Nursing

Health Literacy Review of

PCOS Educational Material HEALTH LITERACY AND PERSON EDUCATION

STUDENT NAME

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Introduction - PCOS

 Polycystic Ovary Syndrome

 Is this material credible?

 Is this material valid?

 Is this material accessible?

 Does this material provide patients with

a better understanding of PCOS?

 Mayo Clinic

 Non-profit healthcare organization

providing healthcare, education, and

research

 Finding Quality Information framework at NIH

 Principles of literacy and health literacy

 What is literacy?

 What is health literacy?

(Mayo Clinic, 2022)

This assignment evaluates a Mayo Clinic website, titled,

“Polycystic Ovary Syndrome (PCOS).” In this

assignment, I will use the Finding Quality Information

framework at NIH and the principles of literacy and

health literacy to evaluate the appropriateness of this

educational material. This website provides an overview

of PCOS for the lay person. The goal of this website is to

provide information for patients on PCOS and the causes,

complications, signs, and symptoms of the disease (Mayo

Clinic, 2022). This website was created by Mayo Clinic.

Mayo Clinic is a non-profit health care organization that

provides healthcare, education, and research (Mayo

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Clinic, n.d.).

Some of the key points will be:

- Is this material credible?

- Is this material valid?

- Is this material accessible?

- Does this material provide patients with a better

understanding of PCOS?

Hyperlinks:

Polycystic Ovary Syndrome

About Mayo Clinic

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Intended Population

(Mayo Clinic, n.d.)

Intended for patients

Women of childbearing age and those that know or care for someone with PCOS

English-language readers

The intended population for the PCOS material is

patients with no medical background. Mayo Clinic also

provides educational material about current practices and

research that is intended for medical professionals.

However, this material is written in lay terms. Since this

material covers PCOS, it is likely intended for those that

may be affected by PCOS, mainly women of childbearing

age. However, it is also likely intended for those that may

know or care for someone with PCOS.

This material is written in English, which requires its

audience to be able to read English. Being a Minnesota-

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based company, a high percentage of Mayo Clinic’s

audience is likely English-speaking. However, Mayo

Clinic is known for being a destination for international

healthcare, which requires language accessibility.

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Literacy vs. Health Literacy

Literacy

The National Literacy Trust defines literacy as,

“the ability to read, write, speak, and listen in a way that lets us communicate effectively and make sense of the world”

(National Literacy Trust, n.d.).

Health Literacy

The CDC defines personal health literacy as,

“the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others”

(CDC, 2022).

The National Literacy Trust defines literacy as, “the

ability to read, write, speak, and listen in a way that lets

us communicate effectively and make sense of the world”

(National Literacy Trust, n.d.).

The Centers for Disease Control and Prevention (CDC)

defines personal health literacy as, “the degree to which

individuals have the ability to find, understand, and use

information and services to inform health-related

decisions and actions for themselves and others” (CDC,

2022).

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Health literacy requires literacy. However, one could be

literate and have poor health literacy. They may not have

a good understanding of the body and its functions.

Additionally, they may not understand how decisions

about their healthcare may affect them.

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Interview

 Wide range of health literacy levels at

the Alternative Learning Center

 Nutrition and health information is

always changing

 Families and interest levels play a role in

health literacy levels

 Misinformation from peers can

contribute to poor health literacy

 Sometimes there is too much

information available to adequately

decipher

 You can find anything you want to hear

on the internet

 It is important to teach our youth about

health and help them improve their

health literacy

I discussed literacy and health literacy with a physical

education and health teacher in the local K12 school

system. She has taught multiple age groups and is

currently at the high school for physical education, and

the Alternative Learning Center (ALC), where she is

teaching health. She notes that there is a wide range of

health literacy with her ALC students. She believes this is

due to the varied reasons that one might attend the ALC,

including drug-related reasons, academic reasons, or

mental health. She notes that many of them think they

understand nutrition, but they really don’t. She also

mentions that some of her students are very informed

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about topics that she would assume they wouldn’t know,

but others have no concept of health at all. She says that

some of them are really smart but have a hard time

showing up to class. Others are motivated to be really

health. She also addresses the misinformation her

students receive from their peers about drugs and alcohol.

