The effects of two health information texts on patient recognition memory: a randomized controlled trial

Abstract

Objective: To compare the effects of two health information texts on patient recognition memory, a key aspect of comprehension.

Methods: Randomized controlled trial (N=60), comparing the effects of experimental and control colorectal cancer (CRC) screening texts on recognition memory, measured using a statement recognition test, accounting for response bias (score range -0.91 to 5.34). The experimental text had a lower Flesch-Kincaid reading grade level (7.4 versus 9.6), was more focused on addressing screening barriers, and employed more comparative tables than the control text.

Results: Recognition memory was higher in the experimental group (2.54 versus 1.09, t=-3.63, P=0.001), including after adjustment for age, education, and health literacy (β=0.42, 95% CI: 0.17, 0.68, P=0.001), and in analyses limited to persons with college degrees (β=0.52, 95% CI: 0.18, 0.86, P=0.004) or no self-reported health literacy problems (β=0.39, 95% CI: 0.07, 0.71, P=0.02).

Conclusion: An experimental CRC screening text improved recognition memory, including among patients with high education and self-assessed health literacy.

Practice implications: CRC screening texts comparable to our experimental text may be warranted for all screening-eligible patients, if such texts improve screening uptake.

Keywords: Colorectal neoplasms; Early detection of cancer; Educational status; Health literacy; Mass screening; Mental recall; Patient education as topic; Patient education handout; Randomized controlled trial; Reading.