Why does Nova Scotia Health create and update patient education pamphlets?
Approximately half of all Canadians experience some challenges understanding the health information and teaching provided to them (Guo, 2012). This is true for many Nova Scotians, especially those whose first language is not English (NS Department of Health, 2010). This can make reading and understanding health materials challenging at the best of times, on top of the added stress of being ill or having an ill family member, loved one, or friend.
To help make sure the information we include in our patient education resources is easy to read and understand, we edit all content for plain language and readability, with the goal of a 6th grade reading level. When our team reviews pamphlet drafts, we remove or explain medical jargon, replacing it with more familiar terms. We do this so readers can better understand their diagnosis, treatment, and instructions given to them by their health care teams (Weiss, 2014).
Further reading:
Writing in plain language helps readers of all literacy levels by clearly communicating important information as simply and concisely as possible (Osborne, 2018). Some health care providers may be concerned that plain language will offend patients who read well (Osborne, 2018). This has been proven to be a misconception − plain language enables everyone to read and use essential health information (Wizowski, Harper & Hutchings, 2014). Likewise, health care providers often overestimate their patient's understanding (Louizou, Panagiotou, Dafli, Smyrnakis & Bamidis, 2024).
What does plain language look like?
Library Services’ Patient Education Team uses “health care” (two words) instead of “healthcare” (one word) in all patient education pamphlets.
Why do we use “health care” instead of “healthcare”?
What about readability formulas?
Since readability formulas are based on mathematical equations that rely on sentence length and syllables, they are not recommended to assess the reading grade level of patient education materials. Research has shown that they are not reliable and do not improve reader comprehension. Writing in plain language and organizing information for increased readability is not something that can be calculated; these are learned skills that take practice (Spivak, 2022). Instead of relying on a calculation, content creators are encouraged to follow plain language guidelines and test their materials before use with their target audience. All patient education resources added to the Nova Scotia Health collection are reviewed for plain language by more than one member of the Patient Education Team.
Organization of pamphlet content
All patient education resources should be designed for maximum readability and be presented in a logical format. When reviewing, the Patient Education Team will edit your draft to ensure the following criteria are met:
Patient education pamphlets that account for varying levels of health literacy support increased people-centred care.
How can you make your patient education pamphlet more people-centred?
Find patient engagement resources on Nova Scotia Health's Engagement guide.
1. Guo, D. (2012). The impact of low literacy on health. UBC Medical Journal, 3(2), 39-41. https://doi.org/10.1016/j.amjsurg.2004.04.005
2. Nova Scotia Department of Health. (2010). Messages for all voices: integrating cultural competence and health literacy in health materials, forms, and signage. Retrieved from https://novascotia.ca/dhw/primaryhealthcare/documents/Messages-for-All-Voices-Full-Length-Tool.pdf
3. Weiss, B.D. (2014). How to bridge the health literacy gap. Family Practice Management, JAN/FEB, 14-18. Retrieved from https://www.aafp.org/fpm/2014/0100/p14.pdf
4. Louizou, E., Panagiotou, N., Dafli, E., Smyrnakis, E., Bamidis, P.D. Medical Doctors Approaches and Understanding of Health Literacy: A Systematic Literature Review. Cureus. 2024 Jan 1;16(1):e51448. doi: 10.7759/cureus.51448.
5. Osborne, H. (2018). Health Literacy from A to Z: Practical ways to communicate your health message (2nd ed.). Lake Placid, NY: Aviva.
7. Spivak, G. (2023, July 10). Readability formulas, programs and tools: Do they work for plain language? Our Languages. Retrieved from https://www.noslangues-ourlanguages.gc.ca/en/blogue-blog/readability-formulas-eng
8. Wizowski, L., Harper, T., Hutchings, T. (2014). Writing health information for patients and families: A guide to developing patient education materials that promote health literacy (4th ed). Hamilton Health Sciences, McMaster University.