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Promoting Health Literacy with Beginnings Guides Part 2: Readability

Reading: decoding the words                  Comprehension: decoding the meaning
We are using the Suitability Assessment of Materials (SAM) to review factors that determine
how well the information fits a particular audience or purpose, in this case how suitable
Beginnings Guides is for promoting maternal health literacy. Previously in this space we looked at
Content. Today we look at Readability, one of five factors that determine literacy demand, that
is the skill level needed to comprehend the text.
Readability     Reading grade level affects comprehension. Over 40 readability formulas provide a
reasonable estimation of reading difficulty. Formulas are based on syllables per word and words
per sentence. Some include vocabulary lists, which are quickly outdated. None tell you that the
information is suitable for a particular reader or group, or how to make it suitable. Readability
testing tells you only how complex the writing is. It is possible to achieve a very good (low)
readability score on text that makes no sense.

Keys to Readability
•   Short common words in short sentences
•   Use of personal pronouns (you, yours)
•   Use of active voice (I did it vs. It was done)
•   Conversational tone - it sounds like something you would actually say to one sitting with you.

The whole idea of readability testing is controversial, primarily because results are expressed as
school grade equivalents. This does not make sense for adults long out of school, and is not very
informative for students since in any 7th grade class you are likely to find students reading at a
2nd grade level and other reading at a college level, so what does 7th grade reading level mean?
Note that a 7th grade reading level does not mean the info is suitable for a 7th grader; but rather
that the “average 7th grader” would comprehend most of the text independently.
Most people read three to five grades below the highest educational achievement. According to
UNESCO, the US average education is 12 years, so most of us read at a middle school level.
Hundreds of studies have documented that most health information exceeds our reading ability.
SAM rates materials with a readability score of 9th grade or higher as “not suitable’.
Beginnings Guides reading level is fourth grade in English, third grade in Spanish. Details
It gets a Superior rating on the SAM. This does not mean the info is suitable for a fourth grader.
Rather, it suggests a person with a fourth grade reading level (different from a 4th grade education)
can read and comprehend it independently. Further testing showed half of those with 6-8 years
schooling in the US or Mexico, and 80% of those with 9-12 years education could use the info
independently. All benefit by discussion of relevant topics.  College educated readers never guessed
they were reading “low literacy materials”.
Next: writing style & sentence construction
See also:
Beginnings Guides Evidence Base and Guidelines for Use

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