1 douglas evans


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1 douglas evans

  1. 1. The Text4baby Program: Evaluation of a Mobile Health Initiative <br />Mobile Health 2011 @ Stanford<br />W. Douglas Evans, Ph.D.<br />wdevans@gwu.edu<br />The George Washington University<br />
  2. 2. text BABY to 511411<br />2<br />
  3. 3. What is text4baby?<br />…a free mobile information service of Healthy Mothers Healthy Babies Coalition (HMHB) <br />…in English and Spanish to promote maternal and child health especially among low-income moms<br />…provides pregnant women and new moms with motivation and information to help them care for their health and their baby’s<br />…sign up by texting BABY (or BEBE) to 511411 to receive 3 free SMS text messages each week, timed to their due date/date of birth<br />…messages connect women to prenatal and infant care services and other resources<br />
  4. 4. Don’t forget your multivitamin! Baby’s spine and brain are developing now. Getting 400 micrograms of folic acid daily is key to help prevent birth defects.<br />Reply Back<br />Be a flu-free mom-to-be! Flu shots are safe during every trimester. You’re at high risk for complications from flu, so protect yourself from getting the flu in the first place. <br />Reply Back<br />Every state has a program to help you have a healthy baby. Call 1-800-311-BABY to find out about services in your area.<br />Reply Back<br />Consult with your doctor before taking any medication, including over-the-counter items you find at the drug store.<br />Reply Back<br />Have you seen your dentist lately? You may notice changes in your gums because of extra blood flow during pregnancy. Floss and brush your teeth to protect your baby’s health!<br />Reply Back<br />Don’t eat any raw or undercooked meat, poultry, fish or shellfish (sushi or sashimi) while pregnant.<br />Reply Back<br />Sample Messages<br />4<br />
  5. 5. Priority Topics<br />
  6. 6. Promotional Materials<br />
  7. 7. Watch the clip here: http://www.mtv.com/videos/misc/496217/text4baby.jhtml#id=1634555<br />
  8. 8. Theory-based Evaluation<br /><ul><li>Text4baby is a health brand
  9. 9. Based on behavior change theory, so is evaluation
  10. 10. Health Belief Model: Texts are a cue to action
  11. 11. Social influence and diffusion stems from texts
  12. 12. Social Cognitive Theory: Self-efficacy, outcome expectations, social modeling  behavior change
  13. 13. mHealth is a new level of social ecology, interacts with existing ecologies like family, community</li></li></ul><li>9<br />Source: Institute of Medicine, 2000<br />
  14. 14. Evaluation conceptual model<br />
  15. 15. Evaluation Questions<br /><ul><li>Who subscribes and what are they like (demographics, psychographics, health profiles)?
  16. 16. What dose is delivered and what are dose-response effects?
  17. 17. Do subscribers also use www.text4baby.org? For what?
  18. 18. Are subscribers more likely to use promoted health information sources (helplines, etc.)?
  19. 19. Are subscribers more likely to form positive pre-natal care and health promoting attitudes/beliefs?
  20. 20. Are subscribers more likely to engage in behaviors targeted by messages?</li></li></ul><li>12<br />Behavioral Mediators (Change Mechanisms)<br />
  21. 21. 13<br />Behavioral Outcomes<br />
  22. 22. Strategy is place-based evaluation:2 Current Evaluation Studies<br /><ul><li>US Army Telemedicine and Advanced Technology Research Center (TATRC)
  23. 23. Conducting RCT in Army hospital facility to compare subscribers/non-subscribers
  24. 24. Launches May 2011
  25. 25. HMHB-sponsored study with Inova Health System
  26. 26. Pilot in community clinics in Fairfax County, Virginia to evaluate message receptivity and short-term outcomes
  27. 27. Launched April 2011</li></li></ul><li>Army RCT Design (sample size)<br />Powered to detect 12% increase in pre-natal care utilization<br />
  28. 28. Fairfax County RCT Design (sample size)<br />Powered to detect 15% increase in intentions to utilize pre-natal care<br />
  29. 29. 17<br />Fairfax Data – Type of Health Care Provider Visit Since Pregnancy<br />
  30. 30. Fairfax Data – Participation in WIC Program<br />18<br />
  31. 31. Fairfax Data – Search Online for Pre-natal Care Information<br />19<br />n = 30<br />
  32. 32. Fairfax Data - Smoking and Alcohol Beliefs<br />20<br />
  33. 33. Fairfax Data – F&V Servings per Day<br />21<br />n = 30<br />
  34. 34. Conclusions & Next Steps<br />Empirically-tested behavioral theory supports mHealth programs like text4baby<br />New programs need to be grounded in theory<br />Need to develop & validate theory-based metrics<br /><ul><li>Imagine in 10 years someone tried to do a meta-analysis of mHealth What’s needed now?</li></ul>Build evidence base!<br />
  35. 35. Thank you!<br />Doug Evans: wdevans@gwu.edu<br />About text4baby: <br /><ul><li>www.text4baby.org
  36. 36. http://text4baby.ning.com</li>