Evaluation of Reading Level of Result Letters Sent to Patients from an Academic Primary Care Practice.

Background: In primary care, low health literacy, particularly reading ability, is associated with worse health outcomes. Most physicians do not receive feedback on the reading levels of written communication that they may provide to patients, including result letters. Objective: Our study compares the readability of result letters, written by resident versus attending physicians, to patients with positive or negative screens for reading ability, as determined by the single-item literacy screener (SILS). Methods: Result letters to 50 patients at high risk and 50 patients at low risk of low reading ability were randomly selected starting from January 1st, 2020 at Albany Medical Center. Flesch-Kincaid Grade Level (FKGL), Gunning Fog Index (GFI), Coleman-Liau Index (CLI), Simple Measure of Gobbledygook (SMOG), and Flesch Reading Ease (FRE) were used to compare the readability of resident versus attending result letters. Results: For all SILS levels, attending physicians wrote result letters at a lower grade level than resident physicians based on the FKGL, GFI, and SMOG indices. The FKGL, GFI, and SMOG readability scores of result letters written to patients with SILS 3-5 were also lower when written by attending physicians compared to resident physicians. Conclusions: Result letters written by attending physicians may be easier to read than result letters written by resident physicians, especially for patients with low reading ability. Future electronic health record (EHR) software should give physicians and providers feedback on the reading level of their written communication.

Seasonal and 2009 Pandemic H1N1 Vaccine Acceptance as a Predictor for COVID-19 Vaccine Acceptance.

The emergence of COVID-19 also began an unprecedented production and distribution of several novel COVID-19 vaccines to combat the pandemic. Unfortunately, with the history of vaccine hesitancy in the United States and abroad, concern remains regarding the ability to vaccinate enough of the population to achieve herd immunity. In this study, 101 adults were surveyed about their vaccine experience in the waiting room of their visit to a Med-Peds clinic in Albany County, NY, to gauge interest in the upcoming rollout of COVID-19 vaccines. Questions included their opinions on seasonal influenza vaccines, the 2009 H1N1 vaccine, and the COVID-19 vaccine. The results of our survey are consistent with previous studies where gaps in acceptance were notable in black populations, lower education, and individuals with public health insurance. Furthermore, 92.9% of respondents who denied getting the 2009 H1N1 pandemic vaccine also did not plan to receive the COVID-19 vaccine (p<0.05), therefore a strong correlation was found between receipt of the previous 2009 H1N1 pandemic vaccine and the COVID-19 vaccine acceptance. The qualitative results of our study revealed that COVID-19 precautions deterred people from receiving the seasonal influenza vaccine, and a lack of information on the COVID-19 vaccine caused hesitancy to receive the vaccine on behalf of patients.