Evaluation of the Florida STD Texting Project for Client Notification of Test Results

Background:  Escalating morbidity, changing resources, and inefficiencies in test result notification procedures led the Florida STD Program to initiate a process to notify clients of their test results via text. An evaluation of the first year of the texting project in three Florida counties aimed to assess the feasibility of texting for client notification and its impact on treatment timeframes.

Methods:  The STD Program modified its existing electronic STD database in order to send test results by text and to record call backs received by clients for treatment follow-up. Data on demographics, opt in, call back rates, delivery success, and time to treatment were used to evaluation the texting project. All clients who were tested for gonorrhea and chlamydia in three clinics were offered text notification and included in the evaluation. Texts were coded for client privacy and positive clients were given a number to call for treatment referral.

Results:  10,272 clients were tested for chlamydia and gonorrhea and offered text notification from February 2012 – January 2013, with 5,353 (52%) opting in. Opt in was highest among positive clients and females (58% each) and lowest among males (45%). Among positive clients who opted in, 198 (57%) called the health department for treatment referral, calling within an average of one day. Only 4% of clients’ texts were returned as undeliverable. Clients who opted into texting received treatment an average of 1.6 days sooner than clients who did not opt in (p=.036).

Conclusions:  The high opt in and call back rate within three very different clinic populations suggests that text notification of STD results is feasible within STD clinics. Overall, texting reduced treatment delays. The Florida STD database is in use in seven other states, and therefore the texting project could be utilized by a much larger population than Florida STD clients.