Multiple automated health literacy assessments: Development of the Health Literacy Editor: Presenter(s): Julie Ayre, The University of Sydney, Australia

Producing health information that people can easily understand is challenging and time-consuming. Existing guidance is often subjective and lacks specificity. This study outlines the development and user-testing of the Health Literacy Editor. This new automated tool helps users write health information that is easy to understand and that adheres to health literacy guidelines. Existing health literacy and plain language guidelines were collated. Items amenable to programmable automated assessment were incorporated into the Editor. The prototype was iteratively refined across four rounds of user-testing with health services staff (N=20). After each round, Yardley’s (2021) optimisation criteria were applied to collate user feedback. These criteria guided which changes would be implemented. The Editor comprises six assessments: readability, complex language, passive voice, text structure, lexical density/diversity, and person-centred language. These are presented as global scores, with additional, more specific feedback flagged in the text itself. Feedback is provided in real-time such that users can iteratively revise and improve the text. Key changes from user-testing included: making the interface more intuitive, reducing the amount of information presented to first-time users, and creating varying ‘levels’ of support (e.g. 1-2 sentences, in-depth videos). Evaluations using the System Usability Scale and Technology Acceptance Model, showed high usability (Mean=84.25/100; SD=13.9) and perceived usefulness by health staff (M=8.62/10; SD=1.35). The Health Literacy Editor is an innovative new tool to improve the quality and safety of written health information. It provides objective, immediate feedback on a range of factors, complementing readability with other, less widely used but important objective assessments such as complex and person-centred language. User-testing with health services staff has made the Editor more intuitive and engaging. This is a scalable intervention to support the uptake of health literacy guidelines by health services and providers of health information.