text4baby overview
TRANSCRIPT
Harnessing the Power of Mobile for Maternal & Child Health: The Text4baby Program
The Need
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The United States has one of the
highest infant mortality rates in the industrialized world.
Each year in the United States: 500,000 (1 in 8) babies are born
prematurely. 28,000 die before their first
birthday. Many factors contribute to these
negative outcomes including: Lack of access to healthcare Negative health behaviors Poverty
Research supports that increasing knowledge around health can help people stay healthier.
Maternal & Child Health in the U.S.
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Distribution of prenatal care adequacy categories: US, 2002
In the United States, 11.3% of live births were to women receiving inadequate care.
Maternal & Child Health in the U.S.
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Percentage of women aged 18--49 years pregnant during October 2010--January 2011 (N = 1,457) who received influenza vaccination before, during, or after pregnancy, by month of delivery or expected month of delivery --- United States, Internet panel survey, April 2011
In 2010-2011, only 49% of pregnant women had received influenza vaccination: 32% during pregnancy and 17% before pregnancy or after delivery.
Maternal & Child Health in the U.S.
\
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Each year in the United States, more than 4,500 infants die suddenly of no immediately, obvious cause. Half of these deaths are due to Sudden Infant Death Syndrome (SIDS), the leading of all deaths among infants aged 1–12 months.
Maternal & Child Health in the U.S.
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82% of adults age 18 and older in the U.S. have cell phones.
81% of adult women in the U.S. have cell phones.
72% of adults with cell phones send and receive text messages.
Adults who text typically send and receive a median of 10 texts a day.
Source: Amanda Lenhart. Cell Phones and American Adults.
Washington, DC: Pew Research Center; 2010
Why go mobile?
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Texting by Insurance Type Texting by Insurance Type
Source: PricewaterhouseCoopers HRI Consumer Survey, 2010
Innovation in MCH
An educational program of the National Healthy Mothers, Healthy Babies Coalition (HMHB).
A free texting service that provides pregnant women and moms with babies under age one with timed health and safety information to help them care for their health and give their babies the best possible start in life.
The largest national mobile health initiative to date with over 400,000 enrollees since launch.
What is Text4baby?
National Partnership National Partnership
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Participating mobile providers have agreed to deliver text4baby to their subscribers at no charge.
Mobile Provider Partners
User gives zip and due date/DOB
User registration via text or website:
Text BABY/BEBE to 511411
How Text4baby Works
User gets free tips 3x/week
Ends if user texts STOP or on the baby’s 1st
b-day
If pregnant, user gets a starter-pack of 6 key
messages (over 2wks)
How Text4baby Works
Text4baby Content
Literature Review
Audience Testing
Priority Topics
Content Development
Federal Government U.S. Department of Health and Human Services: • Centers for Medicare and Medicaid Services • Centers for Disease Control and Prevention • Health Resources and Services Administration, Maternal and Child Health Bureau • HHS Office on Women’s Health •National Institutes of Health U.S. Consumer Product Safety Commission U.S. Department of Agriculture, Food and Nutrition Service U.S. Department of Defense Military Health System U.S. Department of Transportation
Expert Review
Audience Testing
Ongoing Revision
Expert input from: •Alliance for Hispanic Health •American Academy of Pediatrics •American Academy of Pediatric Dentistry
•American College of Nurse-Midwives •American College of Obstetricians and Gynecologists
•National Domestic Violence Hotline •Postpartum Support International •Text4baby Breastfeeding Council
