A nationwide texting program for new moms continues to grow in its second year, and an initial evaluation of the enrollees' feedback is showing promising results.

The public-private partnership called text4baby sends free educational text messages to expecting and new moms. The program now has over 260,000 enrollees, up from more than 150,000 in April.

With the advancement of technology and the widespread access to mobile phones, national agencies are trying to use tools such as texting to promote healthy behaviors.

The U.S. Department of Health and Human Services created a Text4Health Task Force in 2010, trying to “capitalize on the rapid proliferation of mobile phone technology and platforms, such as text messaging,” and reach underserved groups, according to one of the agency's recent announcements.

Maternal and child health, domestic violence and sexual abuse prevention, tobacco control, emergency preparedness, and diabetes and asthma education are among the agency's texting projects.

Although it is too soon to tell whether such texting initiatives will improve health outcomes, positive feedback from women and physicians who use text4baby has turned some skeptics into believers.

“The overwhelming response was that the program brought information into their hands,” said Dr. Yvette LaCoursiere, an assistant clinical professor in the reproductive medicine department at University of California, San Diego. She was involved in the multiagency partnership that conducted a small-scale evaluation of text4baby enrollees in San Diego.

Dr. LaCoursiere calls herself “a bit of a devil's advocate,” and before conducting the survey she had some concerns. For one, she wondered whether the program was well received and whether it would create more work for physicians.

But she found out otherwise, she said.

With the goal of reaching women, especially those who are uninsured or underinsured, text4baby sends three free text messages daily to enrollees, many of which are relevant to their due date (nationally, around 46% of women signed up during their first trimester). It sends out phone numbers of relevant resources, and it alerts women of an outbreak or recall.

In the telephone survey of 122 text4baby users (roughly 10% of San Diego County's text4baby enrollees), 63% of the respondents said that the service helped them remember appointments or immunizations for themselves or their child, 75% said the messages informed them of “medical warning signs that they did not know,” and 71% said the messages promoted a conversation with their physician.

More than half of underinsured respondents (53%) said they called a phone number that was sent in a text4baby message.

“The messages support the messages ob.gyns provide to their patients,” said Dr. LaCoursiere. “I tell my patients it's the text version of a [maternity book].”

Dr. LaCoursiere said that some of her physician colleagues who have signed up for the service have also “picked up some tips” from the messages.

To become more attractive to users and gather their insights, the messaging program is now trying to become interactive.

One of its first interactive projects was a flu module, which asked enrollees whether or not they were planning to get a flu shot this season.

Of the 31% of over 100,000 active text4baby users currently in the “pregnancy” or “new baby' protocol who responded, 40% said they had already gotten the shot, 29% said they were planning to, and 31% said they were not. More than half of those who said they were planning to get the flu shot requested a reminder provided by the module.

Such interactivity can help engage the users and also reinforce key health concepts, according to Dr. Carolyn B. Bridges, associate director of adult immunization at the Centers for Disease Control and Prevention, who spoke about the module at a recent briefing.

Text4baby, which is a program of the National Healthy Mothers, Healthy Babies Coalition, is planning to reach 1 million women by the end of 2012. The program was developed as a free tool to reach mothers across the nation and help reduce the risk of negative birth outcomes, according to the organization. With more than 28,000 infant deaths each year, the United States has one of the highest infant mortality rates among the industrialized nations.

While there are various texting projects underway, maternal and child health might have one of the more eager audiences.

“Pregnant women are hungry for knowledge,” said Dr. LaCoursiere. “They want to learn how to be a good mom. So you have a population who's very interested in learning.”

Text4baby is planning to release radio and television Public Service Announcements and increase its presence on social media in 2012, according to the program's organizers.

Several national evaluations are underway, and the results could be available within the next 2 years.

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'The [text4baby] messages support the messages ob.gyns. provide to their patients.'

Source DR. LaCOURSIERE

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A sample of text4baby messages is shown on a cellphone screen.

Source Naseem S. Miller/Elsevier Global Medical News

National Texting Program for New Moms Continues Growth