Readability assessment of Spanish online patient education materials in gynecologic oncology.

Objective: Over half of Spanish-speaking patients use the internet to understand their diagnosis. We evaluated readability of Spanish online patient education materials (OPEMs) about gynecologic cancer to assess compliance with National Institute of Health (NIH) recommendations to be at or below eighth grade reading level. Methods: We conducted an online search using six Spanish gynecologic cancer terms on three major search engines with cookies and location disabled. The first five results by cancer type were included. Readability was analyzed by Spanish Simple Measure of Gobbledygook (SMOG) and Gilliam-Peña-Mountain (GPM) indices. One-way ANOVA with Tukey's Honestly Significant Difference (HSD) post-hoc analysis was performed. Results: 322 unique OPEMs were retrieved using Spanish queries. This included 132 (41 %) from non-profit organizations, 114 (35.4 %) from governmental organizations, and 63 (19.5 %) from academic medical centers; the remainder were from professional medical society or pharmaceutical company sources. Overall, gynecologic oncology OPEMs were written at a mean 9.8 ± 1.2 grade reading level. Only 14 % of OPEMs were written at or below an eighth grade reading level. There were significant differences in readability by publishing source (p < 0.001). Though there were no significant differences in readability by cancer type (p = 0.07), the mean reading level for all cancer types was between ninth and eleventh grade level. Conclusions: 86% of readily searchable Spanish gynecologic oncology OPEMs are written above recommended reading levels. Gynecologic oncologists should curate and support Spanish-speaking patients in finding high-quality online educational content.