How can we best communicate the findings of public health-related systematic reviews? A Study Within a Review (SWAR)

How can we best communicate the findings of public health-related systematic reviews? A Study Within a Review (SWAR) | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Method Article How can we best communicate the findings of public health-related systematic reviews? A Study Within a Review (SWAR) Niamh Gildernew, Mike Clarke, Miriam Brazzelli, Mari Imamura, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8251143/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract Background and aims: Systematic reviews contain scientific language and complex analyses which may only be comprehensible to researchers or clinicians. However, it is imperative that public health-related systematic reviews are effectively communicated to the public. Plain language summaries and podcasts may improve the communication of important review findings. We conducted a Study Within a Review (SWAR) to evaluate comprehension of plain language systematic review summaries presented as either text or audio. We also aimed to evaluate enjoyment, perceived understanding, interest in reading the full-text, and information retention. Methods Participants (n = 105) were consented and randomly assigned to a Reading or Listening Group and given the relevant type of summary for two systematic reviews. Comprehension, enjoyment, perceived understanding, and interest in reading the full text were assessed immediately. Several weeks later, comprehension was re-assessed to evaluate information retention. Data were non-normally distributed and non-parametric tests were used to compare groups. Results Science-educated participants achieved higher comprehension scores in the Reading Group than those without a science education; however, there was no such difference in the Listening Group. Older participants were less likely to be ‘high-scorers’ than younger people, but only in the Listening Group. Participants’ perceived understanding did not align with their actual comprehension. Information retention was poor across both groups, but particularly in the Reading Group. Conclusions These novel data suggest that plain language summaries of systematic reviews are incompletely understood by some. This SWAR underscores the need for tailored communication strategies to effectively disseminate systematic review findings. Trial registration: This study did not include a health care intervention on human participants. The Study Within a Review (SWAR) was based on a SWAR 02, registered in the Global SWAR Repository: https://www.qub.ac.uk/sites/TheNorthernIrelandNetworkforTrialsMethodologyResearch/SWATSWARInformation/Repositories/SWARStore/ Systematic review Study Within a Review (SWAR) plain language summary lay abstract podcast audio comprehension Figures Figure 1 Background Systematic reviews follow a transparent and reproducible methodology that enhances the reliability of their findings, thereby supporting evidence-based decision-making in health and social care[ 1 ]. They play a crucial role in identifying the strengths and limitations of individual studies, highlighting gaps in existing knowledge, and guiding future research. As such, systematic reviews are essential tools within the research cycle[ 2 – 4 ]. By providing accurate and comprehensive summaries of available evidence, they are highly valuable for healthcare practitioners, policymakers, patients, the public, and researchers. However, despite their importance, the findings of systematic reviews can be challenging to interpret. This challenge is not limited to the general public, policy makers and even producers of clinical guidelines have also been found to misinterpret or misquote the conclusions of systematic reviews [ 5 ]. It is vital that findings of systematic review are communicated effectively to ensure they reach and benefit their intended audiences, particularly when addressing issues of public health relevance. However, as with scientific research more broadly, such reviews are often written in complex language, limiting their readability and making it difficult for non-specialists to engage with the content[ 6 ]. Over the past two decades, research articles have become increasingly difficult to read due to the use of longer, more intricate sentences, and technical vocabulary[ 7 ]. Detailed statistical analyses and extensive methodological discussions that are integral to systematic reviews and meta-analyses further reduce their accessibility. Poor accessibility restricts the public’s ability to use systematic reviews to make informed health-related decisions. Poor understanding may contribute to misinformation, as individuals may turn to secondary sources such as the media, which can sometimes misrepresent or oversimplify scientific findings[ 6 ]. Nevertheless, public health researchers need to ensure that their work is communicated effectively to a broad audience. Plain language summaries aim to simplify the key messages of systematic reviews, increasingly with input from patients and the public. However, the effectiveness of these summaries in enhancing public comprehension is unclear[ 7 ]. Moreover, individuals process information differently depending on the format in which it is presented. For example, reading and listening comprehension activate different neural pathways[ 8 ]. Given that different people process information in different ways, investigating a variety of methods of communicating the findings of systematic reviews is essential to finding the best ways to improve accessibility and engagement. Furthermore, the manner with which people interact with information has changed profoundly in the digital era, with a growing preference for content that is concise, accessible and easy to understand. The rise of social media and online health information platforms has transformed how individuals access and consume medical knowledge, making it imperative for researchers to continually adapt their communication strategies[ 9 ]. Online educational materials, including podcasts and video summaries, are increasingly popular, particularly among younger audiences[ 10 ]. Therefore, exploring whether audio summaries enhance engagement and comprehension compared to written summaries represents a necessary step toward improving knowledge dissemination. A Study Within a Review (SWAR) is a research study embedded within a systematic review that aims to improve aspects relevant to the planning, conduct or dissemination of systematic reviews[ 11 ]. SWARs investigate various aspects of the review process, such as study selection, data extraction and communication of results, to refine methodologies and optimise how evidence syntheses are conducted and shared[ 11 ]. The global SWAR repository[ 12 ], catalogues many SWARs, including some that evaluate methods for enhancing the accessibility of systematic reviews and their findings[ 11 ]. SWAR 02 specifically aims to explore whether readers can understand key messages without having to read the full review, and if there is a difference in understanding various types of summaries. Its first implementation, with 36 participants[ 13 ], compared knowledge transfer using three types of written summary with one audio version for a review of the health effects of using an electric fan during a heatwave[ 14 ]. The SWAR found that differences between the groups were not statistically significant but suggested that the audio summary might be better for knowledge transfer than written summaries. This study was designed based on SWAR 02, to determine the most effective way to communicate the findings of public-health related systematic reviews to the public. We compared two formats for presenting plain language summaries of two systematic reviews: audio and written. Both reviews focused on important public health research topics. Methods This SWAR was a randomised intervention study, conducted in Northern Ireland by the Aberdeen-Belfast Evidence Collaboration (ABEC). Its primary aim was to assess the public’s understanding of systematic review findings when presented as either written or audio summaries. As a secondary aim, we evaluated participants’ enjoyment, perceived understanding and interest in reading the full text of the systematic review. Information retention was also assessed several weeks after participants had read or listened to the summaries. Two systematic reviews addressing important public health issues were selected. Review 1 , conducted by ABEC, focused on biomarkers for identifying sepsis in the emergency room[ 15 ]. The plain language summary written by the ABEC review authors was used for the ‘reading’ arm of this study, while an audio podcast of this plain language summary was recorded by one of this study’s authors (SD) for the ‘listening’ arm of this study. Review 2 was a recently published Cochrane review on the use of eye drops for contact lens wearers, selected as a topic of likely broad public interest[ 16 ]. The podcast script was downloaded from the Cochrane Library and used for the ‘reading’ arm, while a new recording of the same script, produced by one of the study authors (SD), was used for the ‘listening’ arm to maximise consistency between audio interventions. The text of Review 1 (Additional file 1A) and Review 2 (Additional file 1B) are provided in Additional File 1. Participants were recruited using posters displayed in the common areas (and other high-traffic areas) of Queen’s University Belfast, social media platforms (Instagram and Facebook) and via word of mouth (Poster shown in Additional file 2). To encourage participation, refreshments were offered, and potential participants were eligible to enter a prize draw for monetary vouchers. Criteria for inclusion were as follows: adults (18 + years) of any gender who were willing and able to read or listen to review summaries, answer questions, and provide informed consent. Individuals with learning difficulties, hearing or visual impairments, and those under 18 years of age were not deemed eligible for inclusion. The consent process included a pre-study questionnaire containing demographic and background questions to collect the participant’s first name or nickname, age, scientific education, and any scientific training beyond secondary education. Before completing the questionnaire, the lead researcher (NG) provided the participants with a verbal overview of the study, including an estimated participation time of 10–20 minutes. Participants who gave verbal consent were then given time to review the study information sheet, complete the form and indicate their willingness to participate in writing. A unique identification code was created for each participant who agreed to take part. Additional File 3 presents the study Information, consent form and preliminary questions. Participants were randomly assigned to either the ‘Reading Group’ or the ‘Listening Group’ using a smartphone randomisation application (Randomiser by Rob Sammons, Version 9.0.1). The ‘Reading Group’ read the summaries of the two reviews on a tablet or laptop computer while the ‘Listening Group’ listened to the corresponding audio summaries using headphones (Table 1 ). Within each group, alternation was used so that participants began with either Review 1 or Review 2, to minimise potential bias related to improved performance on the second task. All participants completed their assigned tasks face-to-face, in the presence of the lead researcher (NG). See Fig. 1 for Consolidated Standards of Reporting Trials (CONSORT) diagram. Table 1 Participant groups and study tasks Participant Group Study Task Reading Group Participants read the Plain Language Summary of both Review 1 and Review 2 Listening Group Participants listen to the Audio Podcast Summary of both Review 1 and Review 2 After completing the randomly assigned task of either ‘reading’ or ‘listening’ to the summary of their first review, participants were asked to answer questions related to that review’s findings on a Microsoft Word document. They then proceeded to the second review, again following their assigned randomised format, and answered a corresponding set of questions. Additional File 4 presents the Review 1 questions (Additional File 4A) and Review 2 questions (Additional File 4B). The questions were developed by the research team based on a questionnaire from a comparable earlier study by Bredbenner and Simon (2019)[ 7 ], and adapted to align with the specific content of each review summary. Each set included a multiple-choice question and five true/false questions assessing comprehension of the review topic. Correct answers were scored ‘1’ point, yielding a maximum possible score of ‘6’, with higher scores indicating better comprehension. The questions were designed to be relevant to both written and audio formats. Three additional questions assessed participant’s enjoyment, ‘perceived understanding’ of the summary, and their ‘interest in reading the whole review paper after engaging with the summary. Responses were rated on a five-point scale from 0 (‘not a bit’) and 4 (‘very much’), with higher scores indicating better enjoyment, perceived understanding, or interest. Participants were contacted by telephone or email for a follow-up assessment several weeks after their initial assessment. This assessment could be conducted face-to-face or by telephone, and it repeated the six multiple-choice questions assessing the understanding of the review topic. This stage was designed to determine their ability to retain key information over time, and it did not include questions on enjoyment, perceived understanding or interest in reading the full text. Statistical analysis The collected data were checked for normality, and non-parametric tests were used in all cases. We compared groups using Mann-Whitney U tests for continuous data. Categorical data