Available online 20 September 2022

The purpose of this study was to determine the readability level of information on 100 unique websites with information on preeclampsia. Five different readability measures were used to measure each website’s readability via an online readability calculator. All five readability measures determined that a vast majority of the sites sampled were written at unacceptable levels (89%+). Independent one-tailed t-tests (α=0.05) determined that there was no statistical difference in the readability scores of .com vs the other websites on any of the 5 readability assessments. We recommend that efforts be made to simplify language in accordance with plain language recommendations for health information in the United States.

Preeclampsia is a pregnancy complication often accompanied by high blood pressure, and proteinuria after 20 weeks of pregnancy [1]. While preeclampsia can often be controlled effectively, it can be life threatening in severe cases [2]. This is especially true when preeclampsia escalates to eclampsia, causing seizures [1]. Complications for babies include the potential for low birthrate and preterm delivery [1]. In the United States the rates of preeclampsia are roughly 1 in 25 [1].

Research indicates that pregnant people use the internet to attain information related to pregnancy and childbirth. Among the most commonly searched topics are those that pertain to complications [3]. Lack of adequate information resources continues to be a barrier [4] and even when information is accessed, information retrieved is often not discussed with physicians [5]. The importance of discussing information received through independent searching cannot be understated. Because internet information can run the gamut from anecdotal/non-scientific to peer reviewed, reliable information, professional insight can dispel myths or clarify misconceptions.

One of the most important aspects to consider when patients are conducting internet searches is the ease with which one can read the information presented. Readability is the ease with which one can read, and ultimately understand text [6]. Currently, it is suggested that material be written at a 6th grade reading level to meet the average literacy level of adults in the United States [7]. Because the internet is ubiquitous and accessed by the overwhelming majority of people in the United States, it is important to use plain language to meet the needs of the public [8]. This is especially true in crisis situations where it has been shown that written messaging is easier to process than messages delivered in an auditory way [9]. However, research indicates that websites of U.S. obstetrics and gynecology residency programs had patient materials written at substantially higher levels than recommended [10]. There is a gap in research related to the reading level at which general information on the internet is written. Therefore, the purpose of this study was to determine the readability level of information posted on 100 unique websites with information on preeclampsia.

The methods for this study were based on prior research [11]. A cleared browser, Google Chrome was used to attain 100 websites related to preeclampsia. Five different readability measures, Flesch-Kincaid Grade level (FKGL), Gunning Fox Index (GFI), Coleman Liau Index (CLI), Simple Measure of Gobbledygook (SMOG), and Flesch Reading Ease (FRE), were used to measure each website’s readability via an online readability calculator [12]. A score of 80 or greater on the FRE and a score of 6.9 or lower

All five readability measures determined that almost 90% of the study sample was written at unacceptable levels (n=89). The FRE scored 84% of the sample as difficult. This measure also concluded that none of the sampled sites were written at an acceptable level. The GFI, CLI, and SMOG measures produced similar results finding 65%, 92%, and 81% of the sample to be written at a difficult level respectively. In these instances, difficulty implies 4-5 grade levels above what is considered

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

There are more references available in the full text version of this article.

© 2022 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.