ArticleThe Iowa orthopaedic journal
Health Literacy in Clubfoot: A Quantitative Assessment of the Readability, Understandability and Actionability of Online Patient Education Material.
Article in The Iowa orthopaedic journal. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed.
- Evaluation of an Artificial Intelligence-Driven Language Model for Age-Specific Patient Education in Pediatric Orthopaedics.Journal of the Pediatric Orthopaedic Society of North America · 2026Article
- Article
- Content analysis of oral hygiene instruction posts on Instagram: a cross-sectional study.Canadian journal of dental hygiene : CJDH = Journal canadien de l'hygiene dentaire : JCHD · 2025Article
- Readability of health research informed consent forms: case of the National Health Research Ethics Committee in Tanzania.BMC medical ethics · 2025Article
- Can popular AI large language models provide reliable answers to frequently asked questions about rotator cuff tears?JSES international · 2025Article
- Improving the design of patient-generated health data visualizations: design considerations from a Fitbit sleep study.Journal of the American Medical Informatics Association : JAMIA · 2024Article
- Digital Patient Education on Xanthelasma Palpebrarum: A Content Analysis.Clinics and practice · 2023Article
- Common Errors in the Management of Idiopathic Clubfeet Using the Ponseti Method: A Review of the Literature.Children (Basel, Switzerland) · 2023Review
- Google Trends™ and Quality of Information Analyses of Google™ Searches Pertaining to Concussion.Neurotrauma reports · 2023Article
- Assessment of Understandability and Actionability of YouTube Videos on Hemolytic Disease of the Newborn.Cureus · 2023Article
- Comprehension Profile of Patient Education Materials in Endocrine Care.Kansas journal of medicine · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundParents often access online resources to educate themselves when a child is diagnosed with clubfoot and/ or prior to treatment initiation. In order to be fully understood by the average adult American, online health information must be written at an elementary school reading level. It was hypothesized that current available online resources regarding clubfoot would score poorly on objective measures of readability (syntax reading grade-level), understandability (ability to process key messages), and actionability (providing actions the reader may take). Additionally, it was hypothesized that the outcomes measured would not correlate with the order of listed search results.
methodsPatient education materials were identified utilizing two independent online searches (Google.com) of the term "Clubfoot". From the top 50 search results, websites were included if directed at educating patients and their families regarding clubfoot. News articles, non-text material (video), research and journal articles, industry websites, and articles not related to clubfoot were excluded. The readability of included resources was quantified using the Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG) Grade, Coleman-Liau Index (CLI), Gunning-Fog Index( GFI) and Automated Reading Index (ARI). The Patient Education Materials Assessment Tool (PEMAT) was used to assess actionability and understandability using a 0-100% scale for both measures of interest.
resultsOf the 55 unique websites, 37 websites (65.2%) met inclusion criteria. The mean FKGL was 9.2 (+/- 2.1) with only three websites (7.32%) having a reading level ≤6. Mean understandability and actionability scores were 67.2±12.6 and 25.4±25.2, respectively. Thirteen (35%) websites met the understandability threshold of ≥70% but no websites met the actionability criteria. No readability statistics were statistically associated with Google™ search rank (p=0.07). There was no association between readability (p=0.94) nor actionability (p=0.18) scores and Google™ rank. However, understandability scores did correlate with Google™ rank (p=0.02).
conclusionOverall, online clubfoot educational materials scored poorly with respect to readability, understandability, and actionability. There is an association with Google™ search rank for understandability of clubfoot materials. However, readability and actionability are not significantly associated with search rank. In the era of shared decision-making, efforts should be made by medical professionals to improve the readability, understandability, and actionability of online resources in order to optimize parent understanding and facilitate effective outcomes.
Indexed as
Identifiers
34552405PMC8259170What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.