were analysed using the Chi-square Test of Independence. Pearson’s correlation was used to determine the strength and direction of a linear relationship between continuous variables. Participants were divided into ‘High Scorers’ and ‘Low Scorers’ for further analysis, with high scorers being those who achieved a comprehension score greater than the median score. Paired analysis to assess retention of information between the initial assessment and follow-up assessment was done using the non-parametric Wilcoxon Signed Rank test. A p-value < 0.05 was considered statistically significant. Data were collected using Microsoft Forms (Microsoft Corporation; held by QUB, accessed 2024/5), exported to Microsoft Excel version 16.95.1 (Copyright 2025 Microsoft) and then to IBM SPSS statistical package version 30.0.0.0 (172) (IBM Corp. Copyright IBM Corporation 1989–2024) for analysis. Data were tabulated or displayed in graphs. We aimed to recruit approximately 100 participants due to the time constraints related to this being an undergraduate dissertation project. Funding and ethical approval This study was granted ethical approval from the QUB Faculty of Medicine, Health and Life Sciences Research Ethics Committee (Reference number: MHLS 24_223). The study was supported by the Health Research Board (Ireland) and the HSC Public Health Agency (Grant number ESI-2021-001) through Evidence Synthesis Ireland/Cochrane Ireland. The original SWAR 02 protocol had been previously registered in the SWAR Repository[ 12 ]. Results We recruited 105 participants and randomly allocated them into one of two groups: Reading Group (n = 51) or Listening Group (n = 54). The characteristics of the groups were broadly similar for age, sex and being in a science-related career. However, by chance, there were significantly more people with a formal science education in the Listening Group than in the Reading Group (p = 0.012) (Table 2 ). In relation to our primary outcome, median (IQR) comprehension scores were 9 (8–10) of a maximum score of 12 for the summaries of both reviews. These did not differ between the Reading and Listening Groups (Table 2 ). Table 2 Participant characteristics and scores Reading Group (n = 51) Listening Group (n = 54) P-value§ Age in years, median (IQR) 32 (22.8–49.8) (Range 18–80) 28 (23.0–49.0) (Range 18–82) 0.644 Sex Male, n (%) 15 (29.4) 10 (18.5) 0.19 Female, n (%) 36 (70.5) 44 (81.5) Formal science education ± , n (%) 15 (29.4) 29 (53.7) 0.012* In a science-related career^, n (%) 9 (17.6) 12 (22.2) 0.508 Comprehension scores, median (IQR) 9 (8.0–10.0) 9 (8.0–10.0) 0.825 § Mann-Whitney U test or Chi-Square test comparing reading group and listening group ±Participant reports receiving formal scientific education after high school / secondary school (e.g. science classes in college, work in a laboratory) ^Participants reports working in a science-related job *Statistically significant difference IQR, interquartile range Comparison of comprehension scores by subgroups Participants without a formal science education achieved significantly lower comprehension scores than those with a formal science education in the Reading Group (median [IQR] scores of 8 [7.0-9.8] and 10 [9.0–10], respectively), but not in the Listening group. Regarding employment in a science-related field versus other occupations, there was no significant difference in median comprehension scores in either group. Similarly, no significant differences were observed between age or sex subgroups (Table 3). [INSERT TABLE 3] Correlation between comprehension scores and age No significant correlation was observed between age and comprehension scores in the overall sample (p = 0.297), or within the Reading Group (p = 0.429). However, a weak negative association was found between age and comprehension scores within the Listening Group (Pearson’s correlation − 0.34; p = 0.015), indicating that increasing age was weakly but significantly associated with lower comprehension of the audio summaries. High scorers by subgroup High scorers were defined as participants who achieved a comprehension score greater than the median value of 9. Comparisons between high and low scorers were made for age, sex, employment in a science-related field, and formal science education (Table 4 A-D). When comparing high with low scorers, no age difference was observed in the overall sample or within the Reading Group (Table 4 .A). However, those with high scores in the Listening Group were younger (median age (IQR) 26 years, 21.0–40.0) than those with low scores (median age (IQR) 44 (24.5–56.5), p = 0.029). There was no difference regarding high or low scorers for sex (Table 4 .B). A significantly greater proportion of participants with formal science education were high scorers compared with those without, both in the overall sample group and in the Reading Group, but not in the Listening Group (Table 4 .C). Regarding participants working in a science related job versus those who were not in such a job, there was no difference. No significant difference in high versus low comprehension scores was observed between participants employed in science-related roles and those who were not. Table 4 A High scorers (> 9 out of 12) versus low scorers according to age Number Age, Median (IQR) P value^ High scorer (> 9) Total group Yes 61 27 (22.5–46.0) 0.351 No 41 41 (22.5–54.0) High scorer (> 9) Reading Group Yes 30 36 (23.0-52.5) 0.367 No 20 29 (21.0–48.0) High scorer (> 9) Listening Group Yes 31 26 (21.0–40.0) 0.029* No 21 44 (24.5–56.5) ^Mann-Whitney U test *Statistically significant difference IQR, interquartile range Table 4 B High scorers (> 9 out of 12) versus low scorers according to sex Male Female P-value^ High scorer (> 9) Total Group Yes, n 14 48 0.723 No, n 11 32 High scorer (> 9) Reading Group Yes, n 9 22 0.941 No, n 6 14 High scorer (> 9) Listening Group Yes, n 5 26 0.6 No, n 5 18 ^Chi-square analysis Table 4 C High scorers (> 9 out of 12) versus low scorers according to history of formal science education Formal science education: YES Formal science education: NO P-value^ High scorer (> 9) Total Group Yes, n 34 28 0.001* No, n 10 33 High scorer (> 9) Reading Group Yes, n 14 17 0.002* No, n 1 19 High scorer (> 9) Listening Group Yes, n 20 11 0.064 No, n 9 14 ^Chi-square analysis *Statistically significant difference Table 4 D High scorers (> 9 out of 12) versus low scorers according to being in a science-related job Working in a science-related job: YES Working in a science-related job: NO P-value^ High scorer (> 9) Total Group Yes, n 15 47 0.197 No, n 6 37 High scorer (> 9) Reading Group Yes, n 8 23 0.057 No, n 1 19 High scorer (> 9) Listening Group Yes, n 7 24 0.941 No, n 5 18 ^Chi-square analysis Enjoyment, perceived understanding, and interest in reading more Our secondary aim was to compare the two summaries in terms of enjoyment, perceived understanding and interest in reading the full text of the systematic review (Tables 5 A-C; Fig. 1 ). Using Pearson’s correlation, no significant association was found between comprehension scores and reported enjoyment, perceived understanding, or interest in reading the full text of the review. Enjoyment, perceived understanding and interest in reading the full text were all positively correlated. A moderate correlation was observed between perceived understanding and interest in reading the full text (R = 0.526, P < 0.01), while strong correlations were found between perceived understanding and reported enjoyment of the summary (R = 0.658, P < 0.001) and between enjoyment and interest in reading the full text (R = 0.606, P < 0.001). Table 5 A Participants’ responses for ‘enjoyment’ according to groups (reading and listening) ‘I enjoyed reading / listening to this summary’ Study group Summary ‘Not at all’ ‘A bit’ ‘Average’ ‘Mostly’ ‘Very much’ Reading Group Sepsis (51) 0 4 (7.8) 11 (21.6) 26 (51) 10 (19.6) Contact lenses (51) 0 4 (7.8) 15 (29.4) 16 (31.4) 16 (31.4) Both summaries (108) 0 8 (7.9) 25 (24.7) 42 (41.6) 26 (25.7) Listening Group Sepsis (54) 1 (1.9) 6 (11.1) 16 (29.6) 16 (29.6) 15 (27.8) Contact lenses (54) 1 (1.8) 7 (13.0) 17 (31.5) 17 (31.5) 12 (22.2) Both summaries (108) 2 (1.8) 13 (12.0) 33 (30.6) 33 (30.6) 27 25.0) Data presented as n (%) Table 5 B Participants’ responses for perceived understanding according to groups (reading and listening) ‘I understand this research after reading / listening to this summary’ Study group Summary ‘Not at all’ ‘A bit’ ‘Average’ ‘Mostly’ ‘Very much’ Reading Group Sepsis (51) 0 9 (17.6) 10 (19.6) 18 (35.3) 14 (27.5) Contact lenses (51) 0 5 (9.8) 14 (27.5) 18 (35.3) 14 (27.5) Both summaries (102) 0 14 (13.7) 24 (23.5) 36 (35.3) 28 (27.5) Listening Group Sepsis (54) 1 (1.9) 11 (20.4) 17 (31.5) 17 (31.5) 8 (14.8) Contact lenses (54) 2 (3.7) 12 (22.2) 8 (14.8) 21 (38.9) 11 (20.4) Data presented as n (%) Table 5 C Participants’ responses for interest in reading more according to groups (reading and listening) ‘I would like to read the full review paper after reading / listening to this summary’ Study group Summary ‘Not at all’ ‘A bit’ ‘Average’ ‘Mostly’ ‘Very much’ Reading Group Sepsis (51) 1 (2.0) 13 (25.5) 13 (25.5) 16 (31.4) 8 (15.7) Contact lenses (51) 2 (3.9) 10 (19.6) 19 (37.3) 9 (17.6) 11 (21.6) Both summaries (102) 3 (2.9) 23 (22.5) 32 (31.4) 25 (24.5) 19 (18.6) Listening Group Sepsis (54) 9 (16.7) 10 (18.5) 12 (22.2) 14 (25.9) 9 (16.7) Contact lenses (54) 11 (20.4) 11 (20.4) 18 (33.3) 9 (16.7) 5 (9.3) Both summaries (108) 20 (18.5) 21 (19.4) 30 (27.8) 23 (21.3) 11 (10.2) Data presented as n (%) Retention of information Between two and five weeks after their interaction with the summaries, 14 participants from the Reading Group and 17 from the Listening Group attended a follow-up assessment. To evaluate information retention, only participants who completed both the initial and follow-up assessments were included in the following analysis. For the overall sample (Reading and Listening combined), the median (IQR) follow-up score was 8 (7.0–9.0), which was significantly lower than their initial assessment score of 9 (8.0–10.0; p < 0.001). In the Reading Group, the median (IQR) follow-up comprehension score was 7 (7.0-8.3), which was lower than the initial score of 9.5 (9.0, 10.0; p < 0.001). In contrast, the Listening Group showed no significant change between the initial assessment median (IQR) comprehension score of 8 (7.0, 9.0) and the follow-up score of 8 (7.5, 9.0; p = 0.658). Similarly, paired analyses confirmed that median follow-up scores were significantly lower than initial scores in the overall sample and the Reading Group (p < 0.0001 and P < 0.001, respectively), but not in the Listening Group (p = 0.439). Discussion In this SWAR, we sought to explore the most effective way of communicating the findings of health-related systematic reviews to the public. Specifically, we compared comprehension of plain language summaries in a written or audio format. Our secondary aim was to assess participants’ enjoyment, perceived understanding and interest in reading the full text of the systematic review, as well as measuring their retention of information several weeks after the initial assessment. Whilst there was no overall difference in comprehension between the Reading Group and the Listening Group, there were several notable findings. We found that participants with a formal science education achieved higher comprehension scores than those without such an education, both in the overall sample and in the Reading Group. Although the summaries were written in plain language and intended to be accessible to readers of all education levels, individuals with a science background appear to have a clear advantage in understanding scientific concepts or content. Research suggests that successful reading comprehension depends on the reader’s ability to link ideas within a text in a meaningful way, a process called coherence. Coherence is established through inference generation, which involves connecting information from within the text and integrating it with the reader’s prior knowledge. Factors influencing coherence include the reader's prior knowledge of the topic, their reading proficiency and their purpose for reading (for study or for pleasure)[ 17 ]. We found that the advantage associated with having a science education was evident only in the Reading Group, suggesting that the written summaries may have been less accessible to individuals with limited scientific knowledge. This finding highlights the need to ensure that written plain language summaries of systematic reviews are appropriately tailored to different audiences. In contrast, audio summaries were accessible and comprehensible even for individuals who did not have a formal science background, indicating that this medium may be more effective for some audiences. Our findings are consistent with those in the original iteration of SWAR 02[ 13 ]. In that study conducted with 36 university staff members in Northern Ireland, audio delivery via podcast resulted in higher comprehension scores than written summaries, which varied in content. In our study, by contrast, the written and audio summaries were identical in content, yet the reasons why listening may promote better comprehension than reading remain unclear. Previous research suggests that reading and listening comprehension activate different brain patterns, with reading activating more left-lateralised brain regions[ 18 ]. There are also differences in the amounts of total brain activation between audio and visual stimuli[ 19 ]. Despite the importance of the public's understanding of health-related information, there is a notable lack of research comparing public comprehension of scientific findings presented through different communication formats, representing a significant gap in the current evidence base[ 7 ]. In this study, comprehension scores also indicated potential age-related differences, with