0002-5551-6111
ORCID for Ryan Swiers: ORCID iD orcid.org/0000-0002-7439-2356
ORCID for Floor Christie-De Jong: ORCID iD orcid.org/0000-0001-5275-8030

Catalogue record

Date Deposited: 19 Aug 2025 08:50
Last Modified: 19 Aug 2025 09:44

Contributors

Author: Jo Dunnett ORCID iD
Author: Anastasia Trebacz ORCID iD
Author: Jack Holkham ORCID iD
Author: Ryan Swiers ORCID iD
Author: Floor Christie-De Jong ORCID iD
Author: Chloe Baldasera
Author: Lorna Dawson

University Divisions

Faculty of Health Sciences and Wellbeing > School of Medicine

Subjects

Sciences > Health Sciences
Sciences

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