JCPSLP Vol 22 No 2 2020

Methods Search strategy

satisfaction ratings, comprehension of content, usability, emotional responses, and other opinions held by participants about the documents being studied ( n = 15) (Brown, Skinner, Ashley, Reed, & DeLany Dixon, 2016; Cassini et al., 2011; Donaldson, McDermott, Hollands, Copley, & Davidson, 2004; Fletcher, Hawkins, & Thornton, 2015; Flynn & Parsons, 1994; Miller & Watkins, 2010; Pelco, Ward, Coleman, & Young, 2009; Phelps, Platt, France, Gray, & Iredale, 2004; Rahill, 2018; Roggenbuck et al., 2015; VandenBoom, Trepanier, & Carmany, 2018; Weddig, 1984; Wiener, 1985, 1987; Wiener & Kohler, 1986). Questionnaires in six of the studies included both closed and open questions (Cassini et al., 2011; Fletcher et al., 2015; Pelco et al., 2009; Phelps et al., 2004; Rahill, 2018; VandenBoom et al., 2018). Semi-structured interviews were used in three studies to investigate reader opinions of the allied health documents (Donald & Kelly- Campbell, 2016; Donaldson et al., 2004; Makepeace & Zwicker, 2014). The readers The readers represented in the included studies were parents ( n = 9) (Donald & Kelly-Campbell, 2016; Donaldson et al., 2004; Flynn & Parsons, 1994; Makepeace & Zwicker, 2014; Miller & Watkins, 2010; Rahill, 2018; Roggenbuck et al., 2015; Weddig, 1984; Wiener & Kohler, 1986), teachers or school administrators ( n = 7) (Fletcher et al., 2015; Flynn & Parsons, 1994; Mallin, Beimcik, & Hopfner, 2012; Pelco et al., 2009; Rahill, 2018; Wiener, 1985, 1987), patients ( n = 2) (Cassini et al., 2011; Phelps et al., 2004), and allied health professionals ( n = 2) (Fletcher et al., 2015; Flynn & Parsons, 1994). Three studies included multiple groups of readers in the research (Fletcher et al., 2015; Flynn & Parsons, 1994; Rahill, 2018) and three studies did not report engagement with any readers (Brown et al., 2016; Mallin, Schellenberg, & Smith, 2012; VandenBoom et al., 2018). Demographic information provided about the readers was either not reported ( n = 2) (Brown et al., 2016; Wiener, 1985), or reported inconsistently. Where it was reported, details on demographics included age ( n = 9) (Donald & Kelly-Campbell, 2016; Donaldson et al., 2004; Fletcher et al., 2015; Flynn & Parsons, 1994; Mallin, Beimcik, et al., 2012; Pelco et al., 2009; Phelps et al., 2004; Roggenbuck et al., 2015; Wiener, 1987), gender ( n = 11) (Brown et al., 2016; Cassini et al., 2011; Donald & Kelly-Campbell, 2016; Fletcher et al., 2015; Flynn & Parsons, 1994; Makepeace & Zwicker, 2014; Mallin, Beimcik, et al., 2012; Pelco et al., 2009; Phelps et al., 2004; Wiener, 1987; Wiener & Kohler, 1986), broad education level (e.g., high school, undergraduate, postgraduate) ( n = 5) (Makepeace & Zwicker, 2014; Miller & Watkins, 2010; Pelco et al., 2009; Roggenbuck et al., 2015; Weddig, 1984), relationship status ( n = 1) (Donald & Kelly-Campbell, 2016), and cultural background ( n = 2) (Donald & Kelly-Campbell, 2016; Roggenbuck et al., 2015). The writers The included studies reported on research relating to the disciplines of psychology ( n = 10) (Fletcher et al., 2015; Mallin, Beimcik, et al., 2012; Mallin, Schellenberg, et al., 2012; Miller & Watkins, 2010; Pelco et al., 2009; Rahill, 2018; Weddig, 1984; Wiener, 1985, 1987; Wiener & Kohler, 1986), genetic counselling ( n = 5) (Brown et al., 2016; Cassini et al., 2011; Phelps et al., 2004; Roggenbuck et al., 2015; VandenBoom et al., 2018), occupational therapy ( n = 2) (Donaldson et al., 2004; Makepeace & Zwicker,

From October to December 2018, the first author searched five scientific databases (Medline, Cinahl, Web of Science, Embase and Scopus) for peer-reviewed literature. Search terms were used to locate relevant literature relating to: (a) the readers (e.g. [patient OR client] AND [readability OR comprehension OR understanding OR satisfaction]); (b) the writers (e.g. Allied health OR ‘Allied Health profession*’ OR Allied Health Practi*’); and( c) the reports written by allied health professionals (e.g., report AND [assessment OR therapy OR funding]). The search terms also included the names of 20 allied health professions (Allied Health Professions Australia, n.d.). The search was conducted again in September 2020. The first author screened the titles, abstracts and full- text of studies from the search results. Only studies that related to readability, accessibility, health literacy demands or reader satisfaction of written allied health reports were included. Studies were excluded if they related to health professionals other than allied health professionals or studied documents that were not allied health reports (e.g. patient education, pamphlets, brochures, or fact sheets). In addition, citation searching, updating search terminology (e.g., “patient letter”), internet searches, recommendations from colleagues, and an appeal on Twitter by the first author for relevant literature, yielded further items. Methods used in this review were consistent with scoping review methodology (Noble & Smith, 2018; Peters, Godfrey, Khalil, McInerney, Parker, & Soares, 2015). A copy of the full search strategy is available from the first author. Data extraction and analysis Using a customised form (available from the first author on request), data were extracted and critically analysed utilising the Sørensen et al. (2012) model of health literacy which encapsulates accessing, understanding, appraising, and applying health information. Extracted data included information about the readers (i.e., patients, parents, and teachers), disciplines involved in writing the reports (the writers), the country of origin and practice setting (context); the types of written reports or documents, and the design, methods and strategies used to evaluate outcomes of interventions. Table 1 presents details of extracted data. Results The initial search returned 109 potentially relevant titles. The first author screened titles and abstracts for papers relevant to the research question. This process identified 24 potentially relevant papers for full-text review. Full-text review conducted by the first author excluded 13 papers where the “writers” were medical specialists (e.g., ear, nose and throat doctors or psychiatrists) or general practitioners (GPs), or the “documents” examined in the study did not perform functions similar to allied health professional reports (e.g., referral, appointment or instruction letters), leaving 11 relevant papers for inclusion in the review. Additional search strategies described above revealed a further 8 papers relevant for inclusion, providing a total of 19 papers. The search was conducted again in September 2020, resulting in no additional included papers. Figure 1 presents a flow diagram of the search and screening results. Study designs and methods The included studies used predominantly quantitative designs. Questionnaires were most often used to measure

Ian Skinner (top) and Bronwyn Hemsley

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JCPSLP Volume 22, Number 2 2020

Journal of Clinical Practice in Speech-Language Pathology