The Military Families Learning Network hosted a webinar focused on utilizing text4baby and Just In Time Parenting as communication tools to support parents. Participants can receive follow-up emails with evaluations and resources after providing their email in the chat. Text4baby is a free mobile health service aiming to improve maternal and infant health outcomes by delivering timely information via text messages to pregnant women and new mothers.

1. A few days after the presentation, we will send an evaluation and links to an
archive and resources.
We appreciate your feedback. To receive these emails, please enter your
email address in the chat box before we start the recording.
All chat will be recorded and archived.
Welcome to the
Military Families Learning Network Webinar:
Novel Communication Tools: Using Text4Baby & Just In Time
Parenting to Meet the Needs of Parents
This material is based upon work supported by the National Institute of Food and Agriculture, U.S. Department of Agriculture,
and the Office of Family Policy, Children and Youth, U.S. Department of Defense under Award Numbers 2010-48869-20685 and 2012-48755-20306.

2. To receive notifications of future webinars and other learning opportunities
from the Military Families Learning Network, sign up for the Military Families
Learning Network Email Mailing list at: http://bit.ly/MFLNlist
www.eXtension.org/militaryfamilies facebook.com/militaryfamilies
bit.ly/MFLNwebinars
blogs.eXtension.org/militaryfamilies twitter.com/MilFamLN
Welcome to the
Military Families Learning Network
This material is based upon work supported by the National Institute of Food and Agriculture, U.S. Department of Agriculture,
and the Office of Family Policy, Children and Youth, U.S. Department of Defense under Award Numbers 2010-48869-20685 and 2012-48755-20306.

3. • Webinar participants who want to get 2.0 NASW CE Credits (or just
want proof of participation in this training) need to take the post-test
provided at the end of the webinar
» CE Certificates of completion will be automatically emailed to participants upon
completion of the post-test.
» Questions/concerns surrounding the National Association of Social Workers
(NASW) CE credit certificates can be emailed to this address:
MFLNmilitaryfamilyadvocate@gmail.com
» Sometimes state/professional licensure boards for fields other than social work
recognize NASW CE Credits, however, you would have to check with your state
and/or professional boards if you need CE Credits for your field.
• To learn more about obtaining CE Credits, please visit this website:
http://blogs.extension.org/militaryfamilies/family-development/professional-
development/nasw-ce-credits/
CE Credit Information

4. Today’s Presenters:
Luisa Soaterna-Castañeda, MPH is the Multicultural Outreach Manager for the
Text4Baby program at the National Healthy Mothers, Healthy Babies Coalition (HMHB).
She coordinates outreach to multicultural communities and faith-based communities, as
well as targeted outreach among designated partners whose work involves Spanish-
speaking audiences. She also provides technical assistance for various states while also
overseeing the development, translation and editing of bilingual materials, messages and
resources. Luisa has extensive experience as a community advocate, interpreter and
leader in public health. She has worked with the U.S. Department of Health and Human
Services’ Office of Minority Health, the Virginia Department of Social Services and the
Virginia Governor’s Office as the Latino Liaison. Luisa was recently appointed to serve on
the Commonwealth of Virginia Health Commissioner’s Minority Health and Health Equity
Advisory Committee (MHHEAC) and she currently serve as a board member to
Colaborando Juntos, a non-profit based out of Richmond, Virginia whose primary
purpose is to connect service providers who cater to the Latino community.
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5. Today’s Presenters:
Aaron T. Ebata, PhD is an Associate
Professor and Extension Specialist in the
Department of Human and Community
Development at the University of Illinois at
Urbana-Champaign (UIUC). He received his
B.S. degrees in Biology and Psychology from
the University of Hawaii and completed his
M.S. and Ph.D. degrees in Human
Development and Family Studies from Penn
State. Dr. Ebata's research and outreach
interests focus on applying research to develop
and evaluate programs that promote healthy
parenting practices. He has collaborated on
research on military families following
reintegration and currently focuses on
technological applications for outreach. Dr.
Ebata serves as the director of the Autism
Program at UIUC, which provides consultation,
resources, and training for families with
individuals on the autism spectrum, as well as
for professionals who serve them. A former
elementary and preschool teacher, Dr. Ebata is
the father of two teen-aged sons.
Pat Tanner Nelson, Ed.D. is an Extension
Specialist and a Professor in the Departments of
Human Development and Family Studies and
Applied Economics and Statistics at the
University of Delaware. Pat is a Certified Family
Life Educator with the National Council on Family
Relations. She received her doctorate in Family
and Community Education from Teachers
College, Columbia University, a graduate degree
in Family Life Education (Michigan State
University) and B.S. in Human Ecology (Kansas
State University). Dr. Nelson focuses on parent
education and support, family stress
management, and work/family integration. She is
a co-team leader for eXtension Just in Time
Parenting, a national interactive resource that
strives to bring high quality, research-based
information to families at the time it can be most
useful and make the biggest difference in their
lives.
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PHOTO
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PHOTO

