Free Texting Program for Expectant Moms Continues to Grow

Most of the patients Dr. Michele Wylen sees are low-income women, many of whom are on Medicaid or have no health insurance.

As an ob.gyn. at the Arlington County (Va.) Public Health Division, she is aware of the statistics: Preterm birth rates are higher among women who have less access to health care services, and the nation has a high infant mortality rate, higher than many other industrialized counties. She is an advocate for reliable tools that would better inform her patients, even if it’s outside of her office. So Dr. Wylen and the county health department embraced the text4baby program when it launched early last year.

The free text messaging service keeps her patients informed about their pregnancy and the first year of motherhood through simple text messages sent out regularly, tailored to the mother’s due date or the age of the infant.

"Patients may not understand everything, but they can ask about it," she said in an interview. "It’s a springboard for patients to ask questions.

"And what’s compelling is that everyone, at least most people, have access to a cell phone," she said. "And this is a great way to disseminate information."

In an era that some researchers call the "Wild West" of social media, this simple texting program that targets pregnant women and new moms, especially those who are lower income and have less access to health care services, is showing promise. Most researchers and industry experts agree that the program is the first of its kind in the United States to reach such a wide audience of women in a significant and delicate stage of their lives.

Since its inception in February 2010, more than 150,000 women have signed up to receive the free texts. The National Healthy Mothers, Healthy Babies Coalition (HMHB), the nonprofit group that has been nurturing the program and writing the text messages, has an ambitious goal of reaching 1 million women by the end of 2012.

"It’s a tool we can reach women with, instead of putting an ad on the bus." With text4baby, they will have the ability to reach women wherever they are, according to Judy Meehan, executive director of the HMHB, referring to the participants enrolled in the texting program.

Each text message contains a small snippet of information, explained Ms. Meehan; one idea per message and why it is important for the mom to pay attention to that idea.

This is how the program works: Women send the word BABY (or BEBE in Spanish) to 511411. They then put in their due date and their zip code and they’re enrolled in the free texting program. They will first receive a "starter pack" of about six text messages and then they receive three messages per week in early afternoons, tailored to their due date or the age of their newborn. The messages range from health tips, to numbers to call to find a provider, to urgent messages such as notification about recalls or new guidelines.

Behind the scenes, a team of 19 individuals edit the text messages, making sure they’re accurate and based on evidence-based medicine that comes from some of the prominent sources of information in the country, such as the Centers for Disease Control and Prevention. The program has nearly 500 partner organizations, including health departments, community health centers, and physician offices. Its main financial sponsor is Johnson & Johnson, along with other sponsors including with WellPoint, Pfizer, and CareFirst, but there are no promotions in the text messages. And 19 mobile carriers have gotten on board to make the texting program available for free. The program was developed by Voxiva and rolled out by the White House Office of Science and Technology Policy.

So how effective has it been?

It’s too soon to tell, according to W. Douglas Evans, Ph.D., director of Public Health Communications and Marketing at the George Washington University in Washington. Dr. Evans has been involved in studies evaluating the effectiveness of text4baby. Two large studies are underway, but the final data won’t be available until early 2012, he said.

There has been little research done on the impact of texting (short messaging service or SMS) on health behaviors, partly because such social media and tools as texting have begun to take a more prominent role in health care only in recent years. "Mobile health has existed for only a few years. It’s a very new field, that’s why there’s not much research," said Dr. Evans.

But several factors make text4baby appealing and potentially successful in modifying behaviors.

The texts are free and their medium, a mobile phone, is widely used by Americans. In 2010, 96% of the U.S. population had a form of wireless connection, according to the Wireless Association CTIA. "One of the potentials of text4baby is to reach a lot of people – and that’s a leveler," said Dr. Evans. In addition, although the information isn’t interactive, at least not yet, it’s targeted and based on the mother’s pregnancy due date and continuing until the baby turns 1-year-old.

