Standards
Health-literacy standards
What each standard measures, how it scores and where it comes from. A readability formula counts words and sentences; a criteria-based standard looks at whether people can understand the material and act on it.
Send a blank template, not a copy with a patient's or member's details.
Same page, two ways of looking
What a formula sees, and what a standard sees
A readability formula reads only the sentences: how long they are and how long their words are. A criteria-based standard looks at the whole page, from the main message to the step the reader should take.
Each dot is a word whose syllables are counted. Dashed parts are not counted.
- Main message
- Words and sentences
- Numbers
- The action step
- Pictures
- Layout and design
| Standard | What it measures | How it scores |
|---|---|---|
| N-PLATIHA (Institute for Healthcare Advancement) | Plain-language assessment of the text and design of health materials | Item by item against the N-PLAT criteria |
| PEMATAHRQ (2013) | How understandable and actionable patient education materials are, in print and audiovisual form | 0–100% for understandability and for actionability |
| SAMDoak, Doak and Root | How suitable materials are: content, literacy demand, graphics, layout, learning stimulation and cultural fit | 0–39% not suitable, 40–69% adequate, 70–100% superior |
| CDC Clear Communication IndexCDC | Research-based items on the main message, calls to action, language, numbers and risk | A percentage of the items that apply; 90 or higher passes |
See a reviewed plan notice, start to finish
Read more
- N-PLAT: plain-language assessment of text and designN-PLAT is IHA’s plain-language assessment for health materials. It looks at the words and the design together, item by item.
- PEMAT: is it understandable, and can people act on it?AHRQ’s Patient Education Materials Assessment Tool scores two things a readability formula can’t: whether people can understand a material, and whether they can act on it.
- Readability formulas: what a reading grade does and doesn’t tell youFlesch Reading Ease, Flesch–Kincaid Grade Level and SMOG estimate how hard English text is to read from the length of its sentences and words. Here is how each works and where each falls short.
- Spanish readability measures: measure Spanish as SpanishEnglish formulas misread Spanish, where words are longer on average. Spanish has its own measures: Fernández-Huerta, the Szigriszt-Pazos perspicuity index with the INFLESZ scale, and SOL.
See the standards applied to one of your documents
Upload one notice, letter or handout. It is scored against N-PLAT, with the reason behind every score and what to fix first. Personal information is redacted first, and you check it.
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