eP740 - The Readability and Understandability of Online Hereditary Gastrointestinal Cancer Registries

Purpose/Background: Hereditary gastrointestinal cancer registries offer patients an important mechanism to provide data to reduce future cancer incidence, morbidity, and mortality. Patient facing websites from individual registries provide information about education and enrollment, however whether these websites are written at an appropriate reading level with informative content for the average patient is unknown. Our objective was to evaluate the content, readability, and understandability of patient-directed websites for hereditary gastrointestinal cancer registries.Methods/Interventions: Hereditary registry websites designed for patients were identified through lists provided by the Collaborative Group of the Americas on Inherited Gastrointestinal Cancers (CGA-ICG) and American Society of Colon and Rectal Surgeons (ASCRS). Content areas were established following assessment of all websites. Readability of each website was determined using the Flesch-Kincaid readability test and the Simple Measure of Gobbledygook (SMOG) index. Understandability was measured using the Patient Education Materials Assessment Tool (PEMAT). Fisher’s exact test and rank sum tests were used to compare these measures across website type and by number of content areas.Results/Outcomes: Overall, 22 websites were evaluated. Of these websites, 90.1% were academic, and 9.9% were nonprofit. A total of 9 content areas were determined including themes related to family history, hereditary disease, disease education, oncological treatment, screening, registry details, team, and supportive tools. The median number of content areas covered per website was 6.7 (Stdev 0.95). The most common content areas were family history and oncologic treatment (100% of websites) followed by disease education (86.3%) and hereditary disease (81.8%). Only 50% of websites had content on supportive tools. Readability scores using the Flesch-Kincaid (mean 25.2, Stdev 16.1) and SMOG Index (Mean 16.88, Stdev 3.2) correlated to an undergraduate or “difficult to read” reading level. The mean PEMAT score was 59.9 (SD 20.4, IQR 50-66.7) corresponding to poor understandability. When websites were split into “graduate” vs. “undergraduate” reading level, we found no differences in understandability scores or in the number of content areas per website (p>0.05).Conclusion/

Discussion: Hereditary gastrointestinal cancer registries websites are important to recruit and educate patients, however all are written at a level well above the recommended reading level (8th grade or below). Websites included nine key content areas but only half included information on supportive tools. These findings highlight key health-literacy sensitive opportunities to improve hereditary registry websites.