{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T17:42:14Z","timestamp":1780076534644,"version":"3.54.0"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Background The high prevalence of limited health literacy among patients threatens the success of secure electronic messaging between patients from diverse populations and their providers.<\/jats:p>\n               <jats:p>Objective The purpose of this study is to generate hypotheses about the readability of patient and provider electronic messages.<\/jats:p>\n               <jats:p>Methods We collected 31 patient-provider e-mail exchanges ( n = 119 total messages) from a safety-net primary care clinic. We compared the messages\u2019 mean word count and Flesch-Kincaid Grade Levels (FKGLs), calculated the frequency of provider messages below an FKGL = 8, and assessed readability concordance between patients\u2019 and providers\u2019 messages.<\/jats:p>\n               <jats:p>Results Patients used more words in their initial e-mails compared to providers, but the FKGLs were similar, and 68% of provider messages were written below an FKGL = 8. Of 31 exchanges, 9 (29%) contained at least one patient message with an FKGL &amp;gt; 3 grade levels lower than the corresponding provider message(s).<\/jats:p>\n               <jats:p>Conclusion Our study demonstrates that most providers are able to respond to patient electronic messages with a matching reading level.<\/jats:p>","DOI":"10.1093\/jamia\/ocv087","type":"journal-article","created":{"date-parts":[[2015,7,16]],"date-time":"2015-07-16T01:50:17Z","timestamp":1437011417000},"page":"202-206","source":"Crossref","is-referenced-by-count":8,"title":["Readability assessment of patient-provider electronic messages in a primary care setting"],"prefix":"10.1093","volume":"23","author":[{"given":"Jacob B","family":"Mirsky","sequence":"first","affiliation":[{"name":"University of California, San Francisco, School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Tieu","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, University of California, San Francisco, School of Medicine and UCSF Center for Vulnerable Populations at San Francisco General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney","family":"Lyles","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, University of California, San Francisco, School of Medicine and UCSF Center for Vulnerable Populations at San Francisco General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Urmimala","family":"Sarkar","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, University of California, San Francisco, School of Medicine and UCSF Center for Vulnerable Populations at San Francisco General 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Scientific Affairs, American Medical Association","volume":"281","author":"Health literacy: report of the Council on Scientific Affairs","year":"1999","journal-title":"JAMA."},{"key":"2020110613031676400_ocv087-B12","article-title":"A mixed-methods study of patient-provider e-mail content in a safety-net setting","author":"Jacob Mirsky","year":"2015","journal-title":"J Health Commun."},{"key":"2020110613031676400_ocv087-B13","author":"Kincaid"},{"issue":"3","key":"2020110613031676400_ocv087-B14","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1177\/1090198105277329","article-title":"A systematic review of readability and comprehension instruments used for print and web-based cancer information","volume":"33","author":"Friedman","year":"2006","journal-title":"Health Educ Behav."},{"issue":"9","key":"2020110613031676400_ocv087-B15","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1007\/s11606-012-2046-0","article-title":"Readability of patient education materials 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