older participants tending to score lower than younger participants in the Listening Group, while no such difference was observed in the Reading Group. This suggests that reading may be more accessible and comprehensible than listening for older individuals. Such findings may reflect broader shifts in how people consume information in the digital age, where there is an increasing preference for concise and easily digestible content. The rise of social media and online health information platforms has transformed how people engage with medical knowledge, necessitating adaptation of communication strategies. Online educational resources, such as podcasts and video summaries, are particularly popular among younger audiences[ 9 ]. Conversely, older individuals are more likely to be accustomed to reading printed newspapers than their digital equivalents[ 20 ], possibly due to greater scepticism toward online news sources[ 21 ]. The observed age-related difference may therefore be related to the extent of individuals’ familiarity and practice with different media formats for obtaining information. There was no association between comprehension scores and participants' reported enjoyment or perceived understanding of the summaries. This suggests that participants were often not aware when they did not fully understand the information being presented. We found a decline in information retention after several weeks among participants in the Reading Group, suggesting that the written plain language summaries were not effective in facilitating long-term retention of the information presented. Other studies have reported that listening to a podcast can enhance information retention over comparable time frames[ 22 ]. For instance, a 2022 study involving medical trainees found that those who listened to podcasts performed significantly better than those who read the text on two out of three topics assessed immediately after the learning session and that this improvement persisted for one topic at a four-week follow-up[ 22 ]. However, a 2010 study examined information retention among students who were randomly assigned to either read a 3330-word article or listen to a 21-minute podcast containing identical content[ 23 ]. When evaluated two days later, reading resulted in significantly better information retention. Initially, students expressed a preference for podcasts due to their convenience and engaging format, but this preference diminished once they recognised that the podcast format did not facilitate the same level of detailed recall as reading[ 23 ]. These findings suggest a potential trade-off between enjoyment and the depth or accuracy of comprehension. Implications for public health researchers and review authors Effective dissemination and communication of research is a crucial part of the research process. The findings of this study offer valuable insights that could inform future strategies for communicating the results of systematic reviews to the public. Researchers should view the strong engagement and enthusiasm shown by participants as evidence of significant public interest in research. However, the study also revealed that the existing plain language summaries were not sufficiently simple for some participants and contained elements that were not fully understood. When developing plain language summaries of systematic reviews, non-expert audiences may respond better to a simplified versions that emphasise the importance and impact of the research, even if this requires omitting some technical detail[ 24 ]. Although the median comprehension scores across our overall sample were relatively high, suggesting a reasonable level of understanding, it is possible that the summaries were too detailed for individuals without a formal science education. Because our questions focused on specific data within the summaries, future efforts to communicate review findings may benefit from adopting a more narrative, story-driven approach that highlights real-world relevance and impact[ 24 ]. For audiences with little prior knowledge of the topic, less detailed and more story-structured summaries may be particularly effective. Given that the comprehension scores in the Listening Group did not vary according to scientific education, it may be beneficial to provide audio versions of plain language summaries for all systematic reviews. However, since our findings suggest that older people may achieve better comprehension from written rather than audio formats, audio dissemination may be less critical for public health topics specifically targeting this age group. Finally, the observation that participants were not always aware of their misunderstandings underscores the importance of producing clear, accessible plain language summaries that can be understood by individuals with varying levels of scientific literacy. Moreover, the decline in information retention over time highlights the need for ongoing reinforcement of public health messaging. Supplementary written materials such as brief written summaries, infographics, or follow-up content could further enhance understanding and long-term retention of essential information. Implications for future research Further research is needed to better understand how the public consumes and understands the findings of public health-related systematic reviews. One promising area for exploration is the effectiveness of audio delivery formats, such as podcasts, for specific demographic groups. Future research could also examine older adults’ perspectives on online review summaries to determine whether comprehension and enjoyment differ when information is presented in print compared with on-screen formats. There is also a need for future research that compares the different formats for people with learning difficulties or with visual and auditory impairments. In addition, studies should consider those who speak English as a second language to ensure that the communication of review findings in English is both comprehensible and culturally appropriate. Other summary formats that we did not assess in this study, such as infographics and videos, also warrant investigation[ 25 ]. It is essential to prioritise research on information retention from systematic reviews. Longitudinal studies examining how well the public retains important public health messages over extended periods, months or years, could provide valuable insights into the long-term effectiveness of different communication strategies. Strengths and limitations Despite the randomised design, there were more participants with a formal science education in the Listening Group than in the Reading Group, the implications of which remain unclear. The groups were otherwise similar in terms of age, sex or being in a science-related career. Participation declined between the initial session and the follow-up assessment several weeks later, with only a third of participants agreeing to the follow-up. This attrition limited the study’s ability to assess long-term information retention and introduced the potential of self-selection bias, as those who were more interested or motivated may have been more likely to participate in the follow-up than those who were less engaged. Conclusions This expanded iteration of SWAR 02 offers valuable insights into identifying effective methods for communicating the findings of systematic reviews to the public, helping to fill a critical gap in the current literature. Our results indicate that participants with a science education achieved better comprehension scores when presented with a written summary than those without a science education. This suggests that audio summaries may offer greater accessibility and understanding for individuals without a scientific background. Additionally, older adults showed lower comprehension scores than younger adults when listening to audio summaries, suggesting they may benefit more from written materials. Notably, there was no correlation between actual comprehension and participants’ perceptions of their understanding. Furthermore, information retention was generally low across the entire sample, particularly among those in the Reading Group. Overall, our findings highlight the importance of providing research summaries in multiple formats and tailoring communication strategies to the audience's educational background and age. Further research exploring these dynamics is essential to ensure that key findings of systematic reviews are communicated effectively, understood accurately, and retained over time by diverse audiences. Abbreviations SWAR Study Within a Review ABEC Aberdeen Belfast Evidence Collaboration IQR Inter Quartile Range Declarations Ethics approval and consent to participate This study was granted ethical approval from the QUB Faculty of Medicine, Health and Life Sciences Research Ethics Committee (Reference number: MHLS 24_223). Participants completed informed consent forms. Consent for publication Not applicable Availability of data and materials The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Competing interests The authors declare that they have no competing interests Funding This study was supported by the Health Research Board (Ireland) and the HSC Public Health Agency (Grant number ESI-2021-001) through Evidence Synthesis Ireland/Cochrane Ireland. The funder had no role in conceptualisation, design, data collection, analysis, decision to publish, or preparation of the manuscript. Authors' contributions NG: Formal analysis (supporting); Investigation (lead);Visualisation (supporting); Writing – Original Draft Preparation (supporting); Writing – Review and Editing (supporting) MC: Visualisation (supporting); Writing – Original Draft Preparation (supporting); Writing – Review and Editing (supporting); Supervision (equal); Resources (lead); Funding Acquisition (supporting); Project Administration MB Visualisation (supporting); Writing – Original Draft Preparation (supporting); Writing – Review and Editing (supporting); Supervision (equal); Funding Acquisition (supporting); Project Administration GV Visualisation (supporting); Writing – Review and Editing (supporting); Funding Acquisition (supporting) MI Writing – Review and Editing (supporting); Funding Acquisition (supporting) CR Writing – Review and Editing (supporting); Funding Acquisition (supporting) SD Visualisation (lead); Writing – Original Draft Preparation (lead); Writing – Review and Editing (lead); Supervision (equal); Resources (lead); Funding Acquisition (equal); Project Administration All authors read and approved the final version. Acknowledgements The authors acknowledge the members of the public who graciously agreed to participate in this study. We are grateful for your time. Authors’ information MC is founder and curator of the SWAR Repository, held at Queen’s University Belfast. MB, SD, MC, GV, CR and MI are part of the Aberdeen-Belfast Evidence Collaboration, a National Institute for Health & Social Care (NIHR)-funded Evidence Synthesis Group. NG was a final year undergraduate student, BSc Biomedical Sciences, in Queen’s University Belfast References Higgins, J.P.T., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M. J., Welsh, V. A. (Editors), Cochrane Handbook for Systematic Reviews of Interventions . Second ed. 2019, Chichester (UK): John Wiley & Sons. McInnes, N. and B.J.A. Haglund, Readability of online health information: implications for health literacy . Informatics for Health and Social Care, 2011. 36(4): p. 173–189. Lund, H., et al., Evidence-Based Research Series-Paper 2: Using an Evidence-Based Research approach before a new study is conducted to ensure value . J Clin Epidemiol, 2021. 129: p. 158–166. Lund, H., et al., Evidence-Based Research Series-Paper 3: Using an Evidence-Based Research approach to place your results into context after the study is performed to ensure usefulness of the conclusion . J Clin Epidemiol, 2021. 129: p. 167–171. Zhang, Z., et al., Discrepancies in breast cancer guideline recommendations despite similar Cochrane systematic review conclusions . J Evid Based Med, 2024. 17(1): p. 17–25. Wang, S., X. Liu, and J. Zhou, Readability is decreasing in language and linguistics . Scientometrics, 2022. 127(8): p. 4697–4729. Bredbenner, K. and S.M. Simon, Video abstracts and plain language summaries are more effective than graphical abstracts and published abstracts . PLOS ONE, 2019. 14(11): p. e0224697. Zarifsanaiey, N., et al., The importance of integrating flexible learning methods (audio-visual animation vs. visual pamphlet) to enhance awareness, perspectives, and practices in preventing lower back pain in nurses. A quasi-experimental study . Health Sci Rep, 2024. 7(10): p. e70127. Sagan, P. and T. Leighton, The Internet & the future of news. Daedalus (Cambridge, Mass.), 2010. 139(2): p. 119–125. Boreskie, P.E., et al. Medical Education Blog and Podcast Utilization During the COVID-19 Pandemic . Cureus, 2022. DOI: 10.7759/cureus.23361 . Devane, D., et al., Study within a review (SWAR) . Journal of Evidence-Based Medicine, 2022. 15(4): p. 328–332. Research, M.H.F.T.M., SWAR Repository Store 2025, The Northern Ireland Hub for Trials Methodology Research Queen's University Belfast. Maguire, L.K. and M. Clarke, How much do you need: a randomised experiment of whether readers can understand the key messages from summaries of Cochrane Reviews without reading the full review . J R Soc Med, 2014. 107(11): p. 444–9. Gupta, S., et al., Electric fans for reducing adverse health impacts in heatwaves . Cochrane Database Syst Rev, 2012. 2012(7): p. CD009888. Brazzelli, M., Clarke, M., Imamura, M., Virgili, G., Aucott, L., Vadiveloo, T., Manson, P., Cooper, J., Kaye, C. Clinical utility of biomarkers for outcomes prediction in adults with suspected sepsis presenting to the Emergency Department . 