"Part of the movement of social media is that you want to tailor it to the user and what they want," said Dr. Megan A. Moreno of the department of pediatrics at University of Wisconsin, Madison. "I think about what new moms would want, and I think they’d like to have that feeling of companionship – to be connected via texting all through pregnancy and when they’re isolated."

Although the health care community is still testing the waters when it comes to social media, researchers say that it’s important for physicians to talk to their patients about social media programs and be involved and aware of the types of information they receive.

"Social media, texting, and digital media are here, and that is what our patients are using or could use," said Dr. Terry Kind, director of Pediatrics Medical Student Education at Children’s National Medical Center at GW University. "We as the doctor community should get on board. ... Social media is a rapidly evolving area. There are doctors who won’t go near it. But there’s a huge potential for new ways to serve the public health message."

Social media or tools like texting aren’t, of course, the answer for everything. But, "sharing good information is never a bad thing," said Dr. Reuben Varghese, health director of the Arlington public health division. "Even if they don’t listen to it but pass it along to someone else, it’s a success."

Repetition, after all, is powerful, added Dr. Wylen.

Ms. Meehan of HMHB said the group is now looking at ways to keep up with the growth of the program, automating parts of the process, and getting more women to sign up for the service. She also said she looks forward to seeing the results of the ongoing studies on the program to get a broader look at how women understand the messages and how they’re learning.

"This is really version 1.0," said Dr. Evans, referring to mobile health. "There will be a version 2.0 and 3.0."

Most of the patients Dr. Michele Wylen sees are low-income women, many of whom are on Medicaid or have no health insurance.

As an ob.gyn. at the Arlington County (Va.) Public Health Division, she is aware of the statistics: Preterm birth rates are higher among women who have less access to health care services, and the nation has a high infant mortality rate, higher than many other industrialized counties. She is an advocate for reliable tools that would better inform her patients, even if it’s outside of her office. So Dr. Wylen and the county health department embraced the text4baby program when it launched early last year.

The free text messaging service keeps her patients informed about their pregnancy and the first year of motherhood through simple text messages sent out regularly, tailored to the mother’s due date or the age of the infant.

"Patients may not understand everything, but they can ask about it," she said in an interview. "It’s a springboard for patients to ask questions.

"And what’s compelling is that everyone, at least most people, have access to a cell phone," she said. "And this is a great way to disseminate information."

In an era that some researchers call the "Wild West" of social media, this simple texting program that targets pregnant women and new moms, especially those who are lower income and have less access to health care services, is showing promise. Most researchers and industry experts agree that the program is the first of its kind in the United States to reach such a wide audience of women in a significant and delicate stage of their lives.

Since its inception in February 2010, more than 150,000 women have signed up to receive the free texts. The National Healthy Mothers, Healthy Babies Coalition (HMHB), the nonprofit group that has been nurturing the program and writing the text messages, has an ambitious goal of reaching 1 million women by the end of 2012.

"It’s a tool we can reach women with, instead of putting an ad on the bus." With text4baby, they will have the ability to reach women wherever they are, according to Judy Meehan, executive director of the HMHB, referring to the participants enrolled in the texting program.

Each text message contains a small snippet of information, explained Ms. Meehan; one idea per message and why it is important for the mom to pay attention to that idea.

This is how the program works: Women send the word BABY (or BEBE in Spanish) to 511411. They then put in their due date and their zip code and they’re enrolled in the free texting program. They will first receive a "starter pack" of about six text messages and then they receive three messages per week in early afternoons, tailored to their due date or the age of their newborn. The messages range from health tips, to numbers to call to find a provider, to urgent messages such as notification about recalls or new guidelines.

Behind the scenes, a team of 19 individuals edit the text messages, making sure they’re accurate and based on evidence-based medicine that comes from some of the prominent sources of information in the country, such as the Centers for Disease Control and Prevention. The program has nearly 500 partner organizations, including health departments, community health centers, and physician offices. Its main financial sponsor is Johnson & Johnson, along with other sponsors including with WellPoint, Pfizer, and CareFirst, but there are no promotions in the text messages. And 19 mobile carriers have gotten on board to make the texting program available for free. The program was developed by Voxiva and rolled out by the White House Office of Science and Technology Policy.