Message feedback from organizations, including (but not limited to)*: •Arizona Dept of Health Services •Association of Poison Control Centers •Berkeley University •California Dept of Social Services •Carolina Breastfeeding Institute •Cincinnati Children's Hospital •Fairview Hospital (Cleveland) •First Candle •Florida Dept of Health •Georgia Dept of Community Health •Healthy Fathering Collaborative
•Institute for Health and Recovery •Just in Time Parenting •Kansas Dept of Health & Environment •Lamaze International •Massachusetts Breastfeeding Coalition •National Center for Hearing Assessment and Management •National WIC Association •Nevada Dept of Health •New York State Dept of Health •Ohio Dept of Health •Oral Health Kansas •Oregon Dept of Human Services
•Organization of Teratology Information Specialists •Prevent Child Abuse Arizona •Safe Kids USA •The AOA Foundation •The National Campaign to Prevent Teen & Unwanted Pregnancy •Utah County WIC •Virginia Dept of Health •Washington State Dept of Health •DC Breastfeeding Coalition •West Virginia Hospital Association •Wisconsin Childhood Lead Poisoning Prevention Program
Content Development & Review Process
• Emory University Rollins School of Public Health
• Hablamos Juntos
Smoking Cessation Breast Feeding Health Care Access Diabetes Nutrition Oral Health Immunization Prenatal Care Disabilities Family Planning HIV/AIDS Prevention Violence Prevention Physical Activity Safety & Injury Prevention Mental Health Substance Abuse Prevention Developmental Milestones Labor & Delivery Car Seat Safety Safe Sleep Exercise
Messages on Critical Issues
Sample Messages
Diabetes can happen for the 1st time in pregnancy. You may be tested at 24-28 weeks. If you have it, you & your Dr. will make a plan to control it.
Back
Premature babies need extra help with breastfeeding. Even if your baby can’t breastfeed at first, she can still be fed your pumped milk.
Back
A seat belt protects you & your baby. Shoulder belt goes between your breasts & lap strap goes under your belly (not on or above). Wear it every time.
Back
Time for baby’s 2-month checkup! Time for him to get vaccines to protect him from serious diseases. And time for you to share how your baby’s doing!
Back
Keeping your baby’s mouth clean is important even before she has teeth! Wipe her gums each day with a wet washcloth or use a soft baby toothbrush.
Back
Keep your baby away from tobacco smoke. It can damage baby’s heart, lungs & brain and increase baby’s chances of getting colds and ear infections. Back
Sample Messages
Tylenol recall, May 2010
Pertussis outbreak CA (CDC), July 2010
Similac formula recall, September 2010
Sleep positioners warning (FDA), October 2010
New car safety seat guidelines (AAP), March 2011
Deadly hot cars (Safe Kids), July 2011
Benzocaine warning (FDA), August 2011
Window falls prevention (AAP & CDC), September 2011
Warning about crib bumpers (AAP & CDC), October 2011
Carbon monoxide poisoning (CT & MA) in response to power outages, November 2011
Warning about button batteries (Safe Kids), December 2011
CMS enrollment (CMS), February 2012
Medicine safety (CDC), March 2012
Pertussis - 7 states (CDC), April 2012
Delivery of Time-Sensitive Messages
The Public-Private Partnership
Federal Agencies
64 National Health Orgs 125 Hospital Networks
Media
State & Local Health & Medicaid Agencies
representing all 50 states, DC, & US territories
More than 800 Promotional Partners
97 Health Plans
About the Service
Promotional activities have included: Mass emails to colleagues & consumers Printed promotional materials in health clinics/exam & waiting
rooms & hospital discharge packets Medicaid/health plan member enrollment letters/mailings E-newsletter or print newsletter blurbs Word-of-mouth at conferences & community events (“baby
showers”) Promotion through home visiting programs Earned and paid public service advertising on TV, radio,
buses, billboards, etc. Text4baby info recorded on phone “hold” messages Media events Outreach to elected officials
Spreading the Word
Co-branded fact sheet for OB/GYNs.
Information on patient (at right) and members-only web pages
Congressional Leadership Conference session (Feb 2012).
Media release (at right; Feb 2012).
ACOG News article (Spring 2012).
National Women’s Health Week blast email to 37,500 members (May 2012).
Co-sponsorship of Congressional Briefing (May 2012).
