Readability of hearing related internet information in traditional Chinese.

Abstract

Hearing impairment is a prevalent issue that affects many people. However, the prevalence and consequences of hearing impairment may be prevented or managed through proper understanding of health information (El Dib & Mathew, 2012; Tsukada & Sakakibara, 2008). Now, with the advances in technology, the Internet has become a popular and convenient source for health information (Fox, 2006; Siow et al., 2003; Y. Y. Yan, 2010). Despite the convenience that is brought about by the Internet, the majority of health information can be too difficult to understand (Friedman & Hoffman-Goetz, 2006; Laplante- Levésque & Thorén, 2015). To examine this issue, readability scores have often been used to assess the reading difficulty of health information. Readability scores are calculated by readability formulas, based on measuring quantifiable textual features that contribute to reading difficulty (Dubay, 2004). For online hearing health information, most of the focus has been centered on English websites and have found them to be written at levels too difficult for the general public (Laplante-Levésque & Thorén, 2015; Svider et al., 2013). However, there are no studies on Chinese online hearing health information and yet Chinese has the largest number of native speakers in the world (Paul, 2016). Due to the limited Chinese readability formulas available, this study focused on Traditional Chinese online hearing health information using the Jing (Jing ffl, 1995) and CRIE 1.0 (Sung et al., 2016) readability

formulas. A panel of 39 people with no expertise in the hearing health profession and who spoke Mandarin as their primary language, were recruited to identify keywords for the Internet search. Keywords that were mentioned more than once and returned relevant results were £}5R (ear),�]](hearing),ll�� (hearing aids),m� (hard of hearing),�7F� � (can’t hear properly). These keywords were entered into google.com.tw (Google Taiwan) and google.com.hk (Google Hong Kong) to obtain websites for readability analysis. After matching against the inclusion and exclusion criteria, 31 websites were included in the readability analysis. Health information is recommended to be written at the 6th reading grade level and according to the CRIE 1.0 formula, 25% of the websites had a reading grade level greater than 6. However, according to the Jing formula, 81% of the websites had a reading grade level greater than 6. When websites were sorted according to organization type, there was not a significant difference in reading grade level between the different type of organizations. Readability can be improved primarily by reducing the length of the paragraph and using more common characters and words. Future directions include performing readability analysis for online hearing health information written in Simplified Chinese, as the majority of Chinese speakers use Simplified Chinese. This is currently not feasible as there are no reliable readability formulas for Simplified Chinese. Also, to supplement the findings from this study, the websites should be assessed for their suitability and quality.