Assessing Reading Grade Level of Online Mental Health Materials: Practical and Methodological Considerations

Dorothy D Skierkowski, University of Rhode Island


The Internet can be conceptualized as a useful tool for providing people with a vast array of mental health information at the click of a button. Despite this plethora of available knowledge, oftentimes the information that is presented on popular physical and mental health websites is written for an audience with a reading grade level higher than the national 6 th-8th grade average. Although the CDC has developed guidelines for developing online patient health materials that account for disparities in health literacy across various socio-demographic groups, adherence to these guidelines is largely poor and minimally monitored. This discrepancy can have broad public health implications when considering the suggested relationship between low health literacy and poor health outcomes. The present study systematically examines grade level readability scores for online information describing sixteen different mental health disorders, extracted from six highly utilized mental health websites, using a general estimating equations approach. In order to best understand this problem, two manuscripts are presented herein. The first manuscript focuses on public health concerns associated with higher than average reading grade level estimates of online mental health materials, whereas the second manuscript focuses on the methodology used to make these determinations. Results suggest that reading grade level estimates of publicly available online mental health information are much higher than the 6th – 8th grade levels suggested by the CDC, such that the average reader will not be able to effectively understand the selected text. This finding can have broad implications from a public health perspective and maintain existing health disparities.

Subject Area

Mental health|Literacy|Reading instruction|Public health

Recommended Citation

Dorothy D Skierkowski, "Assessing Reading Grade Level of Online Mental Health Materials: Practical and Methodological Considerations" (2017). Dissertations and Master's Theses (Campus Access). Paper AAI10242375.