OBJECTIVES: To assess the effectiveness of plain language compared with standard language versions of COVID-19 recommendations specific to child health. STUDY DESIGN AND SETTING: Pragmatic, allocation-concealed, blinded, superiority randomized controlled trial with nested qualitative component. Trial was conducted online, internationally. Parents or legal guardians (≥18 years) of a child (<18 years) were eligible. Participants were randomized to receive a plain language recommendation (PLR) or standard (SLV) verison of a COVID-19 recommendation specific to child health. Primary outcome was understanding. Secondary outcomes included: preference, accessibility, usability, satisfaction, and intended behavior. Interviews explored perceptions and preferences for each format. RESULTS: Between July and August 2022, 295 parents were randomized; 241 (81.7%) completed the study (intervention n = 121, control n = 120). Mean understanding scores were significantly different between groups (PLR 3.96 [standard deviation (SD) 2.02], SLV 3.33 [SD 1.88], P = 0.014). Overall participants preferred the PLR version: mean rating 5.05/7.00 (95% CI 4.81, 5.29). Interviews (n = 12 parents) highlighted their preference for the PLR and provided insight on elements to enhance future knowledge mobilization of health recommendations. CONCLUSION: Compared to SLVs, parents preferred PLRs and better understood the recommendation. Guideline developers should strive to use plain language to increase understanding, uptake, and implementation of evidence by the public.

Alberta Research Centre for Health Evidence Department of Pediatrics Faculty of Medicine and Dentistry University of Alberta Edmonton Alberta Canada; Cochrane Child Health Department of Pediatrics University of Alberta Edmonton Alberta Canada

Child Health Evaluative Sciences The Hospital for Sick Children Research Institute Toronto Ontario Canada

Child Health Evaluative Sciences The Hospital for Sick Children Research Institute Toronto Ontario Canada; Department of Psychiatry University of Toronto Toronto Ontario Canada

Child Health Evaluative Sciences The Hospital for Sick Children Research Institute Toronto Ontario Canada; Institute of Health Policy Management and Evaluation University of Toronto Toronto Ontario Canada; Division of Neonatology The Hospital for Sick Children Toronto Ontario Canada

Cochrane South Africa South African Medical Research Council Cape Town South Africa; Division of Clinical Pharmacology Department of Medicine Faculty of Medicine and Health Sciences Stellenbosch University Stellenbosch South Africa; Division of Epidemiology and Biostatistics Department of Global Health Faculty of Medicine and Health Sciences Stellenbosch University Stellenbosch South Africa

Czech National Centre for Evidence Based Healthcare and Knowledge Translation Cochrane Czech Republic Czech EBHC JBI Centre of Excellence Institute of Biostatistics and Analyses Faculty of Medicine Masaryk University Brno Bohunice Czech Republic

Departments of Health Research Methods Evidence and Impact and of Medicine McMaster University Hamilton Ontario Canada; Michael G DeGroote and GRADE Centres McMaster University Hamilton Ontario Canada; WHO Collaborating Center for Infectious Diseases Research Methods and Recommendations McMaster University Hamilton Ontario Canada

Departments of Health Research Methods Evidence and Impact and of Medicine McMaster University Hamilton Ontario Canada; Michael G DeGroote and GRADE Centres McMaster University Hamilton Ontario Canada; WHO Collaborating Center for Infectious Diseases Research Methods and Recommendations McMaster University Hamilton Ontario Canada; Department of Biomedical Sciences Humanitas University Milan Italy

Departments of Science and International Studies St Elizabeth University of Public Health and Social Science Bratislava Slovak Republic

Faculty of Nursing University of Alberta Edmonton Alberta Canada

Five02 Labs Inc Toronto Ontario Canada; Canadian Arthritis Patient Alliance Toronto Ontario Canada

Postgraduate Institute of Medical Education and Research Chandigarh India

Schulich School of Medicine and Dentistry Western University London Ontario Canada

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ClinicalTrials.gov
NCT05358990