Materials included in flu season mailing to 35,000 members (Fall 2012)
American College of Obstetricians and Gynecologists
AAP Promotion
Blurbs in SmartBrief, AAP News, & Healthy Child Care America newsletters
President’s letter to 40,000 pediatricians citing evaluation results & encouraging promotion (Jan 2012)
Co-branded Bright Futures/AAP tear-pads mailed to members & in t4b store
Dedicated page on AAP site for pediatricians to view messages (http://www2.aap.org/text4baby/)
American Academy of Pediatrics Promotion
Association of Women’s Health, Obstetric and Neonatal Nurses
Cover article in Journal of Nursing for Women’s Health spring 2011 (at left)
Promotion through Healthy Mom&Baby consumer magazine
Text4baby info on website
Congressional Support Congresswoman Lois Capps (D-CA):
Held a Congressional Briefing in 2010
Distributed a press release expressing her support
Sent a letter to members of the House of Representatives encouraging her colleagues to host text4baby events in their local districts.
Attended events in California to launch the text4baby campaign
Congressman Trey Gowdy (R-SC):
Strong advocate of program
Working with the South Carolina Department of Health and the Environment to spread word about text4baby to constituents
Senator Tom Carper (D-DE):
Hosted a Congressional Briefing in May 2012 Encourages organizations in Delaware to promote text4baby “Text4baby works by providing patients with the information they need to
have a safe, healthy pregnancy in an inexpensive, easy to use format that is delivered regularly to their cell phone. This simple tool can help ensure healthier pregnancies and reduce health care costs that stem from a lack of access to important information about prenatal health.”
Congressional Support
Text4baby in the News
Text4baby in the Media Earned Media Coverage
February 7, 2011, 9:15 pm Mothers-to-Be Are Getting the Message By DAVID BORNSTEIN We’re used to hearing about public initiatives that get mired in politics or entangled in bureaucracy, but we rarely hear about programs that exceed expectations. So here’s one: last week marked the one-year anniversary of a program called text4baby, a service that sends free text messages to women who are pregnant or whose babies are less than a year old, providing them with information, and reminders, to improve their health and the health of their babies. The service, made available through a broad partnership of community health organizations, wireless carriers, businesses, health care providers and government health agencies, is catching on like wildfire: to date, about 135,000 women have signed up – and organizers have set a new goal of reaching one million users by the end of 2012 (there are four million births each year in the U.S.) What are they doing right?
Text4baby in the New York Times Text4baby in the Media: NYT
Text4baby in Time Magazine
“With cell-phone companies comping the text charges, text4baby is the first free, large-scale foray into mobile health education in the U.S. States are creating text4baby coalitions and encouraging nurses to talk up the program. Word is also going out through local health departments and TV channels like Telemundo and MTV.” - May 2010
Text4baby in the Media: Time Magazine
Text4baby on MTV
I didn’t know I was supposed to be cleaning out her mouth already…And they sent me messages about trying to find daycare. They also reminded me about her two-month doctor appointment. I had completely forgotten about it. For me, since I’m new at this and really don’t know, it’s helpful.”
Text4baby on MTV
Text4baby Wins Prestigious Award
HHS Innovates Award
Making a Difference
text4baby Enrollment by Zip CodeVirginia Feb-Aug 2010
Six text4baby billboards went up in Martinsville
Using Data to Drive Enrollment Tracking Enrollment
Date (January 1, 2011 through August 11, 2011)
Number of New Unique Users
Text4baby data allows for a real-time understanding of effective promotional strategies. In 2011, partners in North Carolina ran TV PSAs that increased state enrollment by 400% over one week.
PSAs launch 7/26/11
North Carolina
Radio PSAs
Tracking Enrollment
95% of text4baby survey respondents say they would refer it to a friend (n=24,093)
Text4baby is improving adherence to appointments and immunizations: 67.0% reported that text4baby helped them remember an appointment or immunization that they or their child needed.*
Alliance of Chicago Community Health Services (network of FQHCs) found the percentage of missed appointments was lower among text4baby enrollees (N=917) compared to non-enrollees (N=1,647) when comparing the two patient populations at one point in time (11% vs. 17% missed appointments, respectively). Although these findings are not statistically significant, and were not the result of rigorous research methods, the trend is in a very positive direction and will continue to be monitored.
