CheckMyText! Randomised controlled trial to evaluate the SHeLL Health Literacy Editor

INTERVENTION: Participants will have access to the Editor (https://shell.techlab.works/ ) and self‐directed training materials. The Editor is an online browser‐based tool that helps users develop text‐based health education materials that adhere to health literacy guidelines. The Editor comprises si Xassessments: readability, comple Xlanguage, passive voice, text structure, lexical density and diversity, and person‐centred language. These are each presented as global scores, with additional, more specific feedback flagged in the text itself. Several training resources embedded within the intervention include: 1. Help page: The Editor’s help page containing instructions, video tutorials and worked examples 2. Self‐check tool: 5 questions to check understanding of key concepts (available from the help page) 3. Quick start guide: A 2‐page PDF introducing key concepts (available from the help page) Participants in this group will also be invited to take part in a 30‐minute Zoom call administered by a member of the research team. Participants will be introduced to the tool and any relevant training resources, with opportunity to ask questions. If participants are not able to make the Zoom meeting they will have access to a recording of the same content. Zoom attendance / evidence of viewing of the recording will be used to monitor adherence to the intervention. After completing training, participants in the intervention group will be sent a link to the text revision task. They will receive reminders at 1 and 2 weeks if the task has not been completed. During the text revision task, participants are provided with the following instructions: Your task is to revise each of the texts below so that they are easy for most people to understand. Try to: • make the CONDITION: lack of health literacy; ; lack of health literacy Public Health ‐ Health service research PRIMARY OUTCOME: Grade readings score (Simple Measure of Gobbledygook).[Participants are asked to complete the revision task within the week after completing the training.] SECONDARY OUTCOME: Acceptability: the Technology Acceptance Model (comprises two subscales: perceived usefulness and perceived ease of use). Each subscale produces a score ranging from 1 (low) to 7 (high). Scores are predictive of current and future use of a product.[Participants are asked to complete the revision task within the week after completing the training.] Consumer assessments of information quality: This assessment will be completed by consumers, using selected items from the ‘information and presentation’ subscale of the e‐Health Impact Questionnaire ‐Part 2. This comprises 4 statements, each rated on a 5‐point likert scale strongly disagree to strongly agree). Consumers will also rate the texts according to two additional items using the same response scale: “I know what to do next” and “I would share this information with family and friends.” Each text produced by a trial participant will be rated by 2 consumers ; ; Relevant reference: L. Kelly, S. Ziebland, C. Jenkinson, Measuring the effects of online health information: Scale validation for the e‐Health Impact Questionnaire, Patient Education and Counseling 98(11) (2015) 1418‐1424.[This assessment is conducted separately to the trial (i.e. with separate participants). Assessments will take place immediately after reviewing the revised health information.] Engagement and fidelity: Self‐reported Health Literacy Editor training resources accessed and features within the tool used when revising the text, collected via online survey[Participants are asked to complete the revision task after completing the training.] Expert Patient Education Materials Assessment Tool (PEMAT) assessment: Two co‐investigators will assess each revised text, masked to intervention group. Relevant PEMAT #1 is: The text makes its purpose completely evident ; ; Relevant reference : S.J. Shoemaker, M.S. Wolf, C. Brach, Development of the Patient Education Materials Assessment Tool (PEMAT): a new measure of understandability and actionability for print and audiovisual patient information, Patient Educ Couns 96(3) (2014) 395‐403. PMID:24973195.[Participants are asked to complete the revision task within the week after completing the training.] Expert Patient Education Materials Assessment Tool (PEMAT) assessment: Two co‐investigators will assess each revised text, masked to intervention group. Relevant PEMAT #2 is: The text has no distracting information or content ; ; Relevant reference : S.J. Shoemaker, M.S. Wolf, C. Brach, Development of the Patient Education Materials Assessment Tool (PEMAT): a new measure of understandability and actionability for print and audiovisual patient information, Patient Educ Couns 96(3) (2014) 395‐403. PMID:24973195.[Participants are asked to complete the revision task within the week after completing the training. ; ; ] Expert Patient Education Materials Assessment Tool (PEMAT) assessment: Two co‐investigators will assess each revised text, masked to intervention group. Relevant PEMAT #3 is: The text uses common, everyday language ; ; Relevant reference : S.J. Shoemaker, M.S. Wolf, C. Brach, Development of the Patient Education Materials Assessment Tool (PEMAT): a new measure of understandability and actionability for print and audiovisual patient information, Patient Educ Couns 96(3) (2014) 395‐403. PMID:24973195. ; [Participants are asked to complete the revision task within the week after completing the training.] Expert Patient Education Materials Assessment Tool (PEMAT) assessment: Two co‐investigators will assess each revised text, masked to intervention group. Relevant PEMAT #4 is: The text defines medical terms ; ; Relevant reference : S.J. Shoemaker, M.S. Wolf, C. Brach, Development of the Patient Education Materials Assessment Tool (PEMAT): a new measure of understandability and actionability for print and audiovisual patient information, Patient Educ Couns 96(3) (2014) 395‐403. PMID:24973195. ; [Participants are asked to complete the revision task within the week after completing the training.] Expert Patient Education Materials Assessment Tool (PEMAT) assessment: Two co‐investigators will assess each revised text, masked to intervention group. Relevant PEMAT #5 is: The text uses active voice ; ; Relevant reference : S.J. Shoemaker, M.S. Wolf, C. Brach, Development of the Patient Education Materials Assessment Tool (PEMAT): a new measure of understandability and actionability for print and audiovisual patient information, Patient Educ Couns 96(3) (2014) 395‐403. PMID:24973195. [Participants are asked to complete the revision task within the week after completing the training.] Passive voice: The Editor’s passive voice score indicates the number of passive voice in the text.[Participants are asked to complete the revision task within the week after completing the training.] self‐reported time to complete the task (minutes), collected via online survey[Participants are asked to complete the revision task within the week after completing the training.] Text accuracy / retention of meaning: Two researchers will assess each text for retention of key messages (determined a‐priori), and identify any additional or incorrect information.[Participants are asked to complete the revision task within the week after completing the training.] Text Complexity: The Editor’s text complexity score reports the proportion (as a %) of words in the text being assessed that are flagged by the program as ‘complex.’ This includes acronyms, any words for which a simpler alternative has been identified, based on public health and medical thesauruses, and any words that are flagged as ‘uncommon’ in English, according to a database of more than 270 million words.[Participants are asked to complete the revision task within the week after completing the training.] Usability: assessed by the System Usability Scale, and The System Usability Scale produces a score from 0 (low) to 100 (high).[Participants are asked to complete the revision task within the week after completing the training.] INCLUSION CRITERIA: Eligible participants are Australian people whose work or study involves developing health information. This can include, for example, health information providers, health services staff, and clinicians. Students in medicine, allied health and health sciences are also eligible to take part. Participants are not eligible to take part if they have previous experience using the Health Literacy Editor. For consumers rating the resulting revised health information, eligible participants must be adults (18 years and over) with less than a university level of education.