Are plain language summaries published in health journals written according to instructions and health literacy principles? A systematic environmental scan

Background Plain language summaries (PLSs) are easy-to-understand summaries of research articles that should follow principles of plain language and health literacy. PLS author instructions from health journals help guide authors on word count/PLS length, structure and the use of jargon. However, it is unclear whether published PLSs currently adhere to author instructions.Objectives This study aims to determine (1) the degree of compliance of published PLSs against the PLS author instructions in health journals and (2) the extent to which PLSs meet health literacy principles.Study design We conducted a three-part systematic environmental scan.Methods We examined 26 health journals identified from a previous review. In part 1, we assessed the inclusion frequency of PLSs in the 26 journals; in part 2, we assessed the level of compliance of PLSs with PLS author instructions; and in part 3, we conducted a health literacy assessment of the PLSs.Results Part 1: we found PLSs for 20/26 (76.9%) included journals. Part 2: no journal achieved 100% compliance with PLS author instructions. The highest level was 86% and the lowest was 0%. Part 3: no PLS was written at a readability level suitable for a general audience. The mean reading level was grade 15.8 (range 10.2-21.2and mean percentage of complex words, 31% (range 8.5%-49.8%).Discussion PLSs are an important means through which consumers can access research findings. We found a lack of compliance between PLS author instructions and PLSs published in health journals that may impede access and use by consumers. This study highlights the need for better ways to support authors adhere to PLS instructions and improved monitoring by journals.