Users are increasing health knowledge: 73.4% reported that a text4baby message informed them of medical warning signs they did not know.*
The Service is facilitating interaction with health providers: 63.5% reported talking to their doctor about a topic that they read on a text4baby message.*
Improving access to health services: 39.2% reported they called a service or phone number they received from a text4baby message.*
Underinsured participants are improving their access to health services and health information services as a result of text4baby messages :46.5% reported that they called a service or phone number they received from a text4baby message.*
*Study by National Latino Research Center at California State University, San Marcos and the University of California, San Diego Department of Obstetrics and Gynecology of 342 text4baby users in San Diego
Program Impact
Alliance Healthcare Foundation – National Latino Research Center: Phone survey with t4b users in San Diego, CA – Phase 1 & Phase 2 completed
CareFirst BlueCross BlueShield – George Washington University: Pre/post survey exploring behavior and knowledge change for women in Fairfax County, Virginia - completed, awaiting dissemination
Beaumont Foundation – Emory University: Pre/post survey exploring behavior and knowledge change for WIC recipients in Atlanta, GA- completed, awaiting dissemination
DOD TATRC - Madigan Army Medical Center/George Washington University: Randomized control trial exploring behavior and knowledge change with pregnant women seeking care in Takoma, WA – recruitment ongoing
HHS – Mathematica Policy Research: Behavior and knowledge change in users in 4 communities
External Evaluations
Join the Movement
Action Steps
Become a Friend or Outreach Partner of Text4baby: No cost to your organization.
Access to text4baby logo and Adobe InDesign art files for customization.
Access to zip code-level data to track enrollment.
Promotion in Text4baby Tuesday, a weekly e-mail alert providing program updates.
Technical assistance through HMHB.
Recognition on the text4baby website & in select communications.
Opportunity to be connected with your peers.
Sign up here: http://my.text4baby.org/page/s/partner
Tell all pregnant women and moms with infants < 1 about text4baby. Make sure to say: This service is free to you – your wireless company is
waiving the fees. Even if you don’t have a texting plan, you can get these messages.
I feel good about this content. It comes from a trustworthy source.
Sign up by texting the word BABY to the number 511411.
You will get messages until baby’s 1st birthday but you can stop any time; just reply with STOP.
Action Steps
Spread the word: Send a mass email with information
about text4baby (standard language at www.text4baby.org)
Include text4baby info in your organization’s print or electronic newsletter.
Order free printed materials to hand out to consumers – place a stash next to your check-in/out counters, waiting rooms, exam rooms, and the like. Visit http://tinyurl.com/t4bstore to order.
Action Steps Tear-off pads (4 designs)
Flyers (4 designs)
Go digital: Post on Facebook and Twitter about the
program. Sample post: Free #text4baby service sends helpful pregnancy & baby tips to your cell phone. Text BABY to 511411. http://www.text4baby.org
Add our traceable web button to your webpage. Download it at http://text4baby.org/index.php/partner-resources/2-uncategorised/186
Action Steps
Stop the presses:
Host a media event in your community and invite broadcast, print, and digital outlets to attend.
Call local media you already partner with and tell them about text4baby. Use health observances like Infant Mortality Awareness Month (September) when you pitch.
Share the TV and radio PSAs with local stations in your area. Preview and share them at: TV PSAs: http://www.tvaccessreports.com/text4baby/
Radio PSAs: http://www.plowsharegroup.com/media_downloads/text4baby.php
Action Steps
Connect with others in your area:
Over 800 organizations are already partnering with text4baby. Learn who’s involved in your area so you can team up at http://text4baby.org/index.php/partners
Action Steps
