Top Pediatric First Aid Websites Lack Full Actionability, Study Finds

Online first aid information for children was generally readable, but none of the 10 highest-ranked English-language websites examined in a cross-sectional study met the researchers’ threshold for actionability. The pages had an average actionability score of 42.9%, while 60% were rated adequate for understandability, according to the study published in BMC Pediatrics.

The researchers investigated the patient-oriented websites returned by a standard Google search conducted in March 2026. The sample therefore represented the pages most likely to appear near the top of that search at that time, rather than all first aid information available online. The study evaluated the content of the websites; it did not test how caregivers performed during actual emergencies or whether using the information improved clinical outcomes.

Readability was assessed with six validated scales: the Gunning Fog Index, Coleman–Liau Index, Flesch–Kincaid Grade Level, Automated Readability Index, Simple Measure of Gobbledygook and Flesch Reading Ease. The average reading grade level was 9.12 ± 2.66, above the sixth-grade level used as the study’s recommended benchmark, a difference the researchers reported as statistically significant at p<0.001.

The average Flesch Reading Ease score was 64.16 ± 15.87, placing the material in the “standard” to “fairly difficult” range on that measure. Together, the readability results show that the selected pages were not written at the study’s target grade level, even though the authors characterized pediatric first aid information online as usually readable. The readability scores describe the complexity of the written material rather than how individual readers understood or acted on it.

Understandability and actionability were measured with the Patient Education Materials Assessment Tool for Printable Materials, known as PEMAT-P. Six in 10 websites were considered adequate for understandability, but none reached the study’s actionability threshold. The mean actionability score was 42.9%. This distinction is central to the findings: a page can present information that readers can understand without containing enough practical guidance to be rated actionable under the study’s criteria.

The researchers also evaluated the selected websites against Journal of the American Medical Association benchmark criteria. The pages achieved an average JAMA score of 3.10 ± 0.88, and most met the essential quality requirements considered in the assessment. Attribution was frequently suboptimal, however. The study therefore found a mixed quality profile: the websites generally contained important material, but they were not consistently equipped to support action, and attribution was another recurring weakness.

These results do not demonstrate that caregivers would fail to give appropriate first aid, nor do they establish any change in emergency response or child safety. The cross-sectional design assessed a small, search-selected set of English-language pages at one moment. It also did not directly observe emergency behavior. The findings should therefore be interpreted as an evaluation of the information provided by these websites, not as proof about the decisions or performance of caregivers using them.

The authors concluded that healthcare organisations and content developers should prioritize making online health information actionable. Their concern is relevant because insufficient actionability may hinder appropriate action in time-critical emergencies, with implications for child safety. Whether adding more actionable content would improve real-world first aid or child outcomes remains untested by this study and would require separate evaluation.

Subject of Research: Evaluation of readability, understandability and actionability in online pediatric first aid information

Article Title: Readability, understandability, and actionability of online first aid information for children: a cross-sectional study

Article References: Gökulu, G., & Uzunçıbuk, H. (2026). Readability, understandability, and actionability of online first aid information for children: a cross-sectional study. BMC Pediatrics. https://doi.org/10.1186/s12887-026-07530-x

Image Credits: AI Generated

DOI: 10.1186/s12887-026-07530-x

Keywords: pediatric first aid, online health information, readability, understandability, actionability, health communication, caregivers, child safety, web content, cross-sectional study, online, first