Using the Clear Communication Index to Improve Materials for a Behavioral Intervention

Abstract

Ensuring that written materials used in behavioral interventions are clear is important to support behavior change. This study used the Clear Communication Index (CCI) to assess the original and revised versions of three types of written participant materials from the SIPsmartER intervention. Materials were revised based on original scoring. Scores for the entire index were significantly higher among revised versions than originals (57% versus 41%, p < 0.001); however, few revised materials (n = 2 of 53) achieved the benchmark of ≥90%. Handouts scored higher than worksheets and slide sets for both versions. The proportion of materials scored as having "a single main message" significantly increased between versions for worksheets (7% to 57%, p = 0.003) and slide sets (33% to 67%, p = 0.004). Across individual items, most significant improvements were in Core, with four-items related to the material having a single main message. Findings demonstrate that SIPsmartER's revised materials improved after CCI-informed edits. They advance the evidence and application of the CCI, suggesting it can be effectively used to support improvement in clarity of different types of written materials used in behavioral interventions. Implications for practical considerations of using the tool and suggestions for modifications for specific types of materials are presented.

A health literacy analysis of the consumer-oriented COVID-19 information produced by ten state health departments

“…These health literacy tools will be most useful when they are not used in isolation [20,45,46]. Incorporating the PEMAT, Index, and FKGL tools into the material creation and review process will enhance the understandability, actionability, clarity, and readability of the materials [47], whereas using only one of these tools may serve to ignore other aspects of health literacy. Key items from the PEMAT to consider are using plain language, informative headers, and active voice; key Index items to incorporate are having one main message, using visual cues to emphasize the main message, and including a call to action.…”

Cross-cultural adaptation of the Clear Communication Index to Brazilian Portuguese

“…The CDC-CCI instrument aims to contribute to the improved performance of healthcare professionals who create educational materials, since it leads them to critically analyze their own communicative capacity 17,18 . The use of the CDC-CCI can improve the development and transmission of health messages, as well as the public's orientation regarding actions and better results in health 19 .…”

“…Professionals' use of tools to adapt health messages and materials for low literacy audiences can contribute to improvements in the public's adherence to care and therapeutic outcomes, as well as to reduce social inequalities 22 . The BR-CDC-CCI, after its final validation, can offer healthcare professionals a practical resource, guiding them in the creation and evaluation of materials and educational messages in health, following the example of other studies in the literature 18,19,23 .…”

SIPsmartER delivered through rural, local health districts: adoption and implementation outcomes

“…Through the IVR calls, participants identified their ounces of SSB intake, completed an action plan, and received a motivational message. Intervention activities and materials have been described in detail elsewhere [3, 10, 29–31]. In addition to intervention components, there were specific activities to support participant retention, including re-engagement calls to participants who had not completed two activities in a row [32].…”