Text4baby As a Surveillance/Information Dissemination Tool during Zika Outbreak

Background: In early 2016, concerns about Zika skyrocketed as the virus reached pandemic levels. Linked to microcephaly in babies whose mothers have Zika while pregnant, the virus poses specific and dangerous threats to pregnant women. In early 2016, the CDC issued travel warnings for pregnant women to areas infected with Zika and confirmed sexual transmission of the disease on U.S. soil. As this outbreak continues, government agencies and others involved continue to set guidelines and release new information.

Program background: Text4baby, the largest mobile health initiative in the nation, has used the power of cell phone technology to share important health and safety information with expectant women and new mothers since its launch in 2010. Participants receive free, customized health information, safety tips, interactive surveys, and appointment reminders through at least 3 text messages per week and a free app—timed to the user’s due date or baby’s birthdate—all at no charge. Text4baby, set to reach its 1 millionth user this year, is well positioned to reach pregnant women across the country with important and timely information—including crucial information on Zika virus.

Evaluation Methods and Results: In February 2016, Text4baby worked with CDC to send its first national text messages to users about Zika, with links to CDC resources for pregnant women. In March, Text4baby worked with CDC on a national text message to all pregnant users with a link to a survey (in English and Spanish) to better understand the concerns and needs of our users related to Zika. Among 400+ (a 1% response rate among English users and 4% among Spanish) respondents, 95% reported being concerned about Zika. More than 90% wanted more information about preventing Zika and protecting their pregnancy, and users reported currently getting information on Zika from newspapers/TV/radio (54%), news or medical websites (46%), social media (41%), and their doctor or healthcare provider (31%). Of respondents, 86% wanted more information on Zika from Text4baby by text message (and 54% were interested in updates from Text4baby via email). Respondents wanted updates whenever they’re available (45%) or once a week (32%).

Conclusions: Pregnant women in the United States remain concerned about Zika and are looking for more information to ensure the best outcomes for their babies. Text4baby is already reaching this target audience through text message—a preferred format for future communication on this timely, quickly-evolving topic. Text4baby will continue to work with the CDC to craft and send additional messages to interested users, and will work to refine this model for use during future outbreaks (or other times with high demand for specific, targeted information).

Implications for research and/or practice: Text4baby and others who reach a specific target audience must look for new ways to enhance communication with their users in times of outbreaks or other similar situations. Programs such as Text4baby can also be used as surveillance tools during public health crises. Health information by text message remains a useful tool for quickly disseminating crucial health information to large numbers of people.