She believes that the wide range of health literacy levels

stem from their families and the different levels of

interest that some students and their families show for

health. She also believes that some of our issues with

health literacy stems from all of the accessible

information on the internet. She believes that sometimes

too much information is a not a good thing. She gave an

example about one time when she ate rancid pine nuts,

and her sense of taste was completely off. At the time,

everything she found about her symptoms led to cancer,

which wasn’t ultimately the case. She said that it is hard

to decipher health information from the internet because

there are too many possibilities out there that a medical

professional would be able to rule out. Not many people

will read medical journals, and even those can be hard to

determine credibility and motive. She believes that you

can find whatever answer you want to hear if you are

looking on the internet, and that is not always helpful for

people. She discusses the importance of teaching our

population, especially our youth, about health and the

importance of health literacy, especially because health

and nutrition are always changing.

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Literacy and Health Literacy

 In the U.S. over half the population is at a 7th grade reading level or lower

 Health literacy requires some level of literacy

 One could be literate and still have poor health literacy

(Wylie, 2021)

Both literacy and health literacy are a way to describe

comprehension of communicated information that allows

the information to be utilized by the person. Health

literacy requires some level of literacy. However, one

could be literate and have poor health literacy. They may

not have a good understanding of the body and its

functions. Additionally, they may not understand how

decisions about their healthcare may affect them.

The student population discussed with the health teacher

fits into the intended population for my PCOS

educational material, as many of these students are

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females of childbearing age. As described by the teacher,

there is a wide variety of literacy and health literacy

levels in this population. In the U.S. over half the

population is at a 7th grade reading level or lower (Wylie,

2021).

I do believe that this educational material is appropriate

for the intended population. It is geared toward the lay

person and not medical professionals. It clearly describes

PCOS for those without an understanding of it, describes

the signs and symptoms that may accompany it, and

mentions some complications to watch for. However, it

may be beneficial to have this available in other

languages.

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Readability Tool

(Readability Test, n.d.)

The Flesch Kincaid Reading Ease score is a 53.9

(Readability Test, n.d.). A score between 60 and 80

should be easy for a 12- to 15-year-old to understand

(Readability Test, n.d.). The Flesch Kincaid Reading

Ease is the most widely used measure of readability and

is ranked from 0 to 100 with a higher score being better

(Readability Test, n.d.). It uses words per sentence and

syllables per word to determine a score (Readability Test,

n.d.). Flesch Kincaid describes 65 as a good target for

most businesses (Readability Test, n.d.). However, this

Reading Ease score is 53.9, which is a little bit below

that. This may be slightly difficult for the intended

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audience.

The Flesch Kincaid Grade Level is a 7.2. This score gives

a reference to the American School grade you would

need to be in to comprehend the material (Readability

Test, n.d.). This score is also determined by words per

sentence and syllables per word (Readability Test, n.d.).

They list 7th grade as a good target (Readability Test,

n.d.). At 7.2, the grade level is relatively close to the 7th

grade reading level target, making it an appropriate

resource for the intended population.

The Automated Readability Index is a 6.1 grade level.

This score helps measure how easy the text is to

understand and gives you an estimate of the U. S grade

level. This score is calculated using characters per word

and words per sentence. Over half of U.S. adults read at a

7th grade reading level or below (Wylie, 2021). This score

places this educational material below a 7th grade reading

level, making it an appropriate resource for the intended

population.

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Credibility and Validity

Credibility

Believability, trust, reliability, and

confidence in a person, object, or process

(Sbaffi & Rowley, 2017)

Validity

Soundness and strength of argument

(University of Maryland, n.d.)

One way to evaluate the credibility of a website is to

evaluate the timeliness, authority, audience, relevance,

and perspective of a source (Whitchurch, 2022). This can

be done by looking for appropriate timelines for your

information, such as using recent research (Whitchurch,

2022). It also means looking for authors or organizations

that have the authority to speak on a certain topic, peer-

reviewed journals, or appropriate credentials

(Whitchurch, 2022). It is important to consider the

publication’s purpose for sharing the information

(Whitchurch, 2022).

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To determine the validity of a source, we can look at the

author of a source, how the source got its information,

and the type of source the information is coming from

(University of Maryland, n.d.). When evaluating an

author, consider the credentials of the author and their

mission and goals (University of Maryland, n.d.). We can

also consider the references and whether they are reliable

sources of information and if they are cited correctly, or if

the author didn’t include references at all (University of

Maryland, n.d.). It is also important to consider the type

of source that the information is coming from, such as

commercial sources, non-commercial sources,

educational or scholarly sources, or government sources

(University of Maryland, n.d.).

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NIH Framework  Who runs the site?

 Who pays for the site?

 What is the site’s purpose?

 What is the original source of the site’s information?

 How does the site document the evidence supporting its information?

 Who reviewed the information before the owner posted it on the site?

 How current is the information on the site?

(National Institutes of Health, 2022)

The owner of the site, Mayo Clinic, is clearly noted on

every major page, along with a link to the site’s

homepage. This makes it easy to see who is responsible

for the site and its information.

This site is paid for by the owner, Mayo Clinic, as

evidenced by the “.org” address, which denotes it as a

non-commercial organization. While it does have

advertisements on the page to help fund the website,

there is a clear disclaimer that notes that Mayo Clinic

does not endorse any products. This helps provide

credibility for the site.

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The site’s purpose is to provide site visitors with access

to knowledge, services, and experiences of Mayo Clinic

(Mayo Clinic Staff, 2018). Their goal is to meet visitor

needs, as well as providing access to care at Mayo Clinic.

This helps provide the community with access to

information and care, increasing the credibility of Mayo

Clinic.

The site’s information comes from a variety of sources

including Mayo Clinic medical experts, medical journals,

and credible sources like American College of

Obstetricians and Gynecologists (ACOG). The evidence

supporting its information is documented in the reference

list at the bottom of the page, with links to each source.

This information is then written and reviewed by Mayo

Clinic Staff, which includes a variety of experts for

multiple topics.

The information on the site is very current. The site was

reviewed and updated in September of 2022, and each of

the sources are from the last two years.

The only links to any other sites on this webpage are

links to other areas of Mayo Clinic and the references at

the bottom of the page. For example, there are links to the

Mayo Clinic store, Mayo Clinic appointment requests,

other Mayo Clinic web pages for related information, and

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links to their social media accounts. The other links are

embedded in the reference list for the medical journals

and other credible sites that their medical information

comes from. This helps provide a level of credibility and

validity, as their outside information is accessible, but

they do not otherwise link to other sources.

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Date of

Issue or

Revision

Information gives credibility and validity to the site

Last updated September 8th, 2022

Current evidence from 11 sources all within the last 2 years

Credible sources like medical journals and the American College of Obstetricians and Gynecologists (ACOG)

(Mayo Clinic, 2022)

This site is active and current. The material was last

updated September 8th, 2022. The medical evidence on

the site is current. This is evidenced by the 11 references

they have listed on the site. All the references are from

within the last two years and come from medical journals

or other credible sources like the American College of

Obstetricians and Gynecologists (ACOG). This current

and frequently updated information helps give credibility

and validity to the site and its PCOS material.

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Credentials of

Source

 Bias and sponsorship occur, decreasing credibility and validity

 Disclaimer that Mayo Clinic does not endorse and products or companies

 Bias toward receiving care through Mayo Clinic

 Some of the advertisement seems connected to the healthcare site

 Some of the advertisement seems completely unrelated

(Mayo Clinic, 2022)

The name on this website is Mayo Clinic, and it is run

and written by Mayo Clinic staff. Both bias and

sponsorship occur on this site, decreasing the level of

credibility and validity. However, they give a disclaimer

that Mayo Clinic does not endorse any companies or

products but that the advertising revenue helps support

their not-for-profit mission. Within their educational

material, they provide a link to products and services to

the Mayo Clinic store. They also provide a link to request

an appointment at Mayo Clinic. Off to the side of the

educational material, they have an advertising box that is

advertising Aetna Medicare Solutions and a clothing

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company. While the Aetna advertisement is geared

toward healthcare, since it is on a healthcare site, the

clothing company advertisement seems to be based on

my recent searches and unrelated to the website. The bias

and sponsorship occurring on this site decrease the

credibility and validity. However, the disclaimer helps

reduce the impact of the bias and sponsorship.

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Accuracy and Evidence

(Mayo Clinic, 2022)

The information is accurate. It is backed by 11 credible

references that have all been published in the last two

years. They all come from medical journals or other

credible sources like the American College of

Obstetricians and Gynecologists (ACOG). The intended

audience is their patient population, specifically women

of childbearing age and those who know or care for

someone with PCOS. It is also intended for English-

language readers. I do believe that this information is

appropriate for the intended population. There is also a

disclaimer about when to see a doctor, as well as a link

provided to request an appointment at Mayo Clinic. I

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believe this additional information adds credibility and

validity to the site. The site clearly lists certain criteria to

look for to help determine when one would need to see a

doctor.

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Multimedia or Applications

 Functioning hyperlinks

 Link to references

 Link to appointment requests

 Link to women’s health products sold by Mayo Clinic

 Link to another educational page regarding diagnosis and treatment

(Mayo Clinic, 2022)

Each of the multimedia and applications tools work. The

site provides a few hyperlinks to appointment requests,

women’s health products for sale at Mayo Clinic, PCOS

care at Mayo Clinic, and the opportunity to subscribe to

their emails. Each of these hyperlinks is functioning

correctly. The website is well-organized and easy to

navigate. This helps to provide credibility and validity to

the site.

The site also provides a link to another Mayo Clinic

educational page about diagnosis and treatment of PCOS,

including a section on preparing for an appointment and a

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list of doctors and specialists that treat PCOS. The

references section also provides a link to each of the

references, which helps make the information more

accessible and trustworthy.

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Protection and Security

 Privacy policy

 “Contact Us” hyperlink

 Inquiries directed to appointment request function

(Mayo Clinic Staff, 2022)

This site has a privacy policy that lays out the

information they collect and the reasons for it. They

collect information given to them, personal data, through

filling out forms, surveys, or transactions. They also

collect usage data from their site. They only disclose

personal data for a buyer in the event of a merger, with

consent to fulfill the purpose for which it was provided,

to comply with laws, and other necessary reasons. They

also use encryption technology to provide safety and

security for information provided.

The website users are able to use a “contact us”

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hyperlink. This hyperlink directs users to a page with

multiple options for contact including telephone,

addresses, and phone numbers for multiple locations.

This provides accessibility, increasing the credibility and

validity of the site.

They do not allow users to post to the website or ask a

question. Instead, they direct inquiries to their

appointment request function. This increases credibility

and validity because it encourages proper care and

reduces the misinformation available by unsupervised

commenters on the site.

I believe these functions and safety measures do help

provide a level of credibility and validity. While there are

always privacy risks when using the internet, they do take

measures to help protect information and reduce the risks.

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Summary

Literacy Health literacy

Readability Tool

NIH Framework

Credibility Validity

Mayo Clinic’s educational material on PCOS was

reviewed for literacy, health literacy, NIH Framework,

credibility and validity. This material was evaluated using

a Readability tool to determine the literacy level. The

literacy level was determined to be fairly good for the

intended audience. Health literacy was also discussed and

was determined to be appropriate as it is written for the

lay person and not medical professionals. Using the NIH

framework, the site was evaluated for credibility and

validity and was determined to be appropriate for its

intended audience. Overall, I believe this material is a

good source of information for the target population.

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References

CDC. (2022, February 2). What is health literacy? Take action. Find out. Centers for Disease Control and Prevention.

https://www.cdc.gov/healthliteracy/learn/index.html

Mayo Clinic. (n.d.). About Mayo Clinic . Retrieved December 5, 2022, from https://www.mayoclinic.org/about-mayo-clinic

Mayo Clinic. (2022, September 8). Polycystic ovary syndrome (PCOS) . Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/pcos/symptoms-

causes/syc-20353439

Mayo Clinic Staff. (2018, December 1). Content development policy—About this site—Mayo clinic. Mayo Clinic. https://www.mayoclinic.org/about-this-

site/product-development-policy

Mayo Clinic Staff. (2022, January 27). Privacy policy—About this site—Mayo clinic. Mayo Clinic. https://www.mayoclinic.org/about-this-site/privacy-

policy

National Institutes of Health. (2022, May 4). How to evaluate health information on the internet: Questions and answers.

https://ods.od.nih.gov/HealthInformation/How_To_Evaluate_Health_Information_on_the_Internet_Questions_and_Answers.aspx

CDC. (2022, February 2). What is health literacy? Take

action. Find out. Centers for Disease Control and

Prevention.

https://www.cdc.gov/healthliteracy/learn/index.html

Mayo Clinic. (n.d.). About Mayo Clinic . Retrieved

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December 5, 2022, from

https://www.mayoclinic.org/about-mayo-clinic

Mayo Clinic. (2022, September 8). Polycystic ovary

syndrome (PCOS) . Mayo Clinic.

https://www.mayoclinic.org/diseases-

conditions/pcos/symptoms-causes/syc-20353439

Mayo Clinic Staff. (2018, December 1). Content

development policy—About this site—Mayo clinic. Mayo

Clinic. https://www.mayoclinic.org/about-this-

site/product-development-policy

Mayo Clinic Staff. (2022, January 27). Privacy policy—

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About this site—Mayo clinic. Mayo Clinic.

https://www.mayoclinic.org/about-this-site/privacy-

policy

National Institutes of Health. (2022, May 4). How to

evaluate health information on the internet: Questions

and answers.

https://ods.od.nih.gov/HealthInformation/How_To_Evalu

ate_Health_Information_on_the_Internet_Questions_and

_Answers.aspx

National Literacy Trust. (n.d.). What is literacy? National

Literacy Trust. Retrieved December 5, 2022, from

https://literacytrust.org.uk/information/what-is-literacy/

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Readability test. (n.d.). WebFX. Retrieved December 6,

2022, from https://www.webfx.com/tools/read-able/

Sbaffi, L., & Rowley, J. (2017). Trust and credibility in

web-based health information: A review and agenda for

future research. Journal of Medical Internet Research,

19(6), e218. https://doi.org/10.2196/jmir.7579

University of Maryland. (n.d.). What is a “good” source?

Determining the validity of evidence: Professional

writing program. Retrieved December 7, 2022, from

https://umd.instructure.com/courses/1082806/pages/what

-is-a-good-source-determining-the-validity-of-evidence

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Whitchurch, M. (2022, July 6). Subject guides: Step-by-

step guide & research rescue: evaluating credibility.

https://guides.lib.byu.edu/c.php?g=216340&p=1428399

Wylie, A. (2021, August 1). What’s the latest U.S. literacy

rate? Wylie Communications, Inc.

https://www.wyliecomm.com/2021/08/whats-the-latest-u-

s-literacy-rate/

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References continued

National Literacy Trust. (n.d.). What is literacy? National Literacy Trust. Retrieved December 5, 2022, from https://literacytrust.org.uk/information/what-

is-literacy/

Readability test. (n.d.). WebFX. Retrieved December 6, 2022, from https://www.webfx.com/tools/read-able/

Sbaffi, L., & Rowley, J. (2017). Trust and credibility in web-based health information: A review and agenda for future research. Journal of Medical

Internet Research, 19(6), e218. https://doi.org/10.2196/jmir.7579

University of Maryland. (n.d.). What is a “good” source? Determining the validity of evidence: Professional writing program. Retrieved December 7,

2022, from https://umd.instructure.com/courses/1082806/pages/what-is-a-good-source-determining-the-validity-of-evidence

Whitchurch, M. (2022, July 6). Subject guides: Step-by-step guide & research rescue: evaluating credibility.

https://guides.lib.byu.edu/c.php?g=216340&p=1428399

Wylie, A. (2021, August 1). What’s the latest U.S. literacy rate? Wylie Communications, Inc. https://www.wyliecomm.com/2021/08/whats-the-latest-u-s-

literacy-rate/

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