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Diabetes education program participants were assessed to determine their reading and comprehension skill levels, and written and oral instructions were evaluated to determine the reading level of information presented in the education program. A significant mismatch was found between the reading and comprehension levels of program participants and the level of oral instruction and printed materials. More than half of the program participants could not fully comprehend educational materials at 5th-grade level, while nearly all written materials and oral instructions were presented at the 9th-grade level or above.
McNeal et al. (Tue,) studied this question.