RATIONALE: Plain language recommendations (PLRs) offer clear and understandable statements based on trustworthy guidelines. OBJECTIVE: We aimed to synthesise methodological evidence for developing PLRs in the health care context. METHODS: We followed the JBI methodology for scoping review development and the PRISMA-ScR guidelines for scoping review reporting. PLRs in the context of health care guidelines or patient versions of guidelines were included. A systematic search was run in MEDLINE (Ovid), Embase (Ovid), and the repositories of guideline developers until November 2023. Due to the research´s longitudinal nature, the search was updated in May 2025 to verify findings gathered so far. Reviewers extracted data independently and synthesised evidence narratively. RESULTS: In total, 2512 citations and 66 repositories of guideline developers were screened. Nine articles from databases and eight documents representing seven sources of evidence from guideline developers' repositories were included in the final synthesis. Information about PLRs, their development, and methodology were summarised. Various infographics are used when creating PLRs. The target groups of PLRs are, e.g. patients, policymakers, the public, and healthcare providers. The patients could be involved in creating PLRs. The developers can draw from the GIN Public Toolkit, RIGHT-PVG checklist or DISCERN. Although these methodologies generally cover the development of knowledge translation tools and patients' version of guidelines (PVGs). Numerous tools can be used to translate scientific language and to formulate PLRs. CONCLUSION: We propose policy support for the conduct and implementation of PLRs for healthcare guidelines drawn from available evidence-based resources identified by our review. It is desirable to report approaches for communicating recommendations from healthcare guidelines and verify the actionability and understandability of these formats.

• Keywords
• consumer health information, decision making, guideline as a topic, health education, health knowledge,
• MeSH
• Language * MeSH
• Humans MeSH
• Practice Guidelines as Topic * standards   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Scoping Review MeSH

IMPORTANCE: To ensure that youths can make informed decisions about their health, it is important that health recommendations be presented for understanding by youths. OBJECTIVE: To compare understanding, accessibility, usability, satisfaction, intention to implement, and preference of youths provided with a digital plain language recommendation (PLR) format vs the original standard language version (SLV) of a health recommendation. DESIGN, SETTING, AND PARTICIPANTS: This pragmatic, allocation-concealed, blinded, superiority randomized clinical trial included individuals from any country who were 15 to 24 years of age, had internet access, and could read and understand English. The trial was conducted from May 27 to July 6, 2022, and included a qualitative component. INTERVENTIONS: An online platform was used to randomize youths in a 1:1 ratio to an optimized digital PLR or SLV format of 1 of 2 health recommendations related to the COVID-19 vaccine; youth-friendly PLRs were developed in collaboration with youth partners and advisors. MAIN OUTCOMES AND MEASURES: The primary outcome was understanding, measured as the proportion of correct responses to 7 comprehension questions. Secondary outcomes were accessibility, usability, satisfaction, preference, and intended behavior. After completion of the survey, participants indicated their interest in completing a 1-on-1 semistructured interview to reflect on their preferred digital format (PLR or SLV) and their outcome assessment survey response. RESULTS: Of the 268 participants included in the final analysis, 137 were in the PLR group (48.4% female) and 131 were in the SLV group (53.4% female). Most participants (233 [86.9%]) were from North and South America. No significant difference was found in understanding scores between the PLR and SLV groups (mean difference, 5.2%; 95% CI, -1.2% to 11.6%; P = .11). Participants found the PLR to be more accessible and usable (mean difference, 0.34; 95% CI, 0.05-0.63) and satisfying (mean difference, 0.39; 95% CI, 0.06-0.73) and had a stronger preference toward the PLR (mean difference, 4.8; 95% CI, 4.5-5.1 [4.0 indicated a neutral response]) compared with the SLV. No significant difference was found in intended behavior (mean difference, 0.22 (95% CI, -0.20 to 0.74). Interviewees (n = 14) agreed that the PLR was easier to understand and generated constructive feedback to further improve the digital PLR. CONCLUSIONS AND RELEVANCE: In this randomized clinical trial, compared with the SLV, the PLR did not produce statistically significant findings in terms of understanding scores. Youths ranked it higher in terms of accessibility, usability, and satisfaction, suggesting that the PLR may be preferred for communicating health recommendations to youths. The interviews provided suggestions for further improving PLR formats. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05358990.

• MeSH
• COVID-19 * prevention & control   MeSH
• Outcome Assessment, Health Care MeSH
• Formative Feedback MeSH
• Humans MeSH
• Adolescent MeSH
• Surveys and Questionnaires MeSH
• COVID-19 Vaccines MeSH
• Check Tag
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Names of Substances
• COVID-19 Vaccines MeSH

INTRODUCTION: The COVID-19 pandemic underlined that guidelines and recommendations must be made more accessible and more understandable to the general public to improve health outcomes. The objective of this study is to evaluate, quantify, and compare the public's understanding, usability, satisfaction, intention to implement, and preference for different ways of presenting COVID-19 health recommendations derived from the COVID-19 Living Map of Recommendations and Gateway to Contextualization (RecMap). METHODS AND ANALYSIS: This is a protocol for a multi-method study. Through an online survey, we will conduct pragmatic allocation-concealed, blinded superiority randomized controlled trials (RCTs) in three populations to test alternative formats of presenting health recommendations: adults, parents, and youth, with at least 240 participants in each population. Prior to initiating the RCT, our interventions will have been refined with relevant stakeholder input. The intervention arm will receive a plain language recommendation (PLR) format while the control arm will receive the corresponding original recommendation format as originally published by the guideline organizations (standard language version). Our primary outcome is understanding, and our secondary outcomes are accessibility and usability, satisfaction, intended behavior, and preference for the recommendation formats. Each population's results will be analyzed separately. However, we are planning a meta-analysis of the results across populations. At the end of each survey, participants will be invited to participate in an optional one-on-one, virtual semi-structured interview to explore their user experience. All interviews will be transcribed and analyzed using the principles of thematic analysis and a hybrid inductive and deductive approach. ETHICS AND DISSEMINATION: Through Clinical Trials Ontario, the Hamilton Integrated Research Ethics Board has reviewed and approved this protocol (Project ID: 3856). The University of Alberta has approved the parent portion of the trial (Project ID:00114894). Findings from this study will be disseminated through open-access publications in peer-reviewed journals and using social media. TRIAL REGISTRATION: Clinicaltrials.gov NCT05358990 . Registered on May 3, 2022.

• Keywords
• COVID-19, Knowledge mobilization, Plain language recommendation, Public engagement, Randomized controlled trial, Standard language versions, eCOVID RecMap,
• MeSH
• COVID-19 * MeSH
• Adult MeSH
• Humans MeSH
• Meta-Analysis as Topic MeSH
• Adolescent MeSH
• Surveys and Questionnaires MeSH
• Randomized Controlled Trials as Topic MeSH
• SARS-CoV-2 MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Adolescent MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Ontario MeSH