Posted 12/11/2007

Citizens with basic literacy skills likely unable to comprehend health-related articles on local TV websites

Visitors seeking health information from local television websites are likely to find health-related articles too difficult to read and understand, according to a first-of-its-kind study by University of South Carolina researchers.

Dr. Daniela B. Friedman and Dr. Andrea Tanner evaluated a sampling of top health stories and stories within health sections on TV websites of 79 randomly selected U.S. media markets in 2006.

They examined 278 articles over two days and found most of them written at a senior high school and college level, well beyond the comprehension of average readers or individuals with basic literacy skills.

According to the most recent National Assessment of Adult Literacy, more than 75 million U.S. adults have basic or below basic literacy skills and are unable to understand or use health-related documents or instructions.

"That is why it is so important to consider the literacy abilities of our intended audiences (viewers and/or readers) and communicate health information more clearly," Friedman said.

Tanner, an assistant professor in the School of Journalism and Mass Communications, and Friedman, an assistant professor in the Arnold School's Department of Health, Promotion, Education, and Behavior, found that mean readability of the stories was Grade 11.9 according to the SMOG reading level measure. The Flesch Reading Ease score was 51.6 ("fairly difficult") on a scale that ranges from 100 (very easy to read) to zero (unreadable).

Friedman, who has conducted several health literacy studies with diverse, older populations, said articles "that are written in plain language at a grade 5 to 6 level, that feature easy instructions with bullet points, and that are culturally inclusive" are far better able to convey health information to groups with limited understanding of health messages.

Photos or other illustrations that would enhance readability were largely absent from website health stories. Furthermore, only 14 percent contained a video.

"It is surprising that a majority of the stories contained no video content because in the television news environment, video is readily available and news workers are experienced in presenting visual content," said Tanner.

The implications of the study for public health communication and broadcast journalism are profound in light of today’s media environment where most people receive more of their health and medical information from television than from any other media source.

"Virtually all TV stations have websites with health information content packaged from a variety of local and national sources. Moreover, viewers are encouraged by repeated on-air announcements to look to their websites for additional information or links to other sources," Friedman said.

A 2006 report by the Project for Excellence in Journalism showed that the need for health information is the third most common reason for visiting TV websites after weather and news searches.

While improved readability is a much-desired goal, Friedman and Tanner's study also acknowledges that both "health and media organizations often do not have the resources or time available to tailor reports about new scientific findings into plain language or pre-test disease risk messages for difficult terminology when the information must be disseminated in a timely manner."

Besides readability, the study also assessed the content of the TV websites. The majority of stories were national (47.0 percent) and educational (48.0 percent) pieces. Fewer articles were breaking news (19.8 percent). More articles focused on both prevention and treatment (30.6 percent) rather than on prevention (21.6 percent) or treatment (21.2 percent) alone.

While more articles were on chronic disease conditions, there was still coverage of infectious disease, reflective of the E. coli outbreak and recall of affected bagged spinach during this time. In light of new and emerging infectious diseases (Avian influenza) and increased attention to pandemic viruses and emergency preparedness, it is understandable why there were a number of articles on these topics as well.

Mobilizing information (MI), defined as information found in news that helps people act on pre-existing attitudes, was also examined within the online health content. Only 32.0 percent of stories contained MI and directed readers to additional resources such as a health organization’s name, phone number, or address. Additionally, only 30.0 percent of website stories took advantage of the interactive nature of the Internet by linking readers to other health sites or giving an e-mail address to obtain additional information.

Friedman presented the study at the November 2007 national meeting of the American Public Health Association and it is to appear in the upcoming issue of Journal of Consumer Health on the Internet (volume 11, issue 4).

This study of health news on local TV news websites, the first of its kind, has laid the groundwork for a number of future research possibilities. Friedman and Tanner would like to do a similar study on newspaper websites, which are increasingly important to papers beset by falling circulation and advertising revenue in their print editions.

A native of Canada, Friedman specializes in health communications, literacy and people’s understanding of health risk, and use of Internet and technology in prevention education. Tanner teaches in the electronic and print sequence of the School of Journalism and Mass Communications and focuses her research on television news and health communications.