6. Text4baby: A
Tool for
Engaging
Families
Harnessing the Power of Mobile
for Maternal & Child Health in the
U.S.

7. text4baby
The Need

8. text4baby
Maternal & Child Health in the U.S.
8
• African-American babies die
at a rate more than twice that
of their White counterparts.
• Puerto Ricans have a low
birth weight rate that is 60
percent higher than the rate
for non-Hispanic Caucasians.
• Mexican American mothers
were 1.9 times as likely as
non-Hispanic white mothers to
begin prenatal care in the 3rd
trimester, or not receive
prenatal care at all.
Each day in America:
• 11,686 babies are born
• 1,487 babies are born preterm
• 964 babies are born with low birth weight
• 78 babies die before their first birthday
Source: March of Dimes
Infographic source: http://www.bestmasterofscienceinnursing.com/health/
Infant mortality rate in the U.S. is one of
the highest among developed nations.

9. text4baby
Maternal & Child Health in the U.S.
• Many factors contribute to these
negative outcomes including:
– Lack of access to prenatal care
– Negative health behaviors such as
smoking or substance abuse
– Poverty
– Unsafe sleep for baby
• Ensuring that pregnant women
are well informed about their
pregnancies, connected to
available health resources and
getting prenatal care can help.
• Text4baby leverages moms’ cell
phone to do just that.
The Need
9

10. text4baby
Mobile Devices Help Make a Difference
10
0% 10% 20% 30% 40% 50% 60% 70% 80%
Medicare
Veteran's health
No insurance
Individual policy
Employer-sponsored
Tricare
Medicaid
43%
45%
63%
65%
68%
74%
79%
Text message usage by insurance type
Source: PricewaterhouseCoopers HRI
Consumer Survey, 2010
• 99% of text messages are read. 90% are read within 3 minutes
• People of color are more likely to text than their White counterparts
• Low-income Americans text more than higher-income adults

11. text4baby
Who We Are:
Text4baby at a
Glance

12. Text4baby
Text4baby Supports Your Patients
• Text4baby is the largest mobile health
initiative in the nation reaching over 701,000
moms since launch in 2010 and is available
in all 50 states and the U.S. territories.
• Pregnant women and moms with babies
under one sign up by texting BABY (or
BEBE for Spanish) to 511411.
• Receive FREE messages three times
per week timed to due date or baby’s
birthdate
• Experts review messages routinely to
ensure medical accuracy (CDC, ACOG,
AAP, March of Dimes, etc.)
• Reaches low-income and young women,
particularly those who identify as Hispanic
or African-American. Research shows that
these women are at a higher risk of having
disproportionately poor birth outcomes.
12
• Text4baby reinforces and supports
ongoing patient education and assists
with patient retention through critical
messages and reminders:
What to Expect for Labor
Mom and Baby’s Appointment and
Immunization Reminders
Healthy Eating for Mom and Baby
Safe Sleep
Urgent News (e.g. pertussis outbreaks and
product recalls)
Health Insurance Information
Resource Hotlines and Websites

13. text4baby
Text4baby Founding Partners
Who We Are
13
Non-Profit
maternal and child
health expert
Leader in mobile
health technology
& strategy
Founding Sponsor
& World’s 6th
largest consumer
health company
Association
representing U.S.
mobile phone
companies
Nation’s public
health agency
Federal leader in
innovation
Healthcare sector
communications &
marketing expert

14. text4baby
Mobile Provider Partners
Participating mobile providers have agreed to deliver Text4baby to their
subscribers at no charge.

