Health info too small to read
Most pamphlets containing health facts don't meet the CNIB's legibility guidelines, study finds
By Chris Zdeb, Edmonton Journal
Health pamphlets are more about looks than legibility, it seems: Most can't be read by the people they're designed for.
A new University of Alberta study found only 23 per cent of 388 leaflets collected from pharmacies and clinics in the metro Edmonton area met the legibility recommendations of the Canadian National Institute for the Blind.
Cheryl Sadowski, an associate professor in the faculty of pharmacy and pharmaceutical sciences, who did the study, suspected as much. Working at a seniors' clinic part time, she's watched printed information on subjects such as safety, and more sensitive topics such as elder abuse and erectile dysfunction, being handed out to seniors who'd take one look and say, 'Oh, I can't even read this.' Some bring in the brochures or information sheets the pharmacy gave them with their medication and admit they've never read them because the print is too small.
"This is a generation that doesn't do a lot of advocacy for themselves, doesn't complain, so when we get them at the clinic complaining, you know the problem must be really bad," Sadowski says.
"We know that starting in your 40s, people's vision changes as they get older, yet so much of the printed material made available to older adults isn't taking that into consideration."
It's an issue that's growing in importance as the population ages, says Ellie Shuster, CNIB director of regional communications. The CNIB has been advocating for larger type for years.
"We believe 12-point is sort of the minimum type size for an aging demographic. Fourteen point is the standard at the CNIB."
( The Journal uses 10-point type.)
Sadowski's study found only 33 per cent of the brochures collected by pharmacy student Adriana Chubaty were printed in at least 12-point and most were printed in smaller than 10-point.
One leaflet providing information for patients with cataracts and age-related macular degeneration used a squint-inducing six-point type size, the size used in the Edmonton and area phone book.
"In my opinion, people shrink the type to fit the amount of space they have to print on and it's cheaper to do a three-panel brochure than a four-panel brochure," Shuster says.
Brian Steeves, one of several people waiting for a downtown medical clinic to open one day last week, says he's had to use a magnifying glass to read some of the information that comes with prescription medication.
"I think the print should be read with your naked eye, never mind glasses," he says.
Lyn Zinkiew says sometimes she's had to read prescription information to her boyfriend, who finds the print too small.
"I've had some elderly people who have stopped me in stores to help them read something on over-the-counter medication bottles," Zinkiew says.
"Why can't they make the print bigger for something as important as medication?" Zinkiew says. "They should have better leaflets to hand out or a handout with bigger print that you can get at the counter when you purchase the medication."
If people can't read information easily and quickly, they may not bother and they could miss something important, such as which medications shouldn't be taken with others. Their doctor or pharmacist may have told them, but having
something written is useful to refer to in case they forget.
With hundreds of pamphlets on pharmacy racks, it's understandable that pharmaceutical companies want an eye-catching design that will make theirs stand out, Sadowski says.
"Lots of pamphlets are stylized, almost marketing-driven rather than information-focused," she explains. "But if you want to educate people about reflux, for example, you're more likely to sell your reflux drug to people that can read about it. I think most of the producers of this information haven't really thought through that the people their literature is aimed at can't read it."
There's quite a bit of research these days on health literacy. People are concerned about people who speak English as a second language, the jargon used in medical settings, but it doesn't matter if you make something health-literate if the print is too small to read or printed on a busy background," Sadowski says.
Australia has legislation that stipulates how health literature must be written, but it hasn't worked perfectly, Sadowski says. Neither she nor Chubaty thinks similar legislation is necessary in Canada at this point, but guidelines are difficult to find, and the organizations that developed them need to make them more accessible for companies publishing leaflets, they say.
If all else fails, there's always the aging boomers who, unlike their elders, are less likely to tolerate pamphlets they can't read, and demand better, Sadowski says.
The study was published in the May online edition of Age and Aging, the journal of the British Geriatric Society.
Health Canada is developing guidelines for the labelling of pharmaceutical products. It is also looking at package design and look-alike/ sound-alike health product names to help prevent confusion over medication, a department spokesperson says.
