Oral Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

Evaluating the readability, understandability, and cultural appropriateness of online cancer resources for Aboriginal and Torres Strait Islander peoples (126364)

Daniela Iazzi 1 , Chloe Maxwell-Smith 2 , Cally Jetta 3 , Gail Garvey 4 , Haryana M Dhillon 5 , Mandy Basson 6 , Georgia KB Halkett 1
  1. Curtin School of Nursing, Curtin University, Perth, Western Australia, Australia
  2. Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
  3. Centre for Aboriginal Studies, Curtin University, Perth, Western Australia, Australia
  4. School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
  5. Psycho-Oncology Cooperative Research Group, School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
  6. Sock it to Sarcoma!, Perth, WA, Australia

Background/rationale
Aboriginal and Torres Strait Islander peoples experience significant health disparities in cancer outcomes compared with non-Indigenous Australians. Accessible, culturally appropriate, and evidence-based resources may address information needs of Aboriginal and Torres Strait Islander people with cancer. This study aimed to evaluate the readability, understandability, and cultural appropriateness of cancer websites for Aboriginal and Torres Strait Islander Peoples in Australia.

Methods
An environmental scan using the Google search engine was conducted between January and February 2025 to identify cancer websites targeted toward Aboriginal and Torres Strait Islander Peoples in Australia. The first three pages of search results were screened. Patient/consumer-facing resources were assessed for readability using readability tools and understandability using the Patient Education Materials Assessment Tool (PEMAT)1. Cultural appropriateness of the resources was assessed using criteria previously applied in similar assessments of resources2.

Results
Of 178 cancer websites screened, only ten were patient/consumer facing. Most focused on common cancers, with limited coverage of less prevalent and rare cancers. Readability scores generally exceeded the recommended Grade 6 reading level, with only one resource below Grade 6. Understandability was moderate-to-high with a mean score 77% but many resources failed to use plain language or simple English and lacked summaries. The mean score for cultural appropriateness was 57% (4/7) with only one resource meeting all criteria (7/7). Most resources lacked culturally specific information and did not provide translations in Aboriginal and Torres Strait Islander languages.

Conclusion
Our results highlight the need for cancer resources to be co-designed with Aboriginal and Torres Strait Islander Peoples. These resources should cover a broader range of cancers and be piloted to ensure the information and cultural needs of Aboriginal and Torres Strait Islander communities are met. Websites should optimise the readability and cultural appropriateness of information for Aboriginal and Torres Strait Islander peoples seeking cancer information.

  1. Shoemaker, S. J., Wolf, M. S., & Brach, C. (2014). Development of the Patient Education Materials Assessment Tool (PEMAT): a new measure of understandability and actionability for print and audiovisual patient information. Patient education and counseling, 96(3), 395-40
  2. Diaz, A., McErlane, J., Jeon, M. H., Cunningham, J., Sullivan, V., & Garvey, G. (2023). Patient Information Resources on Cardiovascular Health After Cancer Treatment: An Audit of Australian Resources. JCO Glob Oncol, 9, e2200361. https://doi.org/10.1200/go.22.00361