Mobile Health Messaging: The Text4baby Program

Background: Mobile health offers a channel of communication for getting information to pregnant and new mothers who need it most. Over 96% of Americans have mobile phones and in 2010, 2.1 trillion text messages were sent.

Program background: Text4baby is a free mobile information service that provides timely health information to women via their cell phones starting in pregnancy and extending through their babies' first year. The text4baby program offers women an easy, convenient and contemporary medium they know and trust to get information about their health and that of their children. After registering their due date or their baby’s birth date by texting “BABY” or “BEBE” to 511411, women receive important messages, guided by solid science, about a host of topics and services, including the importance of prenatal and infant care, immunization, nutrition, mental health, breastfeeding, oral health, smoking cessation, infant feeding, child passenger safety, safe sleep and others.

Evaluation Methods and Results: To ensure message content is clear, understandable and actionable by mothers of all literacy levels, the National Healthy Mothers, Healthy Babies Coalition worked with the Emory at Grady Health Literacy Team to perform one-on-one cognitive testing of a subset of messages with the target audience. Overall, women rated messages well, with most responses being “excellent.” The percentage of women able to understand and articulate the main idea of each message varied from 40%-100%, depending on the message. Potential problems that hinder understanding were identified, and messages were revised based on this testing feedback and health literacy standards. The Spanish text4baby messages are undergoing testing for translation quality and cultural relevance across diverse, Spanish-speaking audiences. Results will be available by August.

Conclusions: Text4baby provides pregnant and new moms with information to help them care for their health and give their babies the best possible start in life. Health literacy clearly plays a significant role in a subscriber's ability to read and understand the information in the text messages. Messages should continue to be tested for understanding to ensure that the information and action is understood.

Implications for research and/or practice: Text4baby shows the potential of text messaging as a channel for delivering vital health information to those who need it most. The learnings around content development and health literacy can be used to benefit future mobile health interventions.