© Copyright (c) The Edmonton Journal
By Chris Zdeb, Edmonton Journal
Health pamphlets are more about looks than legibility, it seems: Most can't be read by the people they're designed for.
A new University of Alberta study found only 23 per cent of 388 leaflets collected from pharmacies and clinics in the metro Edmonton area met the legibility recommendations of the Canadian National Institute for the Blind.
Cheryl Sadowski, an associate professor in the faculty of pharmacy and pharmaceutical sciences, who did the study, suspected as much. Working at a seniors' clinic part time, she's watched printed information on subjects such as safety, and more sensitive topics such as elder abuse and erectile dysfunction, being handed out to seniors who'd take one look and say, 'Oh, I can't even read this.' Some bring in the brochures or information sheets the pharmacy gave them with their medication and admit they've never read them because the print is too small.
"This is a generation that doesn't do a lot of advocacy for themselves, doesn't complain, so when we get them at the clinic complaining, you know the problem must be really bad," Sadowski says.
"We know that starting in your 40s, people's vision changes as they get older, yet so much of the printed material made available to older adults isn't taking that into consideration."
It's an issue that's growing in importance as the population ages, says Ellie Shuster, CNIB director of regional communications. The CNIB has been advocating for larger type for years.
"We believe 12-point is sort of the minimum type size for an aging demographic. Fourteen point is the standard at the CNIB."
( The Journal uses 10-point type.)
Sadowski's study found only 33 per cent of the brochures collected by pharmacy student Adriana Chubaty were printed in at least 12-point and most were printed in smaller than 10-point.
One leaflet providing information for patients with cataracts and age-related macular degeneration used a squint-inducing six-point type size, the size used in the Edmonton and area phone book.
"In my opinion, people shrink the type to fit the amount of space they have to print on and it's cheaper to do a three-panel brochure than a four-panel brochure," Shuster says.
Brian Steeves, one of several people waiting for a downtown medical clinic to open one day last week, says he's had to use a magnifying glass to read some of the information that comes with prescription medication.
"I think the print should be read with your naked eye, never mind glasses," he says.
Lyn Zinkiew says sometimes she's had to read prescription information to her boyfriend, who finds the print too small.
"I've had some elderly people who have stopped me in stores to help them read something on over-the-counter medication bottles," Zinkiew says.
"Why can't they make the print bigger for something as important as medication?" Zinkiew says. "They should have better leaflets to hand out or a handout with bigger print that you can get at the counter when you purchase the medication."
If people can't read information easily and quickly, they may not bother and they could miss something important, such as which medications shouldn't be taken with others. Their doctor or pharmacist may have told them, but having
something written is useful to refer to in case they forget.
With hundreds of pamphlets on pharmacy racks, it's understandable that pharmaceutical companies want an eye-catching design that will make theirs stand out, Sadowski says.
"Lots of pamphlets are stylized, almost marketing-driven rather than information-focused," she explains. "But if you want to educate people about reflux, for example, you're more likely to sell your reflux drug to people that can read about it. I think most of the producers of this information haven't really thought through that the people their literature is aimed at can't read it."
There's quite a bit of research these days on health literacy. People are concerned about people who speak English as a second language, the jargon used in medical settings, but it doesn't matter if you make something health-literate if the print is too small to read or printed on a busy background," Sadowski says.
Australia has legislation that stipulates how health literature must be written, but it hasn't worked perfectly, Sadowski says. Neither she nor Chubaty thinks similar legislation is necessary in Canada at this point, but guidelines are difficult to find, and the organizations that developed them need to make them more accessible for companies publishing leaflets, they say.
If all else fails, there's always the aging boomers who, unlike their elders, are less likely to tolerate pamphlets they can't read, and demand better, Sadowski says.
The study was published in the May online edition of Age and Aging, the journal of the British Geriatric Society.
Health Canada is developing guidelines for the labelling of pharmaceutical products. It is also looking at package design and look-alike/ sound-alike health product names to help prevent confusion over medication, a department spokesperson says.
© Copyright (c) The Edmonton Journal
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