Table 7.

Recommendations for item clarification

PEMAT Item	Recommendation
Item 4: Medical terms are used only to familiarize audience with the terms. When used, medical terms are defined (P and A/V)	Expand explanation to include “Medical terms that are necessary to understand the condition or treatment being discussed in the material are defined at first use.”
Item 5: The material uses the active voice (P and A/V)	Include a reminder that one should agree with the item if this characteristic happens at least 80% of the time.
Item 6: Numbers appearing in the material are clear and easy to understand	Rephrase to read “Choose ‘N/A’ if the material has no numbers or if the only numbers in the material are used to identify things such as times, dates, telephone numbers, and addresses.”
Item 13: Text on the screen is easy to read (A/V)	Clarify which text the item is referring to and which can be omitted for the assessment.
Item 15: The material uses visual aids whenever they could make content more easily understood (e.g., illustration of healthy portion size) (P)	Clarify the instructions to read “Choose ‘agree’ if the item doesn’t have characteristic but doesn’t need it.” Or, add a N/A response.
Item 18: The material uses illustrations and photographs that are clear and uncluttered (P and A/V)	Change the item to say “visual aids” instead of “illustrations and photographs” Expand explanation to include understandability of A/V materials, such as video quality and focus.
Item 23: The material provides a tangible tool (e.g., menu planners, checklists) whenever it could help the user take action (P)	Clarify the instructions to read “Choose ‘agree’ if the item doesn’t have characteristic but doesn’t need it.” Or, add a N/A response
Item 26: The material uses visual aids whenever they could make it easier to act on the instructions (P)	Clarify the instructions to read “Choose ‘agree’ if the item doesn’t have characteristic but doesn’t need it.” Or, add an N/A response