“ Text4baby: A New Mobile Health Service for Pregnant Women and New Moms” 2011 USPHS Scientific and Training Symposium

1. “Text4baby: A New Mobile Health Service for Pregnant Women and New Moms” 2011 USPHS Scientific and Training Symposium June 22, 2011 Morrisa B. Rice, MHA, REHS, RS Lieutenant Commander, United States Public Health Service Senior Public Health Analyst United States Department of Health and Human Services Health Resources and Services Administration Office of Women’s Health

2. Text4baby Goals What is text4baby? How Does It Work? Target Audiences Why Mobile Health Message/Content Development Partnerships, Promotion and Outreach Evaluation

3. Text4baby Goals • To demonstrate the potential of mobile health technology to address a critical national health priority: maternal and child health. • To demonstrate the potential of mobile health technology to reach underserved populations with critical health information. • To develop a base of evidence on the efficacy of mobile health interventions. • To catalyze new models for public-private partnerships in the area of mobile health

4. What is text4baby? • Text4baby is a free mobile health education service that provides pregnant women and mothers with an infant under one year of age with free, evidence-based brief health messages. • Text4baby is made possible through a broad public-private partnership comprised of more than 500 partners. It is NOT a government program. • HHS is a promotion/outreach and evaluation partner. • Core founding partners include the National Healthy Mothers, Healthy Babies Coalition, CTIA-The Wireless Foundation, Voxiva, Inc., the Department of Health and Human Services, Grey Health Group, and Johnson and Johnson.

5. Voluntary User registration via text or website User gives zip and due date/DOB If pregnant, starter-pack of 6 key messages Free tips 3x/week Ends if text STOP How text4baby works

6. How text4baby works (cont.) • To receive messages in English, text the word “BABY” to 511411 • To receive messages in Spanish, text the word “BEBE” to 511411 • Select pregnancy set of messages OR new mom set of messages

7. Target Audiences • Primary Audience: • Low income, reproductive age, underserved English and Spanish-speaking women in the United States. • Other Audiences can also voluntarily sign up • Fathers, partners, grandparents and friends

8. Why Mobile Health? • 300 million untapped health behavior change devices • 1.5 trillion text messages sent in 2010 • Average hours per day mobile phones are within arm’s reach: 19 hours • Phones are personal • Source: http://www.nihcm.org/pdf/Meyer.pdf

9. “They’re the most direct, convenient, and dependable form of communication we have. That’s why the President and I believe mobile phones have so much power to empower the consumer toward a healthcare system in the future… • “The introduction of mobile technology in this move toward electronic health records for all Americans is a huge tool in the tool kit that allow us to drive better care and better outcomes… • “Mobile health has enormous benefits for individuals and improving the health of all Americans • HHS Secretary Kathleen Sebelius • October 29, 2009

10. What Mobile Health Can Do? • Education • Reminders • Follow-up • Monitoring • Coaching • Goal-tracking • Empowering

11. Message Content Development • Health Care Access • Immunization • Nutrition • Prenatal Care • Drugs and Alcohol • Emotional Wellbeing • Smoking Cessation • Labor & Delivery • Breastfeeding • Mental Health • Car Seat Safety • Safe Sleep • Violence prevention • Oral Health • Diabetes • Pregnancy Symptoms • Exercise • HIV/AIDs • Developmental Milestones Sample Messages Medicaid can help you pay for your visits to the doctor or midwife. If you need help, call Medicaid to ask if you qualify: 877-543-7669. Congratulations! After leaving the hospital, baby's 1st Dr's visit is in 2-3 days. Medicaid may be able to help with costs. Call 877-543-7669. • Content developed by HMHB in collaboration with HHS, physicians and nurses.

12. Content Development & Review Process CDC (priority topics/ research base) Federal Government Message Development Message Revision Messages “Finalized” Message Testing Content Review Content Review Medical/Nat’l Associations Audience Insight (discussion groups) Review of external feedback Health Care Providers Message Revision

13. Delivery of Time-Sensitive Messages • Pertussis messages: July 8, 2010 • “Whooping cough is spreading in CA: To protect baby, you and everyone near your baby need a whooping cough booster shot. More from CDC: 1-800-232-4636."  • "You and everyone near your baby need a whooping cough booster shot. Don’t risk spreading serious disease to your baby. More from CDC: 1-800-232-4636.“

14. Federal Agencies • Partners, Promotion and Outreach State Health Agencies Alabama Department of Public Health Arizona Department of Health Services Delaware Division of Public Health Florida Department of Health Georgia Department of Community Health Idaho Department of Health & Welfare Kansas Department of Health and Environment Louisiana Office of Public Health Maryland Department of Health and Mental Hygiene Massachusetts Department of Public Health Michigan Department of Community Health Minnesota Department of Health Nevada State Health DivisionNew Hampshire Department of Health and Human Services New Mexico Department of HealthNorth Carolina Department of Health and Human ServicesOhio Department of HealthPennsylvania Department of HealthState of South Dakota Department of HealthUtah Department of HealthVirginia Department of HealthVermont Department of HealthWashington State Department of HealthWest Virginia Office of Maternal, Child and Family HealthWisconsin Department of Health Services Wyoming Department of Health

15. Nearly 14 million messages sent

16. Examples of Current HRSA-Specific text4baby Promotion Activities • Promote text4baby on Maternal and Child Health Bureau website. • Share information about text4baby with all HRSA Bureaus and Offices at meetings. • Share text4baby posters with Federally qualified health centers and other grantee sites. • Send Dear Colleague letter to grantees serving women, children, youth, and families. • Target promotional activities through GIS mapping.

18. NYC Birth Certificate Inserts (est. 150,000 / year)

19. Solano County, CA

20. San Diego, CA

21. Text4baby Evaluation Projects • Department of Health and Human Services – Mathematica and Public Health Institute • Department of Defense Military Health System – George Washington University, Seattle, Washington • CareFirst BlueCross BlueShield – George Washington University, Fairfax County, VA • Beaumont Foundation – Emory University, WIC Programs in Atlanta, GA • Alliance Healthcare Foundation – National Latino Research Center, San Diego, CA • WellPoint Anthem Medicaid members • AmeriChoice/United Healthcare Medicaid members

22. Text4baby Evaluation Projects • HHS Evaluation • Contract with Mathematica/Policy Research Institute • Awarded September 2010 for 2 years • Major Components • Mobile Survey • Key Informant Interviews • Participant Focus Groups • Consumer Safety Net Surveys • Electronic Health Record Reviews

23. Moving Forward • Reaching 1 million moms by the end of 2012 • Text4baby State Enrollment Contest

24. For More Information: National Healthy Mothers, Healthy Babies Coalition: - http://www.hmhb.org/ Go to: text4baby.org Contact: info@text4baby.org Sign up for Text4baby Tuesday: http://eepurl.com/h9h3 Thank You! LCDR Morrisa Rice mrice@hrsa.gov 301-443-6838