2024; Available from: https://www.crd.york.ac.uk/PROSPERO/view/CRD42023454465 . Caffery, B., et al., Lubricating drops for contact lens discomfort in adults . Cochrane Database Syst Rev, 2024. 9(9): p. Cd015751. Clinton, V., et al., Inferential comprehension differences between narrative and expository texts: a systematic review and meta-analysis . Reading and Writing, 2020. 33(9): p. 2223–2248. Michael, E.B., et al., fMRI investigation of sentence comprehension by eye and by ear: Modality fingerprints on cognitive processes . Human Brain Mapping, 2001. 13(4): p. 239–252. Schott, S.L., et al., Heart sounds: a pilot randomised trial to determine the feasibility and acceptability of audio recordings to improve discharge communication for cardiology inpatients protocol . Open Heart, 2019. 6(2): p. e001062. Adoni, H. and G. Nimrod, The emergence of the hybrid older reader: A cross-national study . Communications, 2020. 45(4): p. 414–439. Le, T., et al., Trust in Health Information Sources Differs between Young/Middle and Oldest Old . American Journal of Health Promotion, 2014. 28(4): p. 239–241. Wolpaw, J., et al., A Multimodal Evaluation of Podcast Learning, Retention, and Electroencephalographically Measured Attention in Medical Trainees . Cureus, 2022. 14(11): p. e31289. Daniel, D.B. and W.D. Woody, They Hear, but Do Not Listen: Retention for Podcasted Material in a Classroom Context . Teaching of Psychology, 2010. 37(3): p. 199–203. Hutchins, J.A., Tailoring Scientific Communications for Audience and Research Narrative . Current Protocols Essential Laboratory Techniques, 2020. 20(1). Salzmann, S., C. Walther, and K. Kaspar, A new dimension of simplified science communication: the easiness effect of science popularization in animated video abstracts . Front Psychol, 2025. 16: p. 1584695. Table 3 Table 3 is not available with this version. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 16 Feb, 2026 Reviews received at journal 28 Jan, 2026 Reviewers agreed at journal 07 Jan, 2026 Reviews received at journal 21 Dec, 2025 Reviewers agreed at journal 16 Dec, 2025 Reviewers invited by journal 12 Dec, 2025 Editor assigned by journal 01 Dec, 2025 Submission checks completed at journal 01 Dec, 2025 First submitted to journal 01 Dec, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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13:43:18","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1499713,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8251143/v1/10d1ac83-3b33-48e7-8bea-975276cbb119.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"How can we best communicate the findings of public health-related systematic reviews? A Study Within a Review (SWAR)","fulltext":[{"header":"Background","content":"\u003cp\u003eSystematic reviews follow a transparent and reproducible methodology that enhances the reliability of their findings, thereby supporting evidence-based decision-making in health and social care[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. They play a crucial role in identifying the strengths and limitations of individual studies, highlighting gaps in existing knowledge, and guiding future research. As such, systematic reviews are essential tools within the research cycle[\u003cspan additionalcitationids=\"CR3\" citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. By providing accurate and comprehensive summaries of available evidence, they are highly valuable for healthcare practitioners, policymakers, patients, the public, and researchers. However, despite their importance, the findings of systematic reviews can be challenging to interpret. This challenge is not limited to the general public, policy makers and even producers of clinical guidelines have also been found to misinterpret or misquote the conclusions of systematic reviews [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIt is vital that findings of systematic review are communicated effectively to ensure they reach and benefit their intended audiences, particularly when addressing issues of public health relevance. However, as with scientific research more broadly, such reviews are often written in complex language, limiting their readability and making it difficult for non-specialists to engage with the content[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Over the past two decades, research articles have become increasingly difficult to read due to the use of longer, more intricate sentences, and technical vocabulary[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Detailed statistical analyses and extensive methodological discussions that are integral to systematic reviews and meta-analyses further reduce their accessibility.\u003c/p\u003e \u003cp\u003ePoor accessibility restricts the public\u0026rsquo;s ability to use systematic reviews to make informed health-related decisions. Poor understanding may contribute to misinformation, as individuals may turn to secondary sources such as the media, which can sometimes misrepresent or oversimplify scientific findings[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Nevertheless, public health researchers need to ensure that their work is communicated effectively to a broad audience.\u003c/p\u003e \u003cp\u003ePlain language summaries aim to simplify the key messages of systematic reviews, increasingly with input from patients and the public. However, the effectiveness of these summaries in enhancing public comprehension is unclear[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Moreover, individuals process information differently depending on the format in which it is presented. For example, reading and listening comprehension activate different neural pathways[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Given that different people process information in different ways, investigating a variety of methods of communicating the findings of systematic reviews is essential to finding the best ways to improve accessibility and engagement.\u003c/p\u003e \u003cp\u003eFurthermore, the manner with which people interact with information has changed profoundly in the digital era, with a growing preference for content that is concise, accessible and easy to understand. The rise of social media and online health information platforms has transformed how individuals access and consume medical knowledge, making it imperative for researchers to continually adapt their communication strategies[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Online educational materials, including podcasts and video summaries, are increasingly popular, particularly among younger audiences[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Therefore, exploring whether audio summaries enhance engagement and comprehension compared to written summaries represents a necessary step toward improving knowledge dissemination.\u003c/p\u003e \u003cp\u003eA Study Within a Review (SWAR) is a research study embedded within a systematic review that aims to improve aspects relevant to the planning, conduct or dissemination of systematic reviews[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. SWARs investigate various aspects of the review process, such as study selection, data extraction and communication of results, to refine methodologies and optimise how evidence syntheses are conducted and shared[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. The global SWAR repository[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e], catalogues many SWARs, including some that evaluate methods for enhancing the accessibility of systematic reviews and their findings[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. SWAR 02 specifically aims to explore whether readers can understand key messages without having to read the full review, and if there is a difference in understanding various types of summaries. Its first implementation, with 36 participants[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e], compared knowledge transfer using three types of written summary with one audio version for a review of the health effects of using an electric fan during a heatwave[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. The SWAR found that differences between the groups were not statistically significant but suggested that the audio summary might be better for knowledge transfer than written summaries.\u003c/p\u003e \u003cp\u003eThis study was designed based on SWAR 02, to determine the most effective way to communicate the findings of public-health related systematic reviews to the public. We compared two formats for presenting plain language summaries of two systematic reviews: audio and written. Both reviews focused on important public health research topics.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThis SWAR was a randomised intervention study, conducted in Northern Ireland by the Aberdeen-Belfast Evidence Collaboration (ABEC). Its primary aim was to assess the public\u0026rsquo;s understanding of systematic review findings when presented as either written or audio summaries. As a secondary aim, we evaluated participants\u0026rsquo; enjoyment, perceived understanding and interest in reading the full text of the systematic review. Information retention was also assessed several weeks after participants had read or listened to the summaries.\u003c/p\u003e \u003cp\u003eTwo systematic reviews addressing important public health issues were selected. \u003cb\u003eReview 1\u003c/b\u003e, conducted by ABEC, focused on biomarkers for identifying sepsis in the emergency room[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. The plain language summary written by the ABEC review authors was used for the \u0026lsquo;reading\u0026rsquo; arm of this study, while an audio podcast of this plain language summary was recorded by one of this study\u0026rsquo;s authors (SD) for the \u0026lsquo;listening\u0026rsquo; arm of this study. \u003cb\u003eReview 2\u003c/b\u003e was a recently published Cochrane review on the use of eye drops for contact lens wearers, selected as a topic of likely broad public interest[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. The podcast script was downloaded from the Cochrane Library and used for the \u0026lsquo;reading\u0026rsquo; arm, while a new recording of the same script, produced by one of the study authors (SD), was used for the \u0026lsquo;listening\u0026rsquo; arm to maximise consistency between audio interventions. The text of Review 1 (Additional file 1A) and Review 2 (Additional file 1B) are provided in Additional File 1.\u003c/p\u003e \u003cp\u003eParticipants were recruited using posters displayed in the common areas (and other high-traffic areas) of Queen\u0026rsquo;s University Belfast, social media platforms (Instagram and Facebook) and via word of mouth (Poster shown in Additional file 2). To encourage participation, refreshments were offered, and potential participants were eligible to enter a prize draw for monetary vouchers. Criteria for inclusion were as follows: adults (18\u0026thinsp;+\u0026thinsp;years) of any gender who were willing and able to read or listen to review summaries, answer questions, and provide informed consent. Individuals with learning difficulties, hearing or visual impairments, and those under 18 years of age were not deemed eligible for inclusion. The consent process included a pre-study questionnaire containing demographic and background questions to collect the participant\u0026rsquo;s first name or nickname, age, scientific education, and any scientific training beyond secondary education. Before completing the questionnaire, the lead researcher (NG) provided the participants with a verbal overview of the study, including an estimated participation time of 10\u0026ndash;20 minutes. Participants who gave verbal consent were then given time to review the study information sheet, complete the form and indicate their willingness to participate in writing. A unique identification code was created for each participant who agreed to take part. Additional File 3 presents the study Information, consent form and preliminary questions. Participants were randomly assigned to either the \u0026lsquo;Reading Group\u0026rsquo; or the \u0026lsquo;Listening Group\u0026rsquo; using a smartphone randomisation application (Randomiser by Rob Sammons, Version 9.0.1). The \u0026lsquo;Reading Group\u0026rsquo; read the summaries of the two reviews on a tablet or laptop computer while the \u0026lsquo;Listening Group\u0026rsquo; listened to the corresponding audio summaries using headphones (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Within each group, alternation was used so that participants began with either Review 1 or Review 2, to minimise potential bias related to improved performance on the second task. All participants completed their assigned tasks face-to-face, in the presence of the lead researcher (NG). See Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e for Consolidated Standards of Reporting Trials (CONSORT) diagram.