The free one-way text messaging service is aimed at underserved populations
By Chris Levister –
Tamara Childs is poor, has a tenth-grade education and about to deliver her first baby. Ask the Rialto teen if she’s had any prenatal care, and expect to hear something like this:
“…I can’t afford it. I don’t have health insurance and besides my mom never had it…. .Look at me I came out okay.”
Fortunately says Aneesh Chopra, chief technology officer for the U.S. government, like millions of other low income teens Childs has a cell phone.
Text4baby is a free text messaging service that delivers timely health information three times a week during pregnancy and through a baby’s first year. Women can sign up for the service by texting BABY (or BEBE for Spanish) to 511411.
“Text4baby represents an extraordinary opportunity to expand the way we use our phones, to demonstrate the potential of mobile health technology,” says Chopra.
“The campaign has the potential to reach a lot of mothers. About 90% of U.S. residents have mobile phones, and texting is prevalent among women of childbearing age and minority populations that have higher infant-mortality rates.”
Roughly 40 percent of U.S. births are covered by Medicaid and nearly 80 percent of Medicaid patients send and receive test messages regularly. Currently, 61 percent of text4baby users live in zip codes with household median incomes less than $50,000.
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.) By reaching out through national partnerships to statewide teams and communi ty-based organizations and leaders, “text4baby” is putting important health information in the hands of those who need it most.
For instance, African American mothers are more likely to begin prenatal care late or not receive it at all, resulting in high infant mortality rates and low birth weights.
Some of the causes of poor birth outcomes are unknown. For example, medical experts cannot fully explain why the U.S. has so many pre-term births — about 500,000 a year, or one in eight, representing a 30 percent increase since 1981.
“What we do know is that there are clear steps that increase the odds that a mother will deliver a full-term, healthy baby who thrives in its first year,” said Chopra.
At the top of text4baby’s texting list: making sure pregnant women pay attention to their nutrition, avoid cigarettes and alcohol, control blood pressure and diabetes, watch for infections, get flu shots and make regular prenatal doctor visits. After birth, critical actions include breastfeeding, making “well baby” doctor visits, getting immunization shots and ensuring that babies sleep in a safe position, respond to cues, and are held, spoken to and read to a lot.
This information is widely available from Web sites, baby books and health care providers. But many low-income women have no Internet access. They may have limited education and little time to read. Millions also lack adequate health insurance to cover pregnancy costs. Low-income, minority women are far more likely than other women to delay prenatal care until the third trimester, or go without it altogether. Many are unaware that Medicaid offers expanded eligibility for pregnant women or that the government can provide them and their children with nutritional supports through programs like Women, Infants and Children (WIC).
Text4baby makes it easy to learn about benefits and the importance of care; it supplies 800-numbers where women can get help with things like finding a doctor, quitting smoking, buying an inexpensive crib, or getting started with breastfeeding. “We focus on what’s most important for women to know week by week,” explains Judy Meehan, the chief executive officer of the National Healthy Mothers, Healthy Babies Coalition (HMHB), which runs the program. “The baby is such a motivator for moms. Science tells us that a real behavior change leading to healthy choices can be made at this unique time.”
The “text4baby” program is based on an unprecedented partnership that includes more than 400 organizations from the private and public sectors. It is also a model employed by Let’s Move!, which uses community partnerships to reach families in their own neighborhoods.
Programs through the U.S. Department of Health and Human Services – such as Early Head Start and Federally Qualified Community Health Centers and the Medicaid CHIP (Chi ldren’s Health Insurance Program) – are actively promoting “text4baby,” as are other state- and communitybased organizations.
All of this gets boiled down to 160 characters and, most important, delivered directly to cell phone in boxes, where the messages are most likely to get read.
Currently, 96 percent of users say they would recommend the service to a friend. Doctors report anecdotally that they are seeing a positive impact on mothers’ behavior. But the big news will come with the evaluation results. Does the service increase prenatal care? Can something as simple as text messages be linked to better birth outcomes?
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