15. text4baby
Engaging the Community: More than 1,100 National, State
and Local Partners

16. text4baby Enrollment by Zip Code
Virginia Feb-Aug 2010
Text4baby’s Research Director routinely monitors and analyzes a wide array of data collected by
the program to inform and improve program promotional, outreach, and product strategies.
Additionally, Text4baby provides partners with access to real-time enrollment data to support them
in understanding the impact of outreach initiatives on enrollment.
In Martinsville, Virginia six
text4baby billboards in Martinsville
resulted in enrollment increases
Real-Time Data Portal Tracks Outreach Impact
and Enrollment

17. text4baby
Reach and
Receptiveness

18. text4baby
Text4baby is Reaching its
Target Audience
• Text4baby is reaching
individuals early in their
pregnancy
– 47% enrolled during the
first trimester.
• Text4baby is reaching
women in high-poverty
areas
– A higher percentage of
Text4baby users live (or
lived upon enrollment) in
zip codes with the
highest levels of poverty
compared to the overall
U.S. distribution.
18

19. text4baby
Well Received by Participants
• 99% of WIC participants in an Emory University study (baseline
n=468) had no concerns about enrolling in Text4baby; 95%
reported the enrollment process was easy; 92% regularly read
Text4baby messages; and 88% planned to continue to use
Text4baby.1
• 93% of participants who responded to a Text4baby survey said
they would refer Text4baby to a friend (n=26,650) and rated the
helpfulness of the service a 7.7 out of 10 (n=38,090).2
• The average satisfaction rating for participants who participated in
the California State University San Marcos National Latino
Research Center and University of California, San Diego
(CSUSM/UCSD) evaluation was 8.5 out of 10, with Spanish-
speaking participants reporting a higher level of satisfaction
compared to English-speaking participants.3
Well Received
1. Gazmararian, J., Elon, L., Yang, B., Graham, M., Parker, R. (2013). Text4baby Program: An Opportunity to Reach Underserved Pregnant and Postpartum Women?
Maternal Child Health Journal. Abstract available: http://www.ncbi.nlm.nih.gov/pubmed/23494485.
2. Kaleka, A., Olsen, R., & Sweet, M. (2012, April 28). Utilization of Text4baby to Improve Maternal and Infant Outcomes with an Interdisciplinary Team.Seattle,
Washington. Available: http://www.fmdrl.org/index.cfm?event=c.accessResource&rid=3850.
3.California State University, San Marcos (2011). San Diego Researchers First to Report Positive Impact of Text4Baby Program [press release]. Retrieved
from:https://www.text4baby.org/templates/beez_20/images/HMHB/SD_press_release.pdf. Total sample size for first survey = 122.

20. Text4baby is Making an Impact

21. text4baby
Content Development

22. Text4baby
Delivery and
Exposure
Reactions/
Receptivity
Mediators
Behavior
Change
Health OutcomesSocial, cultural, & physical environment
moderate each pathway
Text4baby’s Logic Model
Adapted from Doug Evans, et al. (2012) mHealth conceptual model of behavior change for the Text4baby project.
Social cognitive theory and the health belief model used to predict behavior change

23. text4baby
Literature
Review
Priority
Topics
Audience
Testing
Content
Development
Expert
Review
Audience
Testing
Ongoing
Revision
Content Development & Review
Text4baby’s Content Manager -- who developed the
American Academy of Pediatrics Bright Futures guidelines
— ensures accuracy, currency, and consistency with
medical research and science.

