The Heart Health Literacy Toolkit: Targeted Cardiovascular Disease (CVD) risk screening with health literacy support by Short Message Service (SMS) in general practice

Research aim: The aim of this study is to test the impact on patient health literacy of an enhanced CVD risk screening model that integrates the Heart Health Literacy Toolkit before, during and after the Heart Health Check. Research setting: The trial will be initiated via text message sent by 10 participating general practices in Western Sydney Local Health District. Research activities will be conducted online. Methodological approach: We will conduct a non-blinded randomised controlled trial [Hybrid effectiveness-implementation trial (type 1)]. Eligible participants will be identified via general practice clinical audit software. Each practice will be asked to identify 600 eligible participants. Eligible participants at each practice will be randomised to either the intervention or control arm. General practices will send Heart Health Check recall SMS to all eligible participants (intervention and control) asking them to come in for cardiovascular screening. GoShare Plus software is an add on to clinical practice software. Intervention (enhanced CVD screening model – recall message with Heart Health Literacy Toolkit). Eligible participants will be sent a recall SMS with embedded link to a study landing page, with study information, study consent and link to the baseline survey. Participants will only be enrolled in the study if they click on the link in the SMS, consent to participate and complete the baseline survey. On completion of the survey they will be sent an SMS with an embedded link to the Heart Health Literacy Toolkit (www.checkyourheart.com.au). There is no requirement for participants to click on the link, or to view specific content. Participants can interact with the website as much or as little as they like. The website includes a video overview of the Heart Health Check, knowledge quiz, interactive risk communication tool, lifestyle change planning tools and medication decision aids. A reminder SMS will be sent at the 2 week timepoint to those people who did not open the embedded link in the initial SMS. At the 13 week timepoint, participants who completed the baseline survey will be sent a link to the follow-up survey via SMS. Participant commitment consists of two online surveys, 13 weeks apart, each expected to take approximately 10 minutes to complete. Recall text messages will be sent in bulk via GoShare Plus software (add on to clinical practice software) by relevant staff within the participating general practice e.g. GP, practice nurse or practice manager. The recall message content will be between 200 - 230 characters long and broken into two sentences. We anticipate the reader will engage with the message for no longer than 1 minute. Reach and content engagement will be reported using a live dashboard developed by Healthily who have developed the GoShare Plus technology. The Dashboard will report on the number of SMS sent, the open rate per practice, the open rate of SMS landing page links per practice and the open rate of SMS links to the Heart Health Literacy Toolkit. Participants in the intervention will also be asked to self-report their use of the Heart Health Literacy Toolkit during the 13 week follow-up survey.