Download Full Text (207 KB)


Far too often in the U.S., healthcare documents are published at a level of reading well above what the intended audience can comprehend. When people cannot comprehend health-related materials, they are said to have low health literacy, which involves the wide range of skills and competencies to comprehend, evaluate and use health information to make informed health-related decisions to lower their health risks. Inability to read patient education materials can lead to poor overall health and high mortality. For this project we partnered with students in UD’s Intensive English Program (IEP), and revised two existing healthcare documents on smoking, a topic that was of interest to them, and made a single document that was more readable and useful for the IEP students. During this project, we tested the readability level of both the original documents and the revised brochure using the Microsoft Word test, SMOG test and the Health Literacy Load Analysis test to ensure the readability level was appropriate for the IEP students who read at a 3rd to 4th grade level to comprehend. Based on the results of our research, we reduced the reading levels of the original documents from a 10th and 11th grade level to a 4th and 7th grade level. We also visited the IEP students twice to collect information that they would like to know about our topic and to field test a draft of our brochure. In the end, our goal was to provide these students with a readable, informative, and useful document that can help them better understand the health effects of smoking, the health risks of secondhand and thirdhand smoke, and the reasons that smokers continue to smoke so that they can take preventative health measures if needed.

Publication Date


Project Designation

Course Project

Primary Advisor

Ann E Biswas

Primary Advisor's Department



Stander Symposium poster


Presenters: Lauren Brooke Alvarez, Jake Michael Knight, Teresa Yuk Yu Wong

Adjusting the existing health documents to raise awareness about health risks of smoking for the Intensive English Program students