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eParticipant groups and study tasks\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParticipant Group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStudy Task\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReading Group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eParticipants read the Plain Language Summary of both Review 1 and Review 2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eListening Group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eParticipants listen to the Audio Podcast Summary of both Review 1 and Review 2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eAfter completing the randomly assigned task of either \u0026lsquo;reading\u0026rsquo; or \u0026lsquo;listening\u0026rsquo; to the summary of their first review, participants were asked to answer questions related to that review\u0026rsquo;s findings on a Microsoft Word document. They then proceeded to the second review, again following their assigned randomised format, and answered a corresponding set of questions. Additional File 4 presents the Review 1 questions (Additional File 4A) and Review 2 questions (Additional File 4B). The questions were developed by the research team based on a questionnaire from a comparable earlier study by Bredbenner and Simon (2019)[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e], and adapted to align with the specific content of each review summary. Each set included a multiple-choice question and five true/false questions assessing comprehension of the review topic. Correct answers were scored \u0026lsquo;1\u0026rsquo; point, yielding a maximum possible score of \u0026lsquo;6\u0026rsquo;, with higher scores indicating better comprehension. The questions were designed to be relevant to both written and audio formats. Three additional questions assessed participant\u0026rsquo;s enjoyment, \u0026lsquo;perceived understanding\u0026rsquo; of the summary, and their \u0026lsquo;interest in reading the whole review paper after engaging with the summary. Responses were rated on a five-point scale from 0 (\u0026lsquo;not a bit\u0026rsquo;) and 4 (\u0026lsquo;very much\u0026rsquo;), with higher scores indicating better enjoyment, perceived understanding, or interest.\u003c/p\u003e \u003cp\u003eParticipants were contacted by telephone or email for a follow-up assessment several weeks after their initial assessment. This assessment could be conducted face-to-face or by telephone, and it repeated the six multiple-choice questions assessing the understanding of the review topic. This stage was designed to determine their ability to retain key information over time, and it did not include questions on enjoyment, perceived understanding or interest in reading the full text.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eThe collected data were checked for normality, and non-parametric tests were used in all cases. We compared groups using Mann-Whitney U tests for continuous data. Categorical data were analysed using the Chi-square Test of Independence. Pearson\u0026rsquo;s correlation was used to determine the strength and direction of a linear relationship between continuous variables. Participants were divided into \u0026lsquo;High Scorers\u0026rsquo; and \u0026lsquo;Low Scorers\u0026rsquo; for further analysis, with high scorers being those who achieved a comprehension score greater than the median score. Paired analysis to assess retention of information between the initial assessment and follow-up assessment was done using the non-parametric Wilcoxon Signed Rank test. A p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant. Data were collected using Microsoft Forms (Microsoft Corporation; held by QUB, accessed 2024/5), exported to Microsoft Excel version 16.95.1 (Copyright 2025 Microsoft) and then to IBM SPSS statistical package version 30.0.0.0 (172) (IBM Corp. Copyright IBM Corporation 1989\u0026ndash;2024) for analysis. Data were tabulated or displayed in graphs. We aimed to recruit approximately 100 participants due to the time constraints related to this being an undergraduate dissertation project.\u003c/p\u003e \u003cp\u003e \u003cb\u003eFunding and ethical approval\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThis study was granted ethical approval from the QUB Faculty of Medicine, Health and Life Sciences Research Ethics Committee (Reference number: MHLS 24_223). The study was supported by the Health Research Board (Ireland) and the HSC Public Health Agency (Grant number ESI-2021-001) through Evidence Synthesis Ireland/Cochrane Ireland. The original SWAR 02 protocol had been previously registered in the SWAR Repository[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eWe recruited 105 participants and randomly allocated them into one of two groups: Reading Group (n\u0026thinsp;=\u0026thinsp;51) or Listening Group (n\u0026thinsp;=\u0026thinsp;54). The characteristics of the groups were broadly similar for age, sex and being in a science-related career. However, by chance, there were significantly more people with a formal science education in the Listening Group than in the Reading Group (p\u0026thinsp;=\u0026thinsp;0.012) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). In relation to our primary outcome, median (IQR) comprehension scores were 9 (8\u0026ndash;10) of a maximum score of 12 for the summaries of both reviews. These did not differ between the Reading and Listening Groups (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eParticipant characteristics and scores\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eReading Group (n\u0026thinsp;=\u0026thinsp;51)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eListening Group (n\u0026thinsp;=\u0026thinsp;54)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP-value\u0026sect;\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge in years, median (IQR)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32 (22.8\u0026ndash;49.8)\u003c/p\u003e \u003cp\u003e(Range 18\u0026ndash;80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28 (23.0\u0026ndash;49.0)\u003c/p\u003e \u003cp\u003e(Range 18\u0026ndash;82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.644\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eMale, n (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15 (29.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10 (18.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.19\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eFemale, n (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36 (70.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e44 (81.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFormal science education\u003c/b\u003e\u003csup\u003e\u003cb\u003e\u0026plusmn;\u003c/b\u003e\u003c/sup\u003e, \u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15 (29.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29 (53.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.012*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIn a science-related career^, n (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9 (17.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12 (22.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.508\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eComprehension scores, median (IQR)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9 (8.0\u0026ndash;10.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9 (8.0\u0026ndash;10.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.825\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e\u0026sect; Mann-Whitney U test or Chi-Square test comparing reading group and listening group\u003c/p\u003e \u003cp\u003e\u0026plusmn;Participant reports receiving formal scientific education after high school / secondary school (e.g. science classes in college, work in a laboratory)\u003c/p\u003e \u003cp\u003e^Participants reports working in a science-related job\u003c/p\u003e \u003cp\u003e*Statistically significant difference\u003c/p\u003e \u003cp\u003eIQR, interquartile range\u003c/p\u003e\n\u003ch3\u003eComparison of comprehension scores by subgroups\u003c/h3\u003e\n\u003cp\u003eParticipants without a formal science education achieved significantly lower comprehension scores than those with a formal science education in the Reading Group (median [IQR] scores of 8 [7.0-9.8] and 10 [9.0\u0026ndash;10], respectively), but not in the Listening group. Regarding employment in a science-related field versus other occupations, there was no significant difference in median comprehension scores in either group. Similarly, no significant differences were observed between age or sex subgroups (Table\u0026nbsp;3).\u003c/p\u003e\n\u003ch3\u003e[INSERT TABLE 3]\u003c/h3\u003e\n\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eCorrelation between comprehension scores and age\u003c/h2\u003e \u003cp\u003eNo significant correlation was observed between age and comprehension scores in the overall sample (p\u0026thinsp;=\u0026thinsp;0.297), or within the Reading Group (p\u0026thinsp;=\u0026thinsp;0.429). However, a weak negative association was found between age and comprehension scores within the Listening Group (Pearson\u0026rsquo;s correlation \u0026minus;\u0026thinsp;0.34; p\u0026thinsp;=\u0026thinsp;0.015), indicating that increasing age was weakly but significantly associated with lower comprehension of the audio summaries.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eHigh scorers by subgroup\u003c/h2\u003e \u003cp\u003eHigh scorers were defined as participants who achieved a comprehension score greater than the median value of 9. Comparisons between high and low scorers were made for age, sex, employment in a science-related field, and formal science education (Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e4\u003c/span\u003eA-D). When comparing high with low scorers, no age difference was observed in the overall sample or within the Reading Group (Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e4\u003c/span\u003e.A). However, those with high scores in the Listening Group were younger (median age (IQR) 26 years, 21.0\u0026ndash;40.0) than those with low scores (median age (IQR) 44 (24.5\u0026ndash;56.5), p\u0026thinsp;=\u0026thinsp;0.029). There was no difference regarding high or low scorers for sex (Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e4\u003c/span\u003e.B). A significantly greater proportion of participants with formal science education were high scorers compared with those without, both in the overall sample group and in the Reading Group, but not in the Listening Group (Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e4\u003c/span\u003e.C). Regarding participants working in a science related job versus those who were not in such a job, there was no difference. No significant difference in high versus low comprehension scores was observed between participants employed in science-related roles and those who were not.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cb\u003eA\u003c/b\u003e High scorers (\u0026gt;\u0026thinsp;9 out of 12) versus low scorers according to \u003cb\u003eage\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNumber\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAge,\u003c/p\u003e \u003cp\u003eMedian (IQR)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP value^\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHigh scorer (\u0026gt;\u0026thinsp;9) Total group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27 (22.5\u0026ndash;46.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.351\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41 (22.5\u0026ndash;54.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHigh scorer (\u0026gt;\u0026thinsp;9) Reading Group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36 (23.0-52.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.367\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29 (21.0\u0026ndash;48.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHigh scorer (\u0026gt;\u0026thinsp;9) Listening Group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26 (21.0\u0026ndash;40.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.029*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e44 (24.5\u0026ndash;56.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e^Mann-Whitney U test\u003c/p\u003e \u003cp\u003e*Statistically significant difference\u003c/p\u003e \u003cp\u003eIQR, interquartile range\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cb\u003eB\u003c/b\u003e High scorers (\u0026gt;\u0026thinsp;9 out of 12) versus low scorers according to \u003cb\u003esex\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP-value^\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHigh scorer (\u0026gt;\u0026thinsp;9)\u003c/p\u003e \u003cp\u003eTotal Group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.723\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHigh scorer (\u0026gt;\u0026thinsp;9)\u003c/p\u003e \u003cp\u003eReading Group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.941\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHigh scorer (\u0026gt;\u0026thinsp;9)\u003c/p\u003e \u003cp\u003eListening Group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e^Chi-square analysis\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cb\u003eC\u003c/b\u003e High scorers (\u0026gt;\u0026thinsp;9 out of 12) versus low scorers according to \u003cb\u003ehistory of formal science education\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFormal science education: YES\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFormal science education: NO\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP-value^\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHigh scorer (\u0026gt;\u0026thinsp;9)\u003c/p\u003e \u003cp\u003eTotal Group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.001*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHigh scorer (\u0026gt;\u0026thinsp;9)\u003c/p\u003e \u003cp\u003eReading Group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.002*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHigh scorer (\u0026gt;\u0026thinsp;9)\u003c/p\u003e \u003cp\u003eListening Group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.064\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e^Chi-square analysis\u003c/p\u003e \u003cp\u003e*Statistically significant difference\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cb\u003eD\u003c/b\u003e High scorers (\u0026gt;\u0026thinsp;9 out of 12) versus low scorers according to \u003cb\u003ebeing in a science-related job\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eWorking in a science-related job: YES\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eWorking in a science-related job: