ABSTRACT
Objective
Health literacy is associated with heart failure (HF) care and outcomes. Online resources
offer important educational materials for patients seeking access to heart transplantation
but tend to be complex and potentially ineffective for non-English speakers and those
with low reading levels. The purpose of this study was to evaluate both the readability
of patient-level information posted on United States heart transplant center websites
and the availability of non-English resources.
Methods and Results
We performed a review of patient-facing information on websites of U.S. heart transplant
centers identified through the United Network for Organ Sharing in August 2022. Written
English text was extracted and assessed for readability by using the Fry Graph Readability
score. Websites were additionally evaluated for non-English language text and translator
tools. Standard ANOVA analysis was used to compare readability levels across transplant
regions. The median Fry readability level to understand a piece of text for all regions
was 15, which is equivalent to a college-junior reading level (range: 7–17, 7th grade
to postgraduate level). There was no statistical difference in median Fry readability
levels among regions (P = 0.16). Of the 139 eligible heart transplant center websites, only 56.1% (78/139)
had non-English resources available for patients. Regions 5 (75% [15/20]) and 6 (75%
[3/4]) had the highest percentage of non-English resources, and region 2 had the lowest
(38% [6/16]).
Conclusions
Heart transplant center online resources are inadequate, and many do not provide translations
of the English language. Additional work is needed to standardize heart-transplant
patient information for a diverse U.S. patient population.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Cardiac FailureAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Racial and ethnic disparities in heart failure: current state and future directions.Curr Opin Cardiol. 2021; 36: 320-328
- CMS Framework for Health Equity.2022 (Published online April 22)
- Disparity Impact Strategy.2021 (Published online October 5)
United States Department of Health and Human Services. Social Determinants of Health. https://health.gov/healthypeople/priority-areas/social-determinants-health
- Health literacy and heart failure: a systematic review.J Cardiovasc Nurs. 2016; 31: 121-130
- Centers for Disease Control and Prevention: Use of the Internet for Health Information: United States, 2009.National Center for Health Statistics, 2011 (Published online July)
- 67.3 million in the United States spoke a foreign language at home in 2018.Center for Immigration Studies, 2022 (Accessed June 9.)
Search membership - Transplant Centers - OPTN. Accessed June 21, 2022. https://optn.transplant.hrsa.gov/about/search-membership/?memberType=Transplant+Centers&state=-1®ion=0
- Cognitive impairments in chronic heart failure: a case controlled study.J Card Fail. 2009; 15: 1-10
- Cognitive impairment in heart failure patients.J Geriatr Cardiol. 2014; 11: 316-328
- Non-English-language resources and readability of kidney transplant center websites in the United States.JAMA Netw Open. 2021; 4e2134236
Article info
Publication history
Published online: October 22, 2022
Accepted:
September 25,
2022
Received in revised form:
September 7,
2022
Received:
July 5,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
Published by Elsevier Inc.
