WASHINGTON, DC—A new mobile health information service is allowing pregnant women and new mothers to receive free health tips via text messages.

The program, text4baby, was started by a public-private collaboration led by the National Healthy Mothers Healthy Babies Coalition (HMHB) and is designed to improve maternal and child health. The service, the first of its kind in the US, is available to any woman with a cell phone who wishes to participate.

The US ranks 30th in the world in infant mortality, behind most European countries, Canada, Australia, New Zealand, Hong Kong, Singapore, Japan, and Israel, according to CDC. Because cell phones are widely used, mobile health communication is seen as a potentially promising tool to promote healthy behaviors in women and adherence to prenatal care.

While the program is not military specific, DoD is an implementation and evaluation partner for the program and will conduct research on it. The military is keenly interested in exploring how mobile health technology can enhance healthcare and is planning a pilot study of text4baby in the military, according to Cynthia Barrigan, RN, MPH, the MHS text4baby coordinator who serves at the Telemedicine & Advanced Technology Research Center (TATRC). “We have been part of this because we really do want to be at the frontlines in the military health system for developing these mobile health applications.”

Reaching Women Through Cell Phones

Text4baby began in February and women who sign up for the service receive three free SMS text messages via their cell phones each week, timed to their due date or the baby’s date of birth. The messages are designed to augment clinical visits, not to replace them.

The text messages include health tips and information topics, such as birth defects prevention, immunizations, nutrition, mental health, oral health, and safe sleep. An example of a sample message used in the service is “Congratulations on your baby’s birth! Baby’s 1st doctor’s visit should be 2 to 3 days after leaving the hospital. Ask your doctor when to schedule it.” Text4baby messages also con- nect women to prenatal and infant care services and other resources.

The messages were developed by HMHB in collaboration with HHS, CDC, NICHD, HRSA, BabyCenter, physicians, and nurses.

A woman can participate in the program at no cost, even if she does not have a text message plan with her mobile service provider. If the user does have a text plan, text4baby will not deduct from the total number of texts she pays for with her regular plan.

There were 46,000 registered users nationwide as of mid-June, according to Barrigan, who noted that physicians in MHS can tell their patients about the service. “We want to encourage physicians to make sure their patients know about this service.”

While MHS offers health tips and information for pregnant women and new mothers via different forms, Barrigan said that mobile health technology may lead to more opportunities to increase awareness of healthy behaviors and of how to take care of themselves and their babies. “The next generation is text messaging and we think it is going to be an important health communication tool, so we want to understand how to best utilize it.”

Army Pilot Program Studies Text4Baby

While MHS beneficiaries can currently access the new service, TATRC is working with the program’s founders on research to evaluate the “public-version” of text4baby in the military population. Researchers will conduct a pilot study at Madigan Army Medical Center this fall to determine whether the military would benefit from a version of text4baby that delivers messages that are more military specific. “Our women have extraordinary circumstances sometimes and extra stress and there is a lot of that linked to deployments.”

Barrigan said that military researchers want to study the impact of text4baby in its population and how helpful beneficiaries find the text messages’ health tips. The result of this pilot will help determine the suitability and efficacy of text4baby as a health promotion tool for widespread implementation and evaluation across MHS.

DoD researchers would also like to “prove the value of mobile health.” Barrigan acknowledged research is also still needed to learn about the art of using text messages for health promotion.

Barrigan said that while the program is designed to reach women, officials in the military questioned whether the messages could also benefit fathers and others supporting the women. “Why not have fathers get these messages also? We are really big on working with the family in the military.”

Text4baby Registration

Registration can be done online at http://www.text4baby.org or from a cell phone. To register by cell phone simply text the word BABY (or BEBE for Spanish) to 511411. The participant will then be asked to enter the baby’s due date or the baby’s birthday and her zip code.

Once a woman has registered she will start receiving free messages with tips for her pregnancy and for caring for her baby. These messages are timed to her due date or her baby’s birth date. If her due date changes, she can text UPDATE to 511411 and enter her new due date.

In order to stop receiving messages from Text4baby, the participant can text STOP to 511411. In order to start the messages again, the user will have to re-register by sending BABY to 511411 (BEBE to 511411 for Spanish messages).

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