NO\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP-value^\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHigh scorer (\u0026gt;\u0026thinsp;9)\u003c/p\u003e \u003cp\u003eTotal Group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.197\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHigh scorer (\u0026gt;\u0026thinsp;9)\u003c/p\u003e \u003cp\u003eReading Group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.057\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHigh scorer (\u0026gt;\u0026thinsp;9)\u003c/p\u003e \u003cp\u003eListening Group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.941\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e^Chi-square analysis\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eEnjoyment, perceived understanding, and interest in reading more\u003c/h3\u003e\n\u003cp\u003eOur secondary aim was to compare the two summaries in terms of enjoyment, perceived understanding and interest in reading the full text of the systematic review (Tables\u0026nbsp;\u003cspan refid=\"Tab9\" class=\"InternalRef\"\u003e5\u003c/span\u003eA-C; Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Using Pearson\u0026rsquo;s correlation, no significant association was found between comprehension scores and reported enjoyment, perceived understanding, or interest in reading the full text of the review. Enjoyment, perceived understanding and interest in reading the full text were all positively correlated. A moderate correlation was observed between perceived understanding and interest in reading the full text (R\u0026thinsp;=\u0026thinsp;0.526, P\u0026thinsp;\u0026lt;\u0026thinsp;0.01), while strong correlations were found between perceived understanding and reported enjoyment of the summary (R\u0026thinsp;=\u0026thinsp;0.658, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and between enjoyment and interest in reading the full text (R\u0026thinsp;=\u0026thinsp;0.606, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cb\u003eA\u003c/b\u003e Participants\u0026rsquo; responses for \u0026lsquo;enjoyment\u0026rsquo; according to groups (reading and listening)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003e\u0026lsquo;I enjoyed reading / listening to this summary\u0026rsquo;\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eStudy group\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eSummary\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lsquo;Not at all\u0026rsquo;\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lsquo;A bit\u0026rsquo;\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lsquo;Average\u0026rsquo;\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lsquo;Mostly\u0026rsquo;\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e\u0026lsquo;Very much\u0026rsquo;\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eReading Group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSepsis (51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4 (7.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11 (21.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e26 (51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e10 (19.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eContact lenses (51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4 (7.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15 (29.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e16 (31.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e16 (31.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eBoth summaries (108)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e8 (7.9)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e25 (24.7)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e42 (41.6)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e26 (25.7)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eListening Group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSepsis (54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (1.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 (11.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e16 (29.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e16 (29.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e15 (27.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eContact lenses (54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (1.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7 (13.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e17 (31.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e17 (31.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e12 (22.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eBoth summaries (108)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e2 (1.8)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e13 (12.0)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e33 (30.6)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e33 (30.6)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e27 \u003cb\u003e25.0)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eData presented as n (%)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab8\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cb\u003eB\u003c/b\u003e Participants\u0026rsquo; responses for perceived understanding according to groups (reading and listening)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003e\u0026lsquo;I understand this research after reading / listening to this summary\u0026rsquo;\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eStudy group\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eSummary\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lsquo;Not at all\u0026rsquo;\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lsquo;A bit\u0026rsquo;\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lsquo;Average\u0026rsquo;\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lsquo;Mostly\u0026rsquo;\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e\u0026lsquo;Very much\u0026rsquo;\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eReading Group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSepsis (51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9 (17.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10 (19.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e18 (35.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e14 (27.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eContact lenses (51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 (9.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e14 (27.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e18 (35.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e14 (27.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eBoth summaries (102)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e14 (13.7)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e24 (23.5)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e36 (35.3)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e28 (27.5)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eListening Group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSepsis (54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (1.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11 (20.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e17 (31.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e17 (31.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8 (14.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eContact lenses (54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (3.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12 (22.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8 (14.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e21 (38.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e11 (20.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eData presented as n (%)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab9\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cb\u003eC\u003c/b\u003e Participants\u0026rsquo; responses for interest in reading more according to groups (reading and listening)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003e\u0026lsquo;I would like to read the full review paper after reading / listening to this summary\u0026rsquo;\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eStudy group\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eSummary\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lsquo;Not at all\u0026rsquo;\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lsquo;A bit\u0026rsquo;\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lsquo;Average\u0026rsquo;\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lsquo;Mostly\u0026rsquo;\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e\u0026lsquo;Very much\u0026rsquo;\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eReading Group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSepsis (51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (2.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13 (25.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13 (25.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e16 (31.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8 (15.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eContact lenses (51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (3.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10 (19.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e19 (37.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e9 (17.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e11 (21.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eBoth summaries (102)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e3 (2.9)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e23 (22.5)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e32 (31.4)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e25 (24.5)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e19 (18.6)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eListening Group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSepsis (54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9 (16.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10 (18.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12 (22.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e14 (25.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e9 (16.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eContact lenses (54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11 (20.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11 (20.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e18 (33.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e9 (16.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5 (9.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eBoth summaries (108)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e20 (18.5)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e21 (19.4)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e30 (27.8)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e23 (21.3)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e11 (10.2)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eData presented as n (%)\u003c/p\u003e\n\u003ch3\u003eRetention of information\u003c/h3\u003e\n\u003cp\u003eBetween two and five weeks after their interaction with the summaries, 14 participants from the Reading Group and 17 from the Listening Group attended a follow-up assessment. To evaluate information retention, only participants who completed both the initial and follow-up assessments were included in the following analysis. For the overall sample (Reading and Listening combined), the median (IQR) follow-up score was 8 (7.0\u0026ndash;9.0), which was significantly lower than their initial assessment score of 9 (8.0\u0026ndash;10.0; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). In the Reading Group, the median (IQR) follow-up comprehension score was 7 (7.0-8.3), which was lower than the initial score of 9.5 (9.0, 10.0; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). In contrast, the Listening Group showed no significant change between the initial assessment median (IQR) comprehension score of 8 (7.0, 9.0) and the follow-up score of 8 (7.5, 9.0; p\u0026thinsp;=\u0026thinsp;0.658). Similarly, paired analyses confirmed that median follow-up scores were significantly lower than initial scores in the overall sample and the Reading Group (p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001 and P\u0026thinsp;\u0026lt;\u0026thinsp;0.001, respectively), but not in the Listening Group (p\u0026thinsp;=\u0026thinsp;0.439).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this SWAR, we sought to explore the most effective way of communicating the findings of health-related systematic reviews to the public. Specifically, we compared comprehension of plain language summaries in a written or audio format. Our secondary aim was to assess participants\u0026rsquo; enjoyment, perceived understanding and interest in reading the full text of the systematic review, as well as measuring their retention of information several weeks after the initial assessment. Whilst there was no overall difference in comprehension between the Reading Group and the Listening Group, there were several notable findings.