The effect of improved readability scores on consumers' perceptions of the quality of health information on the internet

Background. Recent growth and use of the internet as a source of health information has raised concerns about consumers' ability to comprehend this information. Although health scholars argue that writing web pages at an eighth-grade level or lower will help patients, few studies involve actual readers to investigate the effects of improved readability scores on patients' perceptions of this information. Methods. This study examines American consumer evaluations of web pages written at different grade reading levels. In spring of 2005, a community-wide intercept survey was performed in a regional hub city in southeastern Ohio. Five hundred nineteen participants were randomly assigned to receive one of three messages discussing lung cancer prevention: one written at the eighth grade level, one at the ninth grade level, and one at the first year college level. Independent t-tests were conducted to compare the messages on measures of perceived trustworthiness, truthfulness, readability, and completeness. Results. Improving the reading level of online information had no significant effect on consumers' evaluations of the messages' readability or completeness, nor a consistent effect on the perceived truthfulness or trustworthiness of the message. Conclusions. The results suggest that by simply changing the readability level of online information may not improve consumers' evaluation of the quality of health information on the internet. The authors offer alternative possibilities for why some sources of online health information may be seen as more valuable than others.