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

The Internet is used by caregivers to find first aid information for children before they have professional help with the care. To what extent such information would be usable or actionable in a practical emergency is unknown. This study aimed to determine whether top-ranked, patient-oriented online first aid information for children is readable, understandable, and actionable enough for caregivers to use in an emergency. This cross-sectional study investigated the top 10 English-language patient-oriented websites accessed using a standard Google search performed in March 2026. Readability was evaluated using six validated scales (GFI, CLI, FKGL, ARI, SMOG, FRE). All dimensions of understanding and actionability were evaluated using the Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P), and quality was evaluated using Journal of the American Medical Association (JAMA) benchmark criteria. The average reading grade level was 9.12 ± 2.66, well above the sixth grade recommended level (p<0.001). Sixty percent of the websites reported adequacy for understandability, yet none of them met the level of actionability (mean 42.9%). The average FRE score was 64.16 ± 15.87, a measure of “standard” to “fairly difficult” readability. Most websites fulfilled essential quality requirements (mean JAMA score: 3.10 ± 0.88), although attribution was frequently suboptimal. Pediatric first aid information available online is usually readable but lacks enough actionable information, and this gap may prevent caregivers from carrying out appropriate first aid in time-critical emergencies with implications for child safety. Healthcare organisations and content developers should prioritise making online health information actionable.