24. text4baby 24
Content Development Council:
• American Academy of Pediatrics (AAP)
• American College of Nurse-Midwives (ACNM)
• The American College of Obstetricians and
Gynecologists (ACOG)
• Association of Women’s Health, Obstetric and Neonatal
Nurses (AWHONN)
• Centers for Disease Control and Prevention (CDC)
• Health Resources & Services Administration (HRSA)
• March of Dimes (MOD)
• National Association of Pediatric Nurse Practitioners
(NAPNAP)
• Society for Maternal-Fetal Medicine (SMFM)
Experts Develop and Review ALL
Text4baby Content

25. • 267 Messages Total
• Breakdown of messages by broad topic area:
• 61 Safety
• 56 Development
• 45 Nutrition
• 44 Support
• 30 Infectious disease
• 20 Health care access
• 18 Well baby visit
• 18 Symptoms
• 11 Screening
• 9 Prenatal care
• 8 Oral health
Text4baby Addresses Critical Maternal
and Child Health Topics

26. • 58% contain additional health and resource info
• 46% (123 messages) link to text4baby mobile web pages
developed in partnership with major medical associations
• 25% (68 messages) provide a resource phone number
• 45 links to videos
• 15 visit & appointment reminders
• 6% of messages link to external websites
• 9 messages prompt mothers to text back LIKE when they find
a message helpful
• 7 messages encourage mothers to text back MORE to get
additional information
• 4 interactive user feedback and engagement survey
questions (e.g. “Did you ask your provider about a health
topic covered in Text4baby?”)
• 3 interactive modules that connect moms to healthcare,
remind moms of well-baby visits & immunizations, and
encourage flu shot vaccination
• 2 Quizzes (Food safety in pregnancy and car seat safety in
infancy)
Interactivity in Text4baby Service

27. (1/2) text4baby: Every
week of pregnancy is
important for your
baby’s development. So
if you have a healthy
pregnancy, wait for
labor to begin on its
own. (1/2) Go to
text4b.org/088 to watch
a fun video about
waiting for at least 39
weeks.
Message
Layers of Additional
Resources
Mobile Web Pages Provide More Information
Videos and more
information

28. text4baby
Connecting to Health Coverage
Partnership with Centers for Medicare & Medicaid Services (CMS)
– In February 2012, the Connecting Kids to Coverage initiative of CMS partnered
with Text4baby to drive enrollment in CHIP, Medicaid, and Text4baby.
– Text4baby launched a module of interactive messages in December, 2013
designed to encourage Medicaid/CHP application, enrollment and renewal
Medicaid Module Design
– 3 days after enrolling, participants are asked their insurance type.
– Those who respond “no health insurance” are sent info. on Medicaid/CHIP
eligibility and how to enroll. They receive a second message 7 days later asking if
they applied for coverage.
– Those who respond “Medicaid/CHIP” or indicate they have applied for coverage,
receive information on how to renew Medicaid/CHIP coverage.
Partnership with Kaiser Family Foundation (KFF)
– KFF interviewed Text4baby participants to better understand the impact of the
Medicaid Module.
28

29. text4baby29
20%
Employer
Text4baby’s Medicaid / CHIP module

30. Text4baby | Medicaid / CHIP module
Results by Text4baby Participant:
Pregnant vs. Mother with infant < 1 year of age

31. text4baby31
20%
Employer
Text4baby | Medicaid / CHIP module
Results by Language Group

32. text4baby
KFF Findings
• Text4baby featured in February 2014 Issue Brief: Profiles of Medicaid
Outreach and Enrollment Strategies: Using Text Messaging to Reach and
Enroll Uninsured Individuals into Medicaid and CHIP
• Findings from telephone interviews with 43 Text4baby participants exposed
to Text4baby Medicaid Module.
• Highlights include:
– Respondents had limited knowledge of Medicaid/CHIP before Text4baby enrollment
– Many sought additional info. on Medicaid/CHIP after receiving Text4baby messages
– A number of respondents applied for Medicaid/CHIP after receiving Text4baby
messages and most that applied had successfully enrolled
– Most that applied said Text4baby health coverage messages were an important factor
in their decision to apply
– Nearly all said Text4baby is useful and would like to receive more messages about
health insurance
32