So how effective has it been?

It’s too soon to tell, according to W. Douglas Evans, Ph.D., director of Public Health Communications and Marketing at the George Washington University in Washington. Dr. Evans has been involved in studies evaluating the effectiveness of text4baby. Two large studies are underway, but the final data won’t be available until early 2012, he said.

There has been little research done on the impact of texting (short messaging service or SMS) on health behaviors, partly because such social media and tools as texting have begun to take a more prominent role in health care only in recent years. "Mobile health has existed for only a few years. It’s a very new field, that’s why there’s not much research," said Dr. Evans.

But several factors make text4baby appealing and potentially successful in modifying behaviors.

The texts are free and their medium, a mobile phone, is widely used by Americans. In 2010, 96% of the U.S. population had a form of wireless connection, according to the Wireless Association CTIA. "One of the potentials of text4baby is to reach a lot of people – and that’s a leveler," said Dr. Evans. In addition, although the information isn’t interactive, at least not yet, it’s targeted and based on the mother’s pregnancy due date and continuing until the baby turns 1-year-old.

"Part of the movement of social media is that you want to tailor it to the user and what they want," said Dr. Megan A. Moreno of the department of pediatrics at University of Wisconsin, Madison. "I think about what new moms would want, and I think they’d like to have that feeling of companionship – to be connected via texting all through pregnancy and when they’re isolated."

Although the health care community is still testing the waters when it comes to social media, researchers say that it’s important for physicians to talk to their patients about social media programs and be involved and aware of the types of information they receive.

"Social media, texting, and digital media are here, and that is what our patients are using or could use," said Dr. Terry Kind, director of Pediatrics Medical Student Education at Children’s National Medical Center at GW University. "We as the doctor community should get on board. ... Social media is a rapidly evolving area. There are doctors who won’t go near it. But there’s a huge potential for new ways to serve the public health message."

Social media or tools like texting aren’t, of course, the answer for everything. But, "sharing good information is never a bad thing," said Dr. Reuben Varghese, health director of the Arlington public health division. "Even if they don’t listen to it but pass it along to someone else, it’s a success."

Repetition, after all, is powerful, added Dr. Wylen.

Ms. Meehan of HMHB said the group is now looking at ways to keep up with the growth of the program, automating parts of the process, and getting more women to sign up for the service. She also said she looks forward to seeing the results of the ongoing studies on the program to get a broader look at how women understand the messages and how they’re learning.

"This is really version 1.0," said Dr. Evans, referring to mobile health. "There will be a version 2.0 and 3.0."

Most of the patients Dr. Michele Wylen sees are low-income women, many of whom are on Medicaid or have no health insurance.

As an ob.gyn. at the Arlington County (Va.) Public Health Division, she is aware of the statistics: Preterm birth rates are higher among women who have less access to health care services, and the nation has a high infant mortality rate, higher than many other industrialized counties. She is an advocate for reliable tools that would better inform her patients, even if it’s outside of her office. So Dr. Wylen and the county health department embraced the text4baby program when it launched early last year.

The free text messaging service keeps her patients informed about their pregnancy and the first year of motherhood through simple text messages sent out regularly, tailored to the mother’s due date or the age of the infant.

"Patients may not understand everything, but they can ask about it," she said in an interview. "It’s a springboard for patients to ask questions.

"And what’s compelling is that everyone, at least most people, have access to a cell phone," she said. "And this is a great way to disseminate information."

In an era that some researchers call the "Wild West" of social media, this simple texting program that targets pregnant women and new moms, especially those who are lower income and have less access to health care services, is showing promise. Most researchers and industry experts agree that the program is the first of its kind in the United States to reach such a wide audience of women in a significant and delicate stage of their lives.