\u003c/p\u003e \u003cp\u003eWe found that participants with a formal science education achieved higher comprehension scores than those without such an education, both in the overall sample and in the Reading Group. Although the summaries were written in plain language and intended to be accessible to readers of all education levels, individuals with a science background appear to have a clear advantage in understanding scientific concepts or content. Research suggests that successful reading comprehension depends on the reader\u0026rsquo;s ability to link ideas within a text in a meaningful way, a process called coherence. Coherence is established through inference generation, which involves connecting information from within the text and integrating it with the reader\u0026rsquo;s prior knowledge. Factors influencing coherence include the reader's prior knowledge of the topic, their reading proficiency and their purpose for reading (for study or for pleasure)[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eWe found that the advantage associated with having a science education was evident only in the Reading Group, suggesting that the written summaries may have been less accessible to individuals with limited scientific knowledge. This finding highlights the need to ensure that written plain language summaries of systematic reviews are appropriately tailored to different audiences. In contrast, audio summaries were accessible and comprehensible even for individuals who did not have a formal science background, indicating that this medium may be more effective for some audiences.\u003c/p\u003e \u003cp\u003eOur findings are consistent with those in the original iteration of SWAR 02[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. In that study conducted with 36 university staff members in Northern Ireland, audio delivery via podcast resulted in higher comprehension scores than written summaries, which varied in content. In our study, by contrast, the written and audio summaries were identical in content, yet the reasons why listening may promote better comprehension than reading remain unclear. Previous research suggests that reading and listening comprehension activate different brain patterns, with reading activating more left-lateralised brain regions[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. There are also differences in the amounts of total brain activation between audio and visual stimuli[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Despite the importance of the public's understanding of health-related information, there is a notable lack of research comparing public comprehension of scientific findings presented through different communication formats, representing a significant gap in the current evidence base[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn this study, comprehension scores also indicated potential age-related differences, with older participants tending to score lower than younger participants in the Listening Group, while no such difference was observed in the Reading Group. This suggests that reading may be more accessible and comprehensible than listening for older individuals. Such findings may reflect broader shifts in how people consume information in the digital age, where there is an increasing preference for concise and easily digestible content. The rise of social media and online health information platforms has transformed how people engage with medical knowledge, necessitating adaptation of communication strategies. Online educational resources, such as podcasts and video summaries, are particularly popular among younger audiences[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Conversely, older individuals are more likely to be accustomed to reading printed newspapers than their digital equivalents[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e], possibly due to greater scepticism toward online news sources[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. The observed age-related difference may therefore be related to the extent of individuals\u0026rsquo; familiarity and practice with different media formats for obtaining information.\u003c/p\u003e \u003cp\u003eThere was no association between comprehension scores and participants' reported enjoyment or perceived understanding of the summaries. This suggests that participants were often not aware when they did not fully understand the information being presented.\u003c/p\u003e \u003cp\u003eWe found a decline in information retention after several weeks among participants in the Reading Group, suggesting that the written plain language summaries were not effective in facilitating long-term retention of the information presented. Other studies have reported that listening to a podcast can enhance information retention over comparable time frames[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. For instance, a 2022 study involving medical trainees found that those who listened to podcasts performed significantly better than those who read the text on two out of three topics assessed immediately after the learning session and that this improvement persisted for one topic at a four-week follow-up[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. However, a 2010 study examined information retention among students who were randomly assigned to either read a 3330-word article or listen to a 21-minute podcast containing identical content[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. When evaluated two days later, reading resulted in significantly better information retention. Initially, students expressed a preference for podcasts due to their convenience and engaging format, but this preference diminished once they recognised that the podcast format did not facilitate the same level of detailed recall as reading[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. These findings suggest a potential trade-off between enjoyment and the depth or accuracy of comprehension.\u003c/p\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eImplications for public health researchers and review authors\u003c/h2\u003e \u003cp\u003eEffective dissemination and communication of research is a crucial part of the research process. The findings of this study offer valuable insights that could inform future strategies for communicating the results of systematic reviews to the public. Researchers should view the strong engagement and enthusiasm shown by participants as evidence of significant public interest in research. However, the study also revealed that the existing plain language summaries were not sufficiently simple for some participants and contained elements that were not fully understood.\u003c/p\u003e \u003cp\u003eWhen developing plain language summaries of systematic reviews, non-expert audiences may respond better to a simplified versions that emphasise the importance and impact of the research, even if this requires omitting some technical detail[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Although the median comprehension scores across our overall sample were relatively high, suggesting a reasonable level of understanding, it is possible that the summaries were too detailed for individuals without a formal science education. Because our questions focused on specific data within the summaries, future efforts to communicate review findings may benefit from adopting a more narrative, story-driven approach that highlights real-world relevance and impact[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. For audiences with little prior knowledge of the topic, less detailed and more story-structured summaries may be particularly effective.\u003c/p\u003e \u003cp\u003eGiven that the comprehension scores in the Listening Group did not vary according to scientific education, it may be beneficial to provide audio versions of plain language summaries for all systematic reviews. However, since our findings suggest that older people may achieve better comprehension from written rather than audio formats, audio dissemination may be less critical for public health topics specifically targeting this age group.\u003c/p\u003e \u003cp\u003eFinally, the observation that participants were not always aware of their misunderstandings underscores the importance of producing clear, accessible plain language summaries that can be understood by individuals with varying levels of scientific literacy. Moreover, the decline in information retention over time highlights the need for ongoing reinforcement of public health messaging. Supplementary written materials such as brief written summaries, infographics, or follow-up content could further enhance understanding and long-term retention of essential information.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eImplications for future research\u003c/h2\u003e \u003cp\u003eFurther research is needed to better understand how the public consumes and understands the findings of public health-related systematic reviews. One promising area for exploration is the effectiveness of audio delivery formats, such as podcasts, for specific demographic groups. Future research could also examine older adults\u0026rsquo; perspectives on online review summaries to determine whether comprehension and enjoyment differ when information is presented in print compared with on-screen formats. There is also a need for future research that compares the different formats for people with learning difficulties or with visual and auditory impairments. In addition, studies should consider those who speak English as a second language to ensure that the communication of review findings in English is both comprehensible and culturally appropriate. Other summary formats that we did not assess in this study, such as infographics and videos, also warrant investigation[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. It is essential to prioritise research on information retention from systematic reviews. Longitudinal studies examining how well the public retains important public health messages over extended periods, months or years, could provide valuable insights into the long-term effectiveness of different communication strategies.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eStrengths and limitations\u003c/h2\u003e \u003cp\u003eDespite the randomised design, there were more participants with a formal science education in the Listening Group than in the Reading Group, the implications of which remain unclear. The groups were otherwise similar in terms of age, sex or being in a science-related career. Participation declined between the initial session and the follow-up assessment several weeks later, with only a third of participants agreeing to the follow-up. This attrition limited the study\u0026rsquo;s ability to assess long-term information retention and introduced the potential of self-selection bias, as those who were more interested or motivated may have been more likely to participate in the follow-up than those who were less engaged.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThis expanded iteration of SWAR 02 offers valuable insights into identifying effective methods for communicating the findings of systematic reviews to the public, helping to fill a critical gap in the current literature. Our results indicate that participants with a science education achieved better comprehension scores when presented with a written summary than those without a science education. This suggests that audio summaries may offer greater accessibility and understanding for individuals without a scientific background. Additionally, older adults showed lower comprehension scores than younger adults when listening to audio summaries, suggesting they may benefit more from written materials. Notably, there was no correlation between actual comprehension and participants\u0026rsquo; perceptions of their understanding. Furthermore, information retention was generally low across the entire sample, particularly among those in the Reading Group.\u003c/p\u003e \u003cp\u003eOverall, our findings highlight the importance of providing research summaries in multiple formats and tailoring communication strategies to the audience's educational background and age. Further research exploring these dynamics is essential to ensure that key findings of systematic reviews are communicated effectively, understood accurately, and retained over time by diverse audiences.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eSWAR\u0026nbsp; \u0026nbsp;Study Within a Review \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eABEC\u0026nbsp; \u0026nbsp;\u0026nbsp;Aberdeen Belfast Evidence Collaboration \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIQR \u0026nbsp; \u0026nbsp; \u0026nbsp; Inter Quartile Range \u0026nbsp;\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003e\u003cem\u003eEthics approval and consent to participate\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was granted ethical approval from the QUB Faculty of Medicine, Health and Life Sciences Research Ethics Committee (Reference number: MHLS 24_223). Participants completed informed consent forms.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eConsent for publication\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAvailability of data and materials\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eCompeting interests\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eFunding\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was supported by the Health Research Board (Ireland) and the HSC Public Health Agency (Grant number ESI-2021-001) through Evidence Synthesis Ireland/Cochrane Ireland. The funder had no role in conceptualisation, design, data collection, analysis, decision to publish, or preparation of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAuthors\u0026apos; contributions\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNG:\u0026nbsp;\u003c/strong\u003eFormal analysis (supporting); Investigation (lead);Visualisation (supporting); Writing \u0026ndash; Original Draft Preparation (supporting); Writing \u0026ndash; Review and Editing (supporting)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMC:\u003c/strong\u003e Visualisation (supporting); Writing \u0026ndash; Original Draft Preparation (supporting); Writing \u0026ndash; Review and Editing (supporting); Supervision (equal); Resources (lead); Funding Acquisition (supporting); Project Administration\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMB\u003c/strong\u003e Visualisation (supporting); Writing \u0026ndash; Original Draft Preparation (supporting); Writing \u0026ndash; Review and Editing (supporting); Supervision (equal); Funding Acquisition (supporting); Project Administration\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eGV\u003c/strong\u003e Visualisation (supporting); Writing \u0026ndash; Review and Editing (supporting); Funding Acquisition (supporting)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMI\u0026nbsp;\u003c/strong\u003eWriting \u0026ndash; Review and Editing (supporting); Funding Acquisition (supporting)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCR\u003c/strong\u003e Writing \u0026ndash; Review and Editing (supporting); Funding Acquisition (supporting)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSD\u0026nbsp;\u003c/strong\u003eVisualisation (lead); Writing \u0026ndash; Original Draft Preparation (lead); Writing \u0026ndash; Review and Editing (lead); Supervision (equal); Resources (lead); Funding Acquisition (equal); Project Administration\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAll authors\u003c/strong\u003e read and approved the final version.