Spanish-language bariatric surgery patient education materials fail to meet healthcare literacy standards of readability

• Published in: Surgical endoscopy Vol. 37; no. 8; pp. 6417 - 6428
• Main Authors: Padilla, George, Awshah, Sabrina, Mhaskar, Rahul S., Diab, Abdul-Rahman Fadi, Sujka, Joseph A., DuCoin, Christopher, Docimo, Salvatore
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.08.2023; Springer Nature B.V
• Subjects: 2023 SAGES Oral; Abdominal Surgery; Adult; Bariatric Surgery; Comprehension; Ethnicity; Gastroenterology; Gastrointestinal surgery; Gynecology; Hepatology; Hispanic Americans; Humans; Internet; Language; Medicine; Medicine & Public Health; Minority Groups; Patient education; Patient Education as Topic; Proctology; Reading; Spanish language; Surgery; United States; United States; United States > US; Health literacy; Patient education; Spanish; Readability; Hispanic; Bariatric surgery
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/s00464-023-10088-9

Background The Hispanic population is the fastest growing ethnic minority in the United States, contributing to nearly half of the population growth over the last decade. Unfortunately, this population suffers from lower-than-average health literacy rates, leading to poorer health outcomes. Per the American Medical Association and National Institutes of Health, patient education materials (PEMs) should be written at no higher than a 6th grade reading level. Given that US Hispanic adults have the second-highest obesity prevalence, this study aims to analyze the readability of Spanish-language PEMs regarding bariatric surgery available in US-based academic and medical centers. Methods A total of 50 PEMs were found via the query ““cirugía de pérdida de peso” site: (edu OR.org)” on the Google search engine. Thirty-nine sources met the inclusion criteria of belonging to a US-based academic or medical center and containing information regarding the indications for bariatric surgery, descriptions of the types of bariatric surgery, what to expect before and after surgery, or the risks and benefits of bariatric surgery. The excerpts were analyzed according to three readability formulas designed specifically for the Spanish language and evaluated for their reading grade level. Results All 39 sources were at the college reading level per the Fry graph corrected for Spanish. Per the Spaulding formula, 37 sources were “Grade 12 + ” and two sources were “Grade 8–10.” Per the Fernandez-Huerta formula, 16 sources were at the 8th/9th grade reading level, 22 sources were at the 7th grade reading level, and one was at the 6th grade reading level. Conclusion The Spanish-language bariatric surgery PEMs available online from US-based academic and medical centers are generally above the recommended 6th grade reading level. Failure to meet the recommended sixth-grade reading level decreases health care literacy for Spanish-speaking patients within the United States seeking bariatric surgery.