Since its inception in February 2010, more than 150,000 women have signed up to receive the free texts. The National Healthy Mothers, Healthy Babies Coalition (HMHB), the nonprofit group that has been nurturing the program and writing the text messages, has an ambitious goal of reaching 1 million women by the end of 2012.

"It’s a tool we can reach women with, instead of putting an ad on the bus." With text4baby, they will have the ability to reach women wherever they are, according to Judy Meehan, executive director of the HMHB, referring to the participants enrolled in the texting program.

Each text message contains a small snippet of information, explained Ms. Meehan; one idea per message and why it is important for the mom to pay attention to that idea.

This is how the program works: Women send the word BABY (or BEBE in Spanish) to 511411. They then put in their due date and their zip code and they’re enrolled in the free texting program. They will first receive a "starter pack" of about six text messages and then they receive three messages per week in early afternoons, tailored to their due date or the age of their newborn. The messages range from health tips, to numbers to call to find a provider, to urgent messages such as notification about recalls or new guidelines.

Behind the scenes, a team of 19 individuals edit the text messages, making sure they’re accurate and based on evidence-based medicine that comes from some of the prominent sources of information in the country, such as the Centers for Disease Control and Prevention. The program has nearly 500 partner organizations, including health departments, community health centers, and physician offices. Its main financial sponsor is Johnson & Johnson, along with other sponsors including with WellPoint, Pfizer, and CareFirst, but there are no promotions in the text messages. And 19 mobile carriers have gotten on board to make the texting program available for free. The program was developed by Voxiva and rolled out by the White House Office of Science and Technology Policy.

So how effective has it been?

It’s too soon to tell, according to W. Douglas Evans, Ph.D., director of Public Health Communications and Marketing at the George Washington University in Washington. Dr. Evans has been involved in studies evaluating the effectiveness of text4baby. Two large studies are underway, but the final data won’t be available until early 2012, he said.

There has been little research done on the impact of texting (short messaging service or SMS) on health behaviors, partly because such social media and tools as texting have begun to take a more prominent role in health care only in recent years. "Mobile health has existed for only a few years. It’s a very new field, that’s why there’s not much research," said Dr. Evans.

But several factors make text4baby appealing and potentially successful in modifying behaviors.

The texts are free and their medium, a mobile phone, is widely used by Americans. In 2010, 96% of the U.S. population had a form of wireless connection, according to the Wireless Association CTIA. "One of the potentials of text4baby is to reach a lot of people – and that’s a leveler," said Dr. Evans. In addition, although the information isn’t interactive, at least not yet, it’s targeted and based on the mother’s pregnancy due date and continuing until the baby turns 1-year-old.

"Part of the movement of social media is that you want to tailor it to the user and what they want," said Dr. Megan A. Moreno of the department of pediatrics at University of Wisconsin, Madison. "I think about what new moms would want, and I think they’d like to have that feeling of companionship – to be connected via texting all through pregnancy and when they’re isolated."

Although the health care community is still testing the waters when it comes to social media, researchers say that it’s important for physicians to talk to their patients about social media programs and be involved and aware of the types of information they receive.

"Social media, texting, and digital media are here, and that is what our patients are using or could use," said Dr. Terry Kind, director of Pediatrics Medical Student Education at Children’s National Medical Center at GW University. "We as the doctor community should get on board. ... Social media is a rapidly evolving area. There are doctors who won’t go near it. But there’s a huge potential for new ways to serve the public health message."

Social media or tools like texting aren’t, of course, the answer for everything. But, "sharing good information is never a bad thing," said Dr. Reuben Varghese, health director of the Arlington public health division. "Even if they don’t listen to it but pass it along to someone else, it’s a success."

Repetition, after all, is powerful, added Dr. Wylen.

Ms. Meehan of HMHB said the group is now looking at ways to keep up with the growth of the program, automating parts of the process, and getting more women to sign up for the service. She also said she looks forward to seeing the results of the ongoing studies on the program to get a broader look at how women understand the messages and how they’re learning.

"This is really version 1.0," said Dr. Evans, referring to mobile health. "There will be a version 2.0 and 3.0."