Evaluating text messages from primary care clinics using a CLAS rubric.

Area of Science:

• Health Communication
• Health Literacy
• Digital Health

Background:

• Text messaging campaigns show promise for enhancing patient engagement and compliance.
• Emerging text messaging strategies face challenges in health literacy, cultural relevance, and linguistic accessibility.
• A novel numeric rubric was created to assess text messages against Culturally and Linguistically Appropriate Services (CLAS) and National Institutes of Health (NIH) Clear Communication standards.

Purpose of the Study:

• To evaluate the alignment of health-related text messages with CLAS and NIH Clear Communication standards using a developed rubric.
• To provide feedback for improving text messages and enhancing positive patient outcomes.
• To assess the rubric's utility in optimizing health communication via text messaging.

Main Methods:

• A rubric was developed, scoring messages on cultural relevance, accessibility, linguistic appropriateness, literacy level, and clarity of action.
• Two bilingual researchers independently scored 61 text messages, with auditing for consensus.
• Scores ranged from 0 to 4 for each element, totaling a maximum of 20 points.

Main Results:

• Sixty-one text messages from an urban health department's health literacy campaign were evaluated.
• During the second year, 31.5% of messages achieved a high score (3.5/4 or higher) after rubric application and feedback.
• The campaign demonstrated general consistency with NIH best practices and CLAS standards.

Conclusions:

• The developed rubric effectively measures health text message alignment with CLAS and NIH standards.
• Pre-dissemination application of the rubric proved most beneficial for Federally Qualified Health Centers in enhancing message quality.
• The rubric serves as a valuable tool for improving health-related text message effectiveness and patient communication.