33. text4baby
Encouraging Flu Shots Through Interactive
Module: 2012 Flu Module
33
• Overall Goal of the Flu Module:
• Reduce barriers to influenza vaccination by providing tailored educational
messages and offering appointment reminders to ALL text4baby users
• Research Goals:
– Can text4baby be a useful tool to increase:
1. Flu vaccination rates (for pregnant women & moms with
infants)?
2. Intent to get vaccinated during this flu season?
– To address barriers:
1. Forgetting/busy
2. Cost
3. Health concerns such as safety and efficacy

34. text4baby 34

35. 2013-2014 Flu Module Goals
1. Send timely messages and reminders to all T4B users during flu season
• The initial message and general reminder will be implemented monthly (6
times)
2. Send coupon codes for free flu shots to users living in areas near a Rite
Aid
3. Gain insight on the effectiveness of providing coupon codes for
free flu shots via text message
4. Gain data on flu shot prevalence in November and April, to compare to
CDC data

36. text4baby
Text4baby: It's flu season. Everyone 6 months & older needs a flu shot. Babies under 6
months can't get the shot yet, but mom's shot helps protect baby too!
Low-cost flu shots are available. Ask your Dr, health plan or local drug store. To find a
location nearby call CDC at 800-232-4636 or visit text4b.org/125
2013 Flu Module
Text4baby: Checking in! Since October 2013, did you get a flu shot? Reply 1 for Yes, I got it when I was
pregnant; 2 - Yes, I got it after baby was born; 3 – No.
Text4baby: T4B wants to know about baby's flu shot too! Since October 2013, did baby get a flu shot? Reply
1 for Yes or 2 for No
Text4baby:
This is a flu
shot
reminder.
Protect baby
& yourself by
getting the
flu shot! Call
your Dr. or
find a
location at
text4b.org/1
25 or call
800-232-
4636
YES
Text4baby: Rite Aid is giving up
to 10,000 FREE flu shots to T4B
moms over 18 that haven't
gotten a flu shot this season.
Do you want a FREE flu shot?
Reply YES and we will send you a
coupon code to use at Rite Aid.
More info at text4b.org/126
Text4baby: Here is your FREE flu shot
code: CCCCCCCCCCC. Keep your code
safe; we cannot resend it. The code can
only be used once and only at Rite Aid.
Code expires 1/31/2014 or after first
10,000 are claimed. Show code to
pharmacist to redeem. For questions, call
local Rite Aid: riteaid.com/store-locator
1
2
3
2weeks
Text4baby:
Mom, don’t
forget to use
your free flu
shot code at
your nearest
Rite Aid. The
code was
sent in an
earlier T4B
text. Code
expires
1/31/2014
November & April

37. Immunization Module Pilot
Overview
Background/Goal
• Piloted with Immunize Nevada and California Department of Health
• Encourage timely well-baby visits and immunization at birth, 2, 4, 6, and 12
months and gain insight around self-reported visit attendance and
immunization
Design
• Hep B: Education before birth & follow-up after asking if baby received vaccine
• Well-baby Visits & Immunization: (1) Education 2 weeks prior to baby’s 2, 4, 6,
and 12 mo. birthdays, (2) Opportunity to set up reminders at two points, (3)
Follow-up 2 weeks after baby’s 2, 4, 6, and 12 mo. birthdays asking if they
went to their well-baby visit and got their baby vaccinated (for those who
attended)
• Evaluation: Follow-up 3 weeks after 6 or 12 month birthday asking if
messages helped to get baby vaccinated
Sample
• A total of 11,117 participants provided one or more responses to questions
asked from 3/5/13 – 5/23/13; over 40% responded to at least one question and
10% responded to every question
37

