Mara de Luca Funke, Rodriguez González Natalia, Aguilar-Amaya Maria, Wolfersteig Wendy
Office of Evaluation and Contracts, Arizona State University Southwest Interdisciplinary Research Center, Phoenix, AZ, USA.
Digit Health. 2025 Jul 7;11:20552076251352984. doi: 10.1177/20552076251352984. eCollection 2025 Jan-Dec.
Text messaging campaigns by healthcare providers seem to increase patient engagement and compliance. As an emergent strategy, text messaging presents bidirectional challenges related to health literacy, culture, and linguistic fluency. A numeric rubric was developed to measure text messages' alignment to federally mandated Culturally and Linguistically Appropriate Services (CLAS) and the National Institutes of Health (NIH) Clear Communication standards.
Use a CLAS rubric evaluate health-related text messages prior to or after distribution from healthcare providers to patients. Using standardized outcome ratings, offer feedback to improve text messages and subsequently increase reported positive patient outcomes.
Using the novel rubric, two bilingual researchers separately scored each message and conducted auditing to agree on message scores. The rubric considered cultural relevance, accessibility, linguistic accessibility, literacy level appropriateness, and clear action-oriented messaging. Each element was awarded a score out of 4 points, with 20 as a perfect score.
Sixty-one outbound text messages were evaluated as part of a comprehensive evaluation for an urban health department health literacy campaign. Text message evaluation was conducted twice during the two-year campaign, with recommendations integrated during the project's second year. Nearly a third of text messages (31.5%) during the project's second year scored a 3.5 out of 4 or higher.
The campaign was generally consistent with NIH best practices and CLAS standards. Application of the rubric and scores before dissemination was most impactful for Federally Qualified Health Centers to improve the quality of health-related text messages.
医疗服务提供者开展的短信活动似乎能提高患者的参与度和依从性。作为一种新兴策略，短信在健康素养、文化和语言流利度方面带来了双向挑战。开发了一个数字评分标准来衡量短信与联邦规定的文化和语言适宜服务（CLAS）以及美国国立卫生研究院（NIH）清晰沟通标准的契合度。
使用CLAS评分标准在医疗服务提供者向患者发送健康相关短信之前或之后对其进行评估。通过标准化的结果评级，提供反馈以改进短信，进而提高报告的患者积极结果。
使用这个新颖的评分标准，两名双语研究人员分别对每条短信进行评分，并进行审核以就短信分数达成一致。该评分标准考虑了文化相关性、可及性、语言可及性、识字水平适宜性以及明确的行动导向性信息。每个要素的满分是4分，满分是20分。
作为对一个城市卫生部门健康素养活动的全面评估的一部分，对61条外发短信进行了评估。在为期两年的活动中对短信评估进行了两次，并在项目的第二年纳入了建议。在项目的第二年，近三分之一（31.5%）的短信得分在4分制中达到3.5分或更高。
该活动总体上符合NIH的最佳实践和CLAS标准。在传播之前应用评分标准和分数对联邦合格健康中心提高健康相关短信的质量最有成效。
