4. Discussion and conclusion
4.1. Discussion
The readability of sexual health leaflets was poor as the average
reading grade was grade 9 with scores as high as grade 12 and 13.
As an average guide written materials should be between grades 6–
8 although some authors have recommended lower levels of
grades 5–6 [16]. This mismatch between reading grades of leaflets
and recommended reading grades is supported by older studies in
other health topics [16,17]. This is a major challenge as sexual
health leaflets do not match the reading levels of the population
they are designed for, yet health practitioners still continue to
design and distribute these leaflets. A range of reasons have been
suggested as to why health professionals continue to create
resources not fit for practice. These include organizational policy,
assumptions around who and how leaflets will be used, and lack of
knowledge of optimum readability levels [18].
The majority of leaflets performed well in a number of areas,
however 41% of leaflets were only deemed ‘acceptable’. Given the
amount of best practice guidance available [see 11,15,16] this
number is surprisingly high. As with readability, this figure
suggests either health practitioners find it difficult to locate
guidance on best practice, or the process of putting theory into
practice is challenging in some way.
Leaflets performed well in similar areas, for example, all leaflets
had explicit titles, used subheadings and had content aimed at
increasingknowledgeanddesirablereaderbehavior.Thewritingstyle