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Readability was assessed using the SMOG Index and iteratively revised to each lower grade.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measures<\/jats:title>\n                    <jats:p>Primary outcome was knowledge of health conditions. Secondary outcomes were brief knowledge, perceived reading ease, acceptability (i.e., perceived usefulness and likelihood to recommend) and trustworthiness of information.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>2235 participants were randomised and included in the analysis. Mean age was 41\u00a0years and 54.5% identified as female. Low health literacy was identified in 28.2% of participants. We found no evidence of a main effect of grade reading level on knowledge (grade 8: 9.0 (SD\u2009=\u20092.7), grade 10: 9.1 (SD\u2009=\u20092.6), grade 12: 8.9, grade 14: 9.1 (SD\u2009=\u20092.7). Participants with high health literacy had higher knowledge scores overall, however, there was no evidence that health literacy modified the effect of grade reading level. There were no significant differences in any of the secondary outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our study showed no difference in knowledge when grade reading level was manipulated alone. Our findings indicate there is limited value in reducing grade reading level without attention to other health literacy principles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>ANZCTR trial registry number<\/jats:title>\n                    <jats:p>ACTRN12623000224628p.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11606-024-09200-z","type":"journal-article","created":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T12:22:50Z","timestamp":1734697370000},"page":"1820-1828","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["The Readability Study: A Randomised Trial of Health Information Written at Different Grade Reading Levels"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6760-4779","authenticated-orcid":false,"given":"Olivia","family":"Mac","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Ayre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten","family":"McCaffery","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farzaneh","family":"Boroumand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katy","family":"Bell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle M.","family":"Muscat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,12,20]]},"reference":[{"key":"9200_CR1","unstructured":"Brega AG, Barnard J, Mabachi N, Weiss B, DeWalt D, Brach C, et al. 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DMM is supported by an Australian Research Council (ARC) Discovery Early Career Researcher Award (DECRA). OM is supported by a University of Sydney Postgraduate Research Scholarship. The SHeLL Health Literacy Editor is a research tool owned by the University of Sydney. It is sublicensed to Health Literacy Solutions PTY to enable wider public use. DMM, KM and JA are co-directors of Health Literacy Solutions PTY Ltd. DMM, KM and JA take no personal income from Health Literacy Solutions PTY or the Health Literacy Editor.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest:"}},{"value":"The funding organizations had no role in the design and conduct of the study; collection; management, analysis, and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Role of the Funder\/sponsor:"}}]}}