Simplifying informed consent as a universal precaution.

One barrier to participating in clinical research is that patients with low literacy skills (1 in 5 US adults) may struggle to understand the informed consent document (ICD). Writing consents using health literacy and plain language guidelines including simplified syntax and semantics can increase understandability and facilitate inclusivity of research populations with literacy challenges. Our study aim was to evaluate a simplified ICD for understandability while considering factors known to relate to comprehension (reading skills and working memory). We performed an on-line survey of 192 adults ages 18-77 in Georgia. Participants performed significantly better on the simplified ICD test. We built an additional model with all version x measure interactions (i.e., age, sex, race, urbanicity, GMVT, WM). This model did not significantly improve model fit, F < 1.00, suggesting that individual differences did not moderate the effect of simplification. Our findings suggest that using plain language and simplified syntax and semantics in ICD as a universal precaution may reduce cognitive reading burden for adults regardless of differences in reading skill or working memory. Increasing understandability in ICD may help improve targets for clinical trial enrollment.

Leveraging a multidimensional linguistic analysis of constructed responses produced by college readers.

The goal of this study was to assess the relationships between computational approaches to analyzing constructed responses made during reading and individual differences in the foundational skills of reading in college readers. We also explored if these relationships were consistent across texts and samples collected at different institutions and texts. The study made use of archival data that involved college participants who produced typed constructed responses under thinking aloud instructions reading history and science texts. They also took assessments of vocabulary knowledge and proficiency in comprehension. The protocols were analyzed to assess two different ways to determine their cohesion. One approach involved assessing how readers established connections with themselves (i.e., to other constructed responses they produced). The other approach involved assessing connections between the constructed responses and the texts that were read. Additionally, the comparisons were made by assessing both lexical (i.e., word matching) and semantic (i.e., high dimensional semantic spaces) comparisons. The result showed that both approaches for analyzing cohesion and making the comparisons were correlated with vocabulary knowledge and comprehension proficiency. The implications of the results for theory and practice are discussed.

Materials Matter: An Exploration of Text Complexity and Its Effects on Middle School Readers' Comprehension Processing.

Purpose Complex features of science texts present idiosyncratic challenges for middle grade readers, especially in a post-Common Core educational world where students' learning is dependent on understanding informational text. The primary aim of this study was to explore how middle school readers process science texts and whether such comprehension processes differed due to features of complexity in two science texts. Method Thirty 7th grade students read two science texts with different profiles of text complexity in a think-aloud task. Think-aloud protocols were coded for six comprehension processes: connecting inferences, elaborative inferences, evaluative comments, metacognitive comments, and associations. We analyzed the quantity and type of comprehension processes generated across both texts in order to explore how features of text complexity contributed to the comprehension processes students produced while reading. Results Students made significantly more elaborative and connecting inferences when reading a text with deep cohesion, simple syntax, and concrete words, while students made more evaluative comments, paraphrases, and metacognitive comments when reading a text with referential cohesion, complex syntax, and abstract words. Conclusions The current study provides exploratory evidence for features of text complexity affecting the type of comprehension processes middle school readers generate while reading science texts. Accordingly, science classroom texts and materials can be evaluated for word, sentence, and passage features of text complexity in order to encourage deep level comprehension of middle school readers.