The Patient Education Materials Assessment Tool (PEMAT) and User’s Guide

Domain: Understandability

Topic: Organization

Item 8: The material breaks or "chunks" information into short sections (P and A/V)

Ratings: Disagree = 0       Agree = 1    Very short material = N/A

Not Applicable

Choose N/A if the material meets the definition of a very short material:

  • Printable (P): A very short material is defined as a material with two or fewer paragraphs and no more than 1 page in length.
  • Audiovisual (A/V): A very short material is defined as a video or multimedia presentation that is under 1 minute or a multimedia material that has 6 or fewer slides or screenshots.
Explanation

The material should break up information into sections or "chunks" of information that are relatively short to prevent information overload and to make the content easier to understand. Similarly, longer lists need to be broken into smaller chunks as well.

The audiovisual material should also be broken into "chunks," which can be accomplished with the narrator introducing a new section (e.g., now we're going to talk about X), or text or a screenshot to break up the information presented.

Examples
CHOOSE "AGREE" —
Chunking
CHOOSE "DISAGREE" —
No chunking

Understanding High Blood Sugar

Where blood sugar comes from...
Blood sugar comes from the food you eat and drink.

Why insulin is important...
Insulin turns blood sugar into energy—so you have more pep and don't feel tired all the time.

Why your blood sugar goes high...
When you don't have enough insulin, the sugar stays in your blood. Then your blood sugar goes higher than it should.

Understanding Diabetes

Your body needs sugar for energy. It gets sugar from the food you eat and drink. The insulin your body makes helps turn blood sugar into energy. When your body does not make enough insulin, it cannot get energy from the sugar. Without insulin, the sugar stays in your blood. Then your blood sugar goes too high and you feel tired.

Taken from Pfizer, Principles for Clear Health Communication. 2nd Edition.
http://aspiruslibrary.org/literacy/PfizerPrinciples.pdf. Used with permission.

 

CHOOSE "AGREE" —
List broken into "chunks
"
CHOOSE "DISAGREE" —
Long list

Possible migraine triggers:

  • Certain foods eaten 24 hours before the attack:
    • Aged cheese (such as cheddar, provolone).
    • Chocolate.
    • Citrus fruits (such as oranges, grapefruit).
    • Nuts.
    • Monosodium glutamate (MSG is often added to Asian food and some packaged foods).
    • Nitrites (found in preserved meats such as bacon, ham, and lunch meats).
  • Certain beverages drunk 24 hours before the attack:
    • Alcohol (especially red wine).
    • Drinks with caffeine (such as coffee, tea, cola).
  • Changes in daily activities:
    • Stress.
    • Skipping meals.
    • Too much/too little sleep.
    • Travel to different altitudes.
  • Hormonal changes:
    • Menstruation.
    • Pregnancy.
    • Menopause.

Possible migraine triggers:

  • Aged cheese (such as cheddar, provolone).
  • Chocolate.
  • Citrus fruits (such as oranges, grapefruit).
  • Alcohol (especially red wine).
  • Caffeine: coffee, tea, cola.
  • Nuts.
  • Monosodium glutamate (MSG is often added to Asian food and some packaged foods).
  • Nitrites (found in preserved meats such as bacon, ham, and lunch meats).
  • Stress.
  • Skipping meals.
  • Too much/too little sleep.
  • Travel to different altitudes.
  • Menstruation.
  • Pregnancy.
  • Menopause.

Taken from Pfizer, Principles for Clear Health Communication. 2nd Edition.
http://aspiruslibrary.org/literacy/PfizerPrinciples.pdf. Used with permission.

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Item 9: The material's sections have informative headers (P and A/V)

Ratings: Disagree = 0       Agree = 1    Very short material = N/A

Not Applicable

Choose N/A if the material meets the definition of a very short material:

  • Printable (P): A very short material is defined as a material with two or fewer paragraphs and no more than 1 page in length.
  • Audiovisual (A/V): A very short material is defined as a video or multimedia presentation that is under 1 minute or a multimedia material that has 6 or fewer slides or screenshots.
Explanation

Headings should be specific and let the user know what to expect in that section.

Examples

CHOOSE "AGREE"—Informative header: Why you should wear your seatbelt
CHOOSE "DISAGREE"—Poor header: Seatbelts

CHOOSE "AGREE"—Informative header: Medicines for your diabetes
CHOOSE "DISAGREE"—Poor header: Medicines

CHOOSE "AGREE"—Informative header: Safe cooking temperatures
CHOOSE "DISAGREE"—Poor header: Temperatures

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Item 10: The material presents information in a logical sequence (P and A/V)

Ratings: Disagree = 0       Agree = 1

Explanation

The information in a material should be presented in an order that makes sense to the user. The information should build in a natural way. A logical sequence is not necessarily chronological, nor does it mean that you have to start with a background section. Main messages or most important ideas should be at the beginning of sections or lists because users tend to pay more attention to items mentioned first.

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Item 11: The material provides a summary (P and A/V)

Ratings: Disagree = 0       Agree = 1    Very short material = N/A

Not Applicable

Choose N/A if the material meets the definition of a very short material:

  • Printable (P): A very short material is defined as a material with two or fewer paragraphs and no more than 1 page in length.
  • Audiovisual (A/V): A very short material is defined as a video or multimedia presentation that is under 1 minute or a multimedia material that has 6 or fewer slides or 6 screenshots.
Explanation

A material should have a summary of the key points or review the key points at the end of the material, either in writing or orally. The summary usually comes at the end of the material, but for a printable material a summary (e.g., summary box) at the beginning is fine. A checklist of key points (or steps) can also be considered a summary.

Examples

The following are good examples of materials providing summaries, whereas a bad material would not provide a summary.

CHOOSE "AGREE"—Multimedia material with a summary

Four pictures depicting: 1. Eat a healthy diet rich in fruits and vegetables; 2. Get regular physical activity; 3. Drink water instead of sugar-sweetened beverages; and 4. Balance calories consumed with colories used.

Taken from CDC-TV video, National Center for Chronic Disease Prevention and Health Promotion, Finding Balance.
http://www.cdc.gov/CDCTV/findingbalance/

CHOOSE "AGREE"—Printable material with a summary

In summary: 

  • Learn the heart attack warning signs "by heart." 
  • Call 9-1-1 within five minutes of the start of symptoms. Talk with family and friends about the warning signs and the need to call 9-1-1 quickly. 
  • Write out a heart attack survival plan and keep copies handy. Be sure to tell those close to you where to find a copy. If necessary, arrange in advance to have someone care for your children or other dependents in an emergency.

Taken from NIH, The Heart Truth® for Women: If You Have Heart Disease, July 2006.
http://www.nhlbi.nih.gov/educational/hearttruth/downloads/pdf/factsheet-heartdisease.pdf

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Current as of October 2013
Internet Citation: The Patient Education Materials Assessment Tool (PEMAT) and User’s Guide: Domain: Understandability. October 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/prevention-chronic-care/improve/self-mgmt/pemat/pemat6.html