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Effectiveness and acceptability of interventions to improve readability of patient healthcare materials: A narrative systematic review

Dunnett, Jo, Holkham, Jack, Trebacz, Anastasia, Baldasera, Chloe, Francis, Cheryl, Dawson, Lorna, Swiers, Ryan and Christie-De Jong, Floor (2025) Effectiveness and acceptability of interventions to improve readability of patient healthcare materials: A narrative systematic review. Public Health, 248. ISSN 0033-3506

Item Type: Article

Abstract

Objectives: Reading age is a key component of Health literacy (HL) yet many written healthcare materials in the
UK exceed recommended reading levels, making them less accessible to much of the population. Creating barriers
to understanding contributes to health inequalities. Simplifying the way information is written and terminology
used could be a useful and low-cost approach to support HL, yet effectiveness of such interventions
remains unclear. This study aims to systematically review evidence evaluating the effectiveness and acceptability
of healthcare material readability interventions in high income countries.
Study design: Narrative systematic review.
Methods: Searches of CENTRAL, Embase, MEDLINE, CINAHL, ERIC, APA Psych Articles, and Psychology and
Behavioral Science, databases from 2014 to 2024 were conducted. Articles title/abstract and full text were
double screened. Eligible studies examined tailored or improved written healthcare materials across clinical
specialities. Data extraction included study characteristics, and interventions’
, impact on patient acceptability,
comprehension and health outcomes. The Mixed Methods Appraisal Tool (MMAT) was used for critical appraisal.
Results: Thirty studies were included, predominantly from the USA. The majority evaluated interventions using
simplified language, structured formatting, or visual enhancements. Findings indicated that simplified content
was associated with greater patient understanding and preference. However, evidence on behavioural adherence
and direct health outcomes was mixed, with few studies demonstrating statistically significant improvements.
Quality of included studies was generally low, with methodological and reporting limitations.
Conclusions: Readability interventions can enhance patient comprehension and acceptability, yet their long-term
impact on health outcomes remains uncertain. Future research should assess sustained effects and explore
routine implementation in healthcare settings to inform best practices.

Full text not available from this repository.

More Information

Depositing User: Anastasia Trebacz

Identifiers

Item ID: 19448
Identification Number: https://doi.org/10.1016/j.puhe.2025.105937
ISSN: 0033-3506
URI: http://sure.sunderland.ac.uk/id/eprint/19448
Official URL: https://www.sciencedirect.com/science/article/pii/...

Users with ORCIDS

ORCID for Jo Dunnett: ORCID iD orcid.org/0009-0006-3243-0058
ORCID for Jack Holkham: ORCID iD orcid.org/0009-0002-5551-6111
ORCID for Anastasia Trebacz: ORCID iD orcid.org/0000-0002-0528-6082
ORCID for Cheryl Francis: ORCID iD orcid.org/0009-0007-7111-5365
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: 06 Oct 2025 09:14
Last Modified: 06 Oct 2025 09:15

Contributors

Author: Jo Dunnett ORCID iD
Author: Jack Holkham ORCID iD
Author: Anastasia Trebacz ORCID iD
Author: Cheryl Francis 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 Nursing and Health Sciences

Subjects

Sciences > Health Sciences

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