and
its readability could be determined by using the SMOG
formula. The National Work Group on Literacy and Health
recommends that material be written at or below the 6thgrade
level,1,26 because material written at higher levels is
less likely to be read or understood. Developing patient
information at a low readability level is necessary but not
sufficient to improve comprehension. Other methods of
communication, and written information that uses figures,
pictograms, large font, and other characteristics, may also
improve comprehension.27 Future directions should include
the development and testing of patient information materials
written at a low reading level