An Exploratory Study Evaluating Health Promotion Materials: What Kinesiology Students Can Learn from Direct versus Indirect Readability Measures

Evaluations of health promotion material readability may often rely on indirect measures, such as reading grade level formulas or tools like the Suitability Assessment of Materials (SAM) rating form. SAM evaluates vocabulary, sentence complexity, and material’s reading grade level (RGL). Research suggests that adult patients/clients typically struggle with health promotion materials above an 8th grade RGL, regardless of their educational attainment. This exploratory study examined whether indirect readability measures derived from the SAM rating form correspond with direct measures of comprehension. The cloze procedure, a direct readability measure, requiring participants to fill in missing words from a passage of text using prior knowledge and surrounding information, was used for comparison. Twelve college students were randomly assigned to read a mock physical activity promotion web article written at either an 8th or 11th grade RGL. The SAM-rated readability of the 8th-grade version was deemed adequate, consistent with its grade level. However, its initial comprehension scores fell within the “not suitable” range and were lower than those of the 11th-grade version. After revision, comprehension scores for the 8th-grade version improved to “adequate,” although its SAM rating remained unchanged. The 11th-grade version was consistently rated adequate by SAM and achieved somewhat adequate comprehension scores. These results suggest that indirect readability measures may not always reflect true reader understanding. Kinesiology students in higher education should be trained to recognize the limitations of indirect readability tools and to incorporate direct measures to ensure health promotion materials they disseminate are easily understood by diverse patient/client populations.