December 2012 – September 2013

With funding from the Food and Drug Administration through the University of Maryland Center of Excellence in Regulatory Science and Innovation (CERSI), Dr. Carter-Pokras is leading an effort to improve health literacy and cultural competence of FDA consumer materials. She is joined by Dr. Linda Aldoory, Dr. Brad Boekeloo, Dr. Bonnie Braun and Dr. Jie Chen in this project to assess and provide recommendations on the readability, cultural sensitivity, plain language and communication frames of written consumer materials currently disseminated through the Food and Drug Administration (FDA) website on HIV/AIDS.

Drawing upon best practices in assessing readability, cultural competency (ability of individuals/agencies to work together in cross-cultural situations), and plain language aspects of written materials, a grading rubric was developed by adapting items from the Cultural Sensitivity Assessment Tool (CSAT), the Cultural Sensitivity Assessment Checklist (CSAC), the Suitability of Materials (SAM) analysis, and the Toolkit for Making Written Material Clear and Effective, which include common readability indices.

A total of 36 web pages were identified for review. A preliminary analysis showed websites had poor health literacy scores and generally lacked basic information about HIV/AIDS. Four of 36 web pages included HIV/AIDs statistics, and the average score of whether the statistics were reflective of the intended audience was 3.0 out of 4.0. One of 36 pages mentioned a specific racial/ethnic group. No pages addressed perception of HIV/AIDS risk in any racial/ethnic group. The average reading ease score was 15.6, reflecting very difficult material (reading ease scores range from 0-100 with lower scores as more difficult).

Since most Americans read at a 5th grade level, these reading scores reflect an inadequacy of consumer materials to deliver health information to the intended audience. The information provided on the reviewed websites does not reflect culturally appropriate messages required to engage community members disproportionately impacted by HIV/AIDS. Health literacy researchers have a role in ensuring that more accurate and culturally/linguistically appropriate information about HIV/AIDS prevalence, risk, prevention, and treatment options are provided to the public.

The following health literacy and cultural competency tools were used during the development of this project: