“May cause drowsiness – I might get a rash or something?” Qualitative research on the comprehensibility of drug label instructions and the role of health literacy Drug labels instructions are physically attached to each package dispensed to patients and consist of dosage instructions (e.g., ‘Take two capsules twice daily’), auxiliary warnings (e.g., ‘Do not drink alcoholic beverages’) and advices (e.g., ‘Take with food or milk’). They are often misinterpreted which may lead to incorrect drug use. The wordings of instructions are a cause of such misinterpretation, especially for people with limited health literacy. In a qualitative study, we explored pharmacy visitors’ interpretations of drug label instructions and their opinions on potential improvements. Semi-structured interviews were conducted with 39 pharmacy visitors with limited and adequate health literacy. They received seven drug label instructions and explained them in their own words and demonstrated how much and how often they would take the drugs on a timetable. Although pharmacy visitors were able to explain dosage instructions, they often made mistakes in demonstrating them, especially those with limited health literacy. Medical jargon (e.g., ‘drowsiness’) and difficult words (e.g., ‘maximum’) lead to misinterpretations, especially among pharmacy visitors with limited health literacy. When optimizing drug label instructions, a trade-off must be made between the comprehensibility and the nuance of instructions.
Do you get it? Mixed-method monitor for government communications On behalf of the Ministry of the Interior and Kingdom Relations and the Taalunie, the University of Utrecht and the Arnhem-Nijmegen University of Applied Sciences have jointly measured the comprehensibility of government texts. The unique aspect of this study is the combination of three methods: automatic text analysis (LiNT), check interviews (conducted by government communication professionals), and reader surveys (involving readers with different backgrounds and reading abilities). The study provides insight into comprehensibility, applicability and perception of government texts. Over 70 government organizations submitted texts about payment or healthcare that citizens encounter, either on paper or online, during their interactions with the government. The study shows that at least 30 percent of the Dutch population has difficulty understanding and applying the information in the majority of the texts. Unexpected information or an inappropriate tone of voice often led to a negative perception. Here, we show that the combination of research methods is methodologically effective, due to their complementary nature and practical applicability.
LiNT: a readability formula and readability tool This paper introduces a Dutch readability formula and readability tool, LiNT (Leesbaarheidsinstrument voor Nederlandse Teksten). We first relate readability to the broader notion of comprehensibility, and discuss classic problems of readability research. The first and main focus of the paper is the LiNT-formula. We discuss how we prepared 120 texts, collected cloze comprehension data for these texts among 2700 middle school students, extracted text features and derived the LiNT-formula. This formula relates cloze comprehension to four text features, all of which have received support in earlier text comprehension research: word frequency, word concreteness, clause length and dependency length. We next discuss the interpretation of LiNT-scores, and the text complexity levels defined by it. We then examine ten well-known Dutch text genres in terms of LiNT-scores and LiNT-feature scores; and we report how text revisions affect both LiNT-scores and text comprehension levels. Our second topic is a short introduction to the LiNT-tool built around the formula. The tool aims at providing text complexity metrics to communication practitioners. Finally, we discuss whether our formula and tool succeed in avoiding the classic readability research problems, and how they may help to assess readability, diagnose readability problems and choose between text versions.
This study explores knowledge and self-efficacy beliefs about and skills of students from secondary education concerning writing paragraphs. Students in secondary school have to learn how to write coherent paragraphs because coherence within a text contributes to its comprehensibility. To this end four paragraph toolboxes for two genres (informative e-mails and persuasive texts) were developed, both for year-2 students (aged 13-14) and year-5 students (aged 16-17). The toolboxes are designed on the basis of four principles: pay attention to the norms for writing comprehensible paragraphs, start by presenting the genre-specific writing assignment as a whole task, have pupils complete a self-assessment in order to check the comprehensibility of the paragraphs, and work on part tasks. To explore knowledge, self-efficacy beliefs and skills of students, we conducted a questionnaire among 300 students and analysed more than 2100 of their paragraphs to find out if they comply with the paragraph norms. The research results indicate that there is no significant evidence that there exists a causal relation between the use of the developed paragraph toolboxes in education and the increase of knowledge, skills and self-efficacy beliefs. The paper discusses several possible reasons for his outcome.
What role can communication play in solving big societal issues? Communication has served humanity well. It thus makes sense that communication is perceived as a promising instrument for bringing about changes in human behavior that are necessary to solve major problems facing the world. However, to change behavior related to climate change, health, or the environment will require changing deeply held and emotionally charged beliefs. Recent research questions the ability of persuasive messages to bring about such changes: because the information differs from one's existing beliefs, the message is often dismissed as unbelievable; and even if people are willing to look at the arguments, many in most cases lack the ability to appreciate those arguments. And those who are able to do so, are inclined to evaluate these arguments more critically. Communication probably can play an important role in bringing about the necessary changes but not as an instrument in itself.
Effects of innovative formulation education for 3rd and 4th-year students from higher secondary education. This article discusses the effects of a renewed module for formulating education for 3rd- and 4th-year-students from higher secondary education. The renewed module focused on language proficiency and language awareness. During the lessons students learn to work with writing style strategies which help them to make informed formulation choices to solve rhetorical problems; they learn to use 'grammar for writing'. The students also learn to reflect on the effects of their formulations on the reader. Two cohorts of students took part in the intervention. The control cohort followed the regular lessons which are about learning to solve grammatical erros in de contextualized sentences. The experimental cohort received instructions via the renewed lesson series. The students of both cohorts wrote two texts both before and after their lessons formulation. In addition, a questionnaire was administered targeting their appreciation of the lessons and their stylistic awareness. The texts that students wrote were analysed on the use of writing style strategies. The results of the questionnaire show that students of the experimental cohort are significantly more positive about the renewed lessons and that the renewed lessons contributed to their stylistic awareness. In addition, the text analyses showed that students following the renewed lessons significantly used more writing style strategies. The conclusion of this study is that lessons which focus on writing style strategies and grammar for writing can have a significant impact on the writing style of students.
Concreteness of texts: concreteness scores and a measuring tool Experimental research into the effects of concreteness on comprehensibility, interestingness and persuasiveness of texts is often carried out by comparing versions of texts that differ in terms of concreteness. However, in previous studies concreteness has been manipulated in various ways, making it difficult to compare the experimental outcomes. Therefore, Brysbaert et al. (2014) developed a list of concreteness scores for 30,000 words, based on judgements of students. This list helps researchers to compare the concreteness of texts that have been manipulated for experimental research. Nevertheless, Brysbaert et al.'s (2014) list is incomplete, in the sense that it lacks homonyms, multiword expressions, neologisms and proper names. We have collected concreteness scores for words and word groups in these categories to supplement the 'Brysbaert' list. We have also developed the TABLET tool, which gives words in a text a part-of-speech tag, and then searches for the lemma form of the words in the list of concreteness scores as collected by Brysbaert et al. (2014) and us. This tool facilitates the process of determining and manipulating the concreteness of (parts of) texts, and can be used freely by researchers.
