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. Author manuscript; available in PMC: 2023 Jun 1.
Published in final edited form as: Obstet Gynecol. 2022 May 2;139(6):1111–1122. doi: 10.1097/AOG.0000000000004757

Table 2.

Proportion responding correctly to each secondary communication objective by age group and literacy level

Secondary communication objective Question to assess understanding (Key concept) Study group N Point Estimate % 95% Confidence Interval

Ineligible if unsure how many weeks pregnant Beatriz is unsure how far along she is in her pregnancy. What does the label say Beatriz should do? (Eligibility) Total 844 0.99 0.98 0.99
>=9th grade literacy 687 0.99 0.98 0.99
Limited literacy 157 0.99 0.95 1.00
Ages 18–49 543 0.99 0.98 1.00
Ages 12–17 301 0.98 0.96 0.99

Medication doesn’t always work According to the label, if the medication is used correctly, does it always work? (Recognizing risk of treatment failure) Total 844 0.97 0.96 0.98
>=9th grade literacy 687 0.99 0.97 0.99
Limited literacy 157 0.91 0.85 0.95
Ages 18–49 543 0.96 0.94 0.98
Ages 12–17 301 0.99 0.97 1.00
Contraindicated if has porphyria Whitney has a disease called porphyria and is thinking about using this product. Is it OK or not OK for her to start to use this product? (Contraindication) Total 844 0.94 0.92 0.95
>=9th grade literacy 687 0.94 0.92 0.95
Limited literacy 157 0.94 0.89 0.97
Ages 18–49 543 0.94 0.91 0.95
Ages 12–17 301 0.94 0.91 0.96

Contraindicated if allergic to mifepristone Chris is allergic to mifepristone. They want to use this product. What does the label say, if anything, about that? (Contraindication) Total 844 0.94 0.93 0.96
>=9th grade literacy 687 0.95 0.93 0.97
Limited literacy 157 0.91 0.85 0.95
Ages 18–49 543 0.94 0.91 0.95
Ages 12–17 301 0.96 0.93 0.98

Contraindicated if unexplained pain or bleeding Daniela has been having unexplained pain and bleeding during her pregnancy and wants to use this product. What does the label say about that? (Contraindication) Total 844 0.96 0.95 0.97
>=9th grade literacy 687 0.98 0.96 0.99
Limited literacy 157 0.89 0.83 0.94
Ages 18–49 543 0.96 0.94 0.97
Ages 12–17 301 0.96 0.94 0.98

Contraindicated if has anemia Maria has a low red blood cell count, also called anemia. She wants to take this product. What does the label say about that? (Contraindication) Total 844 0.99 0.98 1.00
>=9th grade literacy 687 0.99 0.98 1.00
Limited literacy 157 1.00 0.98 1.00*
Ages 18–49 543 0.99 0.98 1.00
Ages 12–17 301 0.99 0.98 1.00

Contact health care provider if signs of infection Sofia finished taking this product one week ago. She has been feeling sick, with a fever of 101°F, and her bleeding has not stopped. According to the label, what should Sofia do, if anything? (Warning signs) Total 844 0.97 0.96 0.98
>=9th grade literacy 686 0.98 0.97 0.99
Limited literacy 157 0.93 0.88 0.96
Ages 18–49 542 0.97 0.96 0.99
Ages 12–17 301 0.96 0.94 0.98

Take one mifepristone tablet How many tablets of mifepristone should she take? (Dosing regimen) Total 844 0.98 0.96 0.98
>=9th grade literacy 687 0.98 0.97 0.99
Limited literacy 157 0.96 0.91 0.98
Ages 18–49 543 0.97 0.95 0.98
Ages 12–17 301 0.99 0.97 1.00

Take mifepristone orally She swallowed the mifepristone medication. Did she take the mifepristone correctly? (Dosing regimen) Total 844 0.96 0.94 0.97
>=9th grade literacy 687 0.97 0.95 0.98
Limited literacy 157 0.93 0.88 0.96
Ages 18–49 543 0.96 0.94 0.97
Ages 12–17 301 0.96 0.94 0.98

Take misoprostol 24–48 hours after mifepristone Vicki took the first medication on Tuesday at 8 am. When would be the earliest time she could take the next medication? (Dosing regimen) Total 844 0.87 0.84 0.89
>=9th grade literacy 687 0.90 0.87 0.92
Limited literacy 157 0.73 0.66 0.80
Ages 18–49 543 0.86 0.83 0.89
Ages 12–17 301 0.88 0.84 0.91

Take four misoprostol tablets Vicki is now ready to take the misoprostol. Exactly how many tablets should she take? (Dosing regimen) Total 844 1.00 0.99 1.00
>=9th grade literacy 687 1.00 0.99 1.00*
Limited literacy 157 0.99 0.97 1.00
Ages 18–49 543 1.00 0.99 1.00
Ages 12–17 301 1.00 0.99 1.00*

Take misoprostol buccally When taking the misoprostol tablets, how should Vicki take them? (Dosing regimen) Total 844 0.97 0.95 0.98
>=9th grade literacy 687 0.97 0.96 0.98
Limited literacy 157 0.94 0.89 0.97
Ages 18–49 543 0.97 0.95 0.98
Ages 12–17 301 0.97 0.94 0.99

Recognize normal side effects Anna started taking this product this morning. She feels dizzy, has strong cramping, and has been bleeding heavier than a menstrual period, but not too heavy. According to the label, what should Anna do, if anything? (Understanding side effects) Total 841 0.88 0.85 0.90
>=9th grade literacy 684 0.90 0.88 0.92
Limited literacy 157 0.78 0.70 0.84
Ages 18–49 542 0.86 0.83 0.89
Ages 12–17 299 0.91 0.87 0.94

Average secondary communication objectives correct Total 844 0.95 0.95 0.96
>=9th grade literacy 687 0.96 0.96 0.97
Limited literacy 157 0.92 0.90 0.93
Ages 18–49 543 0.95 0.94 0.96
Ages 12–17 301 0.96 0.95 0.97
*

One-sided 97.5% confidence interval used for objectives with point estimates at 100% correct

The lower limit of the 95% confidence interval was below 80%.