A Text Comprehension Approach to Questionnaire Readability: An Example Using Gambling Disorder Measures

Although readability has been traditionally operationalized and even become synonymous with the concept of word and sentence length, modern text analysis theory and technology have shifted toward multidimensional comprehension-based analytic techniques. In an effort to make use of these advancements and demonstrate their general utility, 6 commonly used measures of gambling disorder were submitted to readability analyses using 2 of these advanced approaches, Coh-Metrix and Question Understanding Aid (QUAID), and one traditional approach, the Flesch-Kincaid Grade Level. As hypothesized, significant variation was found across measures, with some questionnaires emerging as more appropriate than others for use in samples that may include individuals with low literacy. Recommendations are made for the use of these modern approaches to readability to inform decisions on measure selection and development. Public Significance Statement Software has been developed to evaluate the ease of reading and comprehending text, including questions frequently seen in psychopathology questionnaires. This study demonstrated how this software, applied to gambling disorder measures, identifies words and sentence structure that interfere with the likelihood of receiving accurate responses. These text comprehension software programs can aid in the development and selection of self-report questionnaires of psychopathology.