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAcknowledgements\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors acknowledge the members of the public who graciously agreed to participate in this study. We are grateful for your time.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAuthors\u0026rsquo; information\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMC is founder and curator of the SWAR Repository, held at Queen\u0026rsquo;s University Belfast.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMB, SD, MC, GV, CR and MI are part of the Aberdeen-Belfast Evidence Collaboration, a National Institute for Health \u0026amp; Social Care (NIHR)-funded Evidence Synthesis Group.\u003c/p\u003e\n\u003cp\u003eNG was a final year undergraduate student, BSc Biomedical Sciences, in Queen\u0026rsquo;s University Belfast\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eHiggins, J.P.T., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M. J., Welsh, V. A. (Editors), \u003cem\u003eCochrane Handbook for Systematic Reviews of Interventions\u003c/em\u003e. Second ed. 2019, Chichester (UK): John Wiley \u0026amp; Sons.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMcInnes, N. and B.J.A. Haglund, \u003cem\u003eReadability of online health information: implications for health literacy\u003c/em\u003e. Informatics for Health and Social Care, 2011. 36(4): p. 173\u0026ndash;189.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLund, H., et al., \u003cem\u003eEvidence-Based Research Series-Paper 2: Using an Evidence-Based Research approach before a new study is conducted to ensure value\u003c/em\u003e. J Clin Epidemiol, 2021. 129: p. 158\u0026ndash;166.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLund, H., et al., \u003cem\u003eEvidence-Based Research Series-Paper 3: Using an Evidence-Based Research approach to place your results into context after the study is performed to ensure usefulness of the conclusion\u003c/em\u003e. J Clin Epidemiol, 2021. 129: p. 167\u0026ndash;171.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhang, Z., et al., \u003cem\u003eDiscrepancies in breast cancer guideline recommendations despite similar Cochrane systematic review conclusions\u003c/em\u003e. J Evid Based Med, 2024. 17(1): p. 17\u0026ndash;25.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWang, S., X. Liu, and J. Zhou, \u003cem\u003eReadability is decreasing in language and linguistics\u003c/em\u003e. Scientometrics, 2022. 127(8): p. 4697\u0026ndash;4729.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBredbenner, K. and S.M. Simon, \u003cem\u003eVideo abstracts and plain language summaries are more effective than graphical abstracts and published abstracts\u003c/em\u003e. PLOS ONE, 2019. 14(11): p. e0224697.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZarifsanaiey, N., et al., \u003cem\u003eThe importance of integrating flexible learning methods (audio-visual animation vs. visual pamphlet) to enhance awareness, perspectives, and practices in preventing lower back pain in nurses. A quasi-experimental study\u003c/em\u003e. Health Sci Rep, 2024. 7(10): p. e70127.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSagan, P. and T. Leighton, \u003cem\u003eThe Internet \u0026amp; the future of news.\u003c/em\u003e Daedalus (Cambridge, Mass.), 2010. 139(2): p. 119\u0026ndash;125.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBoreskie, P.E., et al. \u003cem\u003eMedical Education Blog and Podcast Utilization During the COVID-19 Pandemic\u003c/em\u003e. Cureus, 2022. DOI: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.7759/cureus.23361\u003c/span\u003e\u003cspan address=\"10.7759/cureus.23361\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDevane, D., et al., \u003cem\u003eStudy within a review (SWAR)\u003c/em\u003e. Journal of Evidence-Based Medicine, 2022. 15(4): p. 328\u0026ndash;332.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eResearch, M.H.F.T.M., \u003cem\u003eSWAR Repository Store\u003c/em\u003e 2025, The Northern Ireland Hub for Trials Methodology Research Queen's University Belfast.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMaguire, L.K. and M. Clarke, \u003cem\u003eHow much do you need: a randomised experiment of whether readers can understand the key messages from summaries of Cochrane Reviews without reading the full review\u003c/em\u003e. J R Soc Med, 2014. 107(11): p. 444\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGupta, S., et al., \u003cem\u003eElectric fans for reducing adverse health impacts in heatwaves\u003c/em\u003e. Cochrane Database Syst Rev, 2012. 2012(7): p. CD009888.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBrazzelli, M., Clarke, M., Imamura, M., Virgili, G., Aucott, L., Vadiveloo, T., Manson, P., Cooper, J., Kaye, C. \u003cem\u003eClinical utility of biomarkers for outcomes prediction in adults with suspected sepsis presenting to the Emergency Department\u003c/em\u003e. 2024; Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.crd.york.ac.uk/PROSPERO/view/CRD42023454465\u003c/span\u003e\u003cspan address=\"https://www.crd.york.ac.uk/PROSPERO/view/CRD42023454465\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCaffery, B., et al., \u003cem\u003eLubricating drops for contact lens discomfort in adults\u003c/em\u003e. Cochrane Database Syst Rev, 2024. 9(9): p. Cd015751.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eClinton, V., et al., \u003cem\u003eInferential comprehension differences between narrative and expository texts: a systematic review and meta-analysis\u003c/em\u003e. Reading and Writing, 2020. 33(9): p. 2223\u0026ndash;2248.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMichael, E.B., et al., \u003cem\u003efMRI investigation of sentence comprehension by eye and by ear: Modality fingerprints on cognitive processes\u003c/em\u003e. Human Brain Mapping, 2001. 13(4): p. 239\u0026ndash;252.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSchott, S.L., et al., \u003cem\u003eHeart sounds: a pilot randomised trial to determine the feasibility and acceptability of audio recordings to improve discharge communication for cardiology inpatients protocol\u003c/em\u003e. Open Heart, 2019. 6(2): p. e001062.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAdoni, H. and G. Nimrod, \u003cem\u003eThe emergence of the hybrid older reader: A cross-national study\u003c/em\u003e. Communications, 2020. 45(4): p. 414\u0026ndash;439.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLe, T., et al., \u003cem\u003eTrust in Health Information Sources Differs between Young/Middle and Oldest Old\u003c/em\u003e. American Journal of Health Promotion, 2014. 28(4): p. 239\u0026ndash;241.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWolpaw, J., et al., \u003cem\u003eA Multimodal Evaluation of Podcast Learning, Retention, and Electroencephalographically Measured Attention in Medical Trainees\u003c/em\u003e. Cureus, 2022. 14(11): p. e31289.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDaniel, D.B. and W.D. Woody, \u003cem\u003eThey Hear, but Do Not Listen: Retention for Podcasted Material in a Classroom Context\u003c/em\u003e. Teaching of Psychology, 2010. 37(3): p. 199\u0026ndash;203.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHutchins, J.A., \u003cem\u003eTailoring Scientific Communications for Audience and Research Narrative\u003c/em\u003e. Current Protocols Essential Laboratory Techniques, 2020. 20(1).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSalzmann, S., C. Walther, and K. Kaspar, \u003cem\u003eA new dimension of simplified science communication: the easiness effect of science popularization in animated video abstracts\u003c/em\u003e. Front Psychol, 2025. 16: p. 1584695.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Table 3","content":"\u003cp\u003eTable 3 is not available with this version.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"systematic-reviews","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"sysr","sideBox":"Learn more about [Systematic Reviews](http://systematicreviewsjournal.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/sysr/default.aspx","title":"Systematic Reviews","twitterHandle":"@MedicalEvidence","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Systematic review, Study Within a Review (SWAR), plain language summary, lay abstract, podcast, audio, comprehension","lastPublishedDoi":"10.21203/rs.3.rs-8251143/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8251143/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground and aims:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSystematic reviews contain scientific language and complex analyses which may only be comprehensible to researchers or clinicians. However, it is imperative that public health-related systematic reviews are effectively communicated to the public. Plain language summaries and podcasts may improve the communication of important review findings. We conducted a Study Within a Review (SWAR) to evaluate comprehension of plain language systematic review summaries presented as either text or audio. We also aimed to evaluate enjoyment, perceived understanding, interest in reading the full-text, and information retention.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipants (n = 105) were consented and randomly assigned to a Reading or Listening Group and given the relevant type of summary for two systematic reviews. Comprehension, enjoyment, perceived understanding, and interest in reading the full text were assessed immediately. Several weeks later, comprehension was re-assessed to evaluate information retention. Data were non-normally distributed and non-parametric tests were used to compare groups.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eScience-educated participants achieved higher comprehension scores in the Reading Group than those without a science education; however, there was no such difference in the Listening Group. Older participants were less likely to be ‘high-scorers’ than younger people, but only in the Listening Group. Participants’ perceived understanding did not align with their actual comprehension. Information retention was poor across both groups, but particularly in the Reading Group.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThese novel data suggest that plain language summaries of systematic reviews are incompletely understood by some. This SWAR underscores the need for tailored communication strategies to effectively disseminate systematic review findings.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTrial registration:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study did not include a health care intervention on human participants. The Study Within a Review (SWAR) was based on a SWAR 02, registered in the Global SWAR Repository: https://www.qub.ac.uk/sites/TheNorthernIrelandNetworkforTrialsMethodologyResearch/SWATSWARInformation/Repositories/SWARStore/\u003c/p\u003e","manuscriptTitle":"How can we best communicate the findings of public health-related systematic reviews? A Study Within a Review (SWAR)","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-22 09:03:51","doi":"10.21203/rs.3.rs-8251143/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-02-16T12:10:56+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-28T08:26:47+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"19432053630622477229361060582639229390","date":"2026-01-07T10:39:34+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-21T15:32:09+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"97660203896597473609777318004016645821","date":"2025-12-16T20:29:57+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-12-12T08:50:44+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-12-02T00:55:00+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-12-02T00:54:24+00:00","index":"","fulltext":""},{"type":"submitted","content":"Systematic Reviews","date":"2025-12-01T13:38:14+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"systematic-reviews","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"sysr","sideBox":"Learn more about [Systematic Reviews](http://systematicreviewsjournal.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/sysr/default.aspx","title":"Systematic Reviews","twitterHandle":"@MedicalEvidence","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"ba1ca75e-49ab-41a8-80b4-3389b8ff8f25","owner":[],"postedDate":"December 22nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-16T13:08:26+00:00","versionOfRecord":[],"versionCreatedAt":"2025-12-22 09:03:51","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8251143","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8251143","identity":"rs-8251143","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}