Simple interventions in maternal and neonatal health – folic acid, smoking cessation, blood glucose control – can make a tremendous difference to the overall health of a population. And while the United States spends by far the most on health care, by many metrics we don’t get the kind of return on investment we should expect.
Recently, researchers at University of California San Diego Department of Reproductive Medicine and the National Latino Research Center (NLRC) at Cal State San Marcos University conducted a study to evaluate the results of text4baby, a free mobile phone service for women in the San Diego area.
This free national service provides pregnant and new mothers with maternal, fetal, and newborn health information via text messages and connects them to national health resources for further assistance. And this simple, low-cost intervention – perhaps antithetical to much of our thinking in medicine – showed some surprising results.
The National Healthy Mothers, Healthy Babies Coalition (HMHB) was initially responsible for the national launch. Registration is quite simple. It can be done from the text4baby website or from any mobile device.
Mothers can text the word BABY (or BEBE for Spanish) to the number 511411 and entering in their baby’s due date or birthdate, along with a zip code, to register. Once registered, women will start receiving free messages with tips for pregnancy or caring for their baby.
Researchers surveyed 122 users and interviewed 38 women using the text4baby service in San Diego County to gain insight into their satisfaction with the service and its ability to help them in various areas.
Dr. Yvette Lacoursiere, MD, MPH at the university’s Health System Department of Reproductive Medicine, commented,
“Initial research indicates text4baby is increasing users’ health knowledge, facilitating interaction with health providers, improving adherence to appointments and immunizations and strengthening access to health services.”
According to the study, 3.1% of women reported that text4baby helped them remember an appointment or immunization that they or their child needed, 75.4% reported that text4baby messages informed them of medical warning signs they did not know and 71.3% reported talking to their doctor about a topic that they read on a text4baby message. The findings were presented at the American Public Health Association Conference in Washington D.C.
Furthermore, according to a release from the White House Office of Science and Technology Policy, participating mothers rated text4baby as an 8.5 out of 10 overall. The study additionally concluded:
- 81% have an annual household income under $40,000
- 65% are either uninsured or enrolled in California’s Medicaid program
- 63% said the service helped them remember an appointment or immunization that they or their child needed
- 75% said they learned a medical warning sign they didn’t know previously
- 71% talked to their doctor about a topic they read on a text4baby message
- 39% called a service or phone number they received from a text4baby message (this rose to 53% among individuals without health insurance)
The imedicalapps team has previously discussed the use of text-messaging as a public health tool, such as for self-monitoring reminders or to improve medication compliance with simple refill reminders. This program is the first that we are aware of targetting maternal-child health.
A notice by the Health Resources and Services Administration explained the study’s main objective,
“The goal of this program evaluation is to examine the characteristics of women who utilize the Text4baby mobile phone-based program, to assess their experience with the program, and to determine whether enrollment in Text4baby is associated with healthy behaviors and timely access to health care during pregnancy and an infant’s first year of life.”
Much of medicine is becoming a question of cost vs. benefit. In this kind of low-cost venture, the relative return on investment may turn out to be substantially greater than some of our most advance, and most expensive, treatments.