Assessing Materials

A variety of tools and guidelines have been developed to aid in the assessment of health materials for factors related to health literacy. Descriptions and links to several of these are provided below.

Assessment Tools

The CDC Clear Communication Index, CDC’s Office of the Associate Director for Communication. This 20-item research-based index is intended for use in the development and assessment of public health communication materials that are clear and can be easily understood by the public. The CDC has developed an Index Widget, which can be incorporated into other websites.

The Patient Education Materials Assessment Tool (PEMAT), S. Shoemaker, M. Wolf and C. Brach, Agency for Healthcare Research and Quality. The PEMAT was developed by the AHRQ to allow for the systematic assessment of the understandability and actionability of various patient education materials. Two different versions of the PEMAT exist: one for the evaluation of printable materials and one for the evaluation of audiovisual materials.

The PMOSE/IKIRSCH Document Readability Formula, P. Mosenthal and I. Kirsch. This innovative assessment tool focuses on documents-materials in the form of lists, charts and graphs. Unlike prose, which is full sentences, documents provide different challenges based on format. This formula offers a scoring mechanism for assessing documents.

The SMOG, G. McLaughlin. This tool is for assessing the reading level of prose [material in sentence and paragraph format] and is very useful for field work.  Click here for an overview of the SMOG and directions for use. There is also an online calculator. This Java application calculates a SMOG score for any length of text that is typed or pasted in.  It can be accessed at

The SAM, Doak, Doak and Root.  The SAM, developed by Len and Ceci Doak, offers a tool for assessing texts. The SAM enables reviewers to move beyond mere readability assessments and consider the many important aspects of materials such as organization format, design and culture-that ease or hinder reading, comprehension and use. Information on SAM can be found on pg 51-60 of the Doak, Doak and Root book Teaching Patients with Low Literacy Skills, Second Edition.

General Guidelines

Additional Resources

Click here for additional resources on creating and assessing web and print materials.