38. Immunization Module:
Immunization Key Findings
Well-baby Visit Attendance Higher Among Moms
Who Receive Education & Reminders
- Well-baby visit attendance is higher among
participants who receive educational and
reminder messages about their upcoming visits.
- This relationship was stronger among
respondents receiving messages in Spanish.
High Self-Reported Hep B Vaccination
- Respondents report high rates of hepatitis B
vaccination (81% in CA; 90% in NV).
Respondents Find Messages Helpful
- 72% of respondents reported messages were
helpful in remembering to get baby vaccinated.
- 90% of Spanish-speaking respondents reported
the messages were helpful.
38

39. text4baby
Clinical Text4baby
Implementation

40. text4baby 40
text4baby | Quality Metrics |
Customer Satisfaction
Getting Care
Getting care easily
Getting care quickly
Satisfaction with physicians
How well doctors communicate
Rating of personal doctor
Rating of specialists
Rating of care received
Satisfaction with health plan svcs
Handling claims
Rating of health plan
Customer service
Prevention
Children and adolescents
Well-child visits, infants
Well-child visits, ages 3-6
Access for children ages 7-11
Adolescent well-care visits
Early immunizations
Adolescent immunizations
BMI percentile assessment
Nutrition counseling
Physical activity counseling
Women's reproductive health
Timeliness of prenatal checkups
Postpartum care
Cancer screening
Breast cancer screening
Cervical cancer screening
Colorectal cancer screening
Other Preventative Services
Adult BMI assessment
Chlamydia screening
Flu shots for older adults
Treatment (1)
Asthma
Medicate asthma appropriately (5-11)
Medicate asthma appropriately (12-18)
Medicate asthma appropriately (19-50)
Medicate asthma appropriately (51-64)
Diabetes
Blood pressure control (140/80)
Blood pressure control (140/90)
Retinal eye exams
Glucose testing
Glucose control
LDL cholesterol screening
LDL cholesterol control
Monitoring kidney disease
Heart Disease
Beta blocker after heart attack
Controlling high blood pressure
LDL cholesterol screening
LDL cholesterol control
Treatment (2)
Mental and behavioral health
Depression--adhering to medication for 12 wk
Depression--adhering to medication for 6 mo
Follow-up after mental illness hospitalization
Alcohol/ drug dependence treatment initiated
Alcohol/ drug dependence treated for 30 days
Follow-up after ADHD diagnosis
Continued follow-up after ADHD diagnosis
Other treatment measures
Use of aspirin
Appropriate antibiotics, adults acute bronchitis
Appropriate testing/ care, children/pharyngitis
Medication for rheumatoid arthritis
Monitoring key long-term medications
Steroid after hospitalization for acute COPD
Bronchodilator after hospital/ acute COPD
Testing for COPD
Appropriate antibiotic use, children with URI
Appropriate use of imaging for low back pain
NCQA Scorecard (HEDIS/Star )

41. text4baby 41
EPSDT Measures Text4baby
Early
Assessing and identifying problems early
• Communicating to mothers appropriate
pregnancy and developmental outcomes by
prenatal and age stage
• Increasing awareness of early developmental
milestones and outcomes and encouraging
early intervention
Periodic
Checking children's health at periodic, age-
appropriate intervals
Text4baby messages follow current national
guidelines and create visit prompts and reminders
based on the periodicity of prenatal and
preventive care visits for infants (ie, AAP/Bright
Futures periodicity schedule)
Screening
Providing physical, mental, developmental, dental,
hearing, vision, and other screening tests to
detect potential problems
Text4baby messages encourage the following:
 Prompt preventive care visits for children
including visit reminders
 Encouragement and reminders for
vaccinations based on ACIP
recommendations including resources for
low cost and free vaccinations
 Reminders to ask about lead screening
 Encouragement to seek vision screening
 Resources and education regarding dental
care
 Infancy milestones and resource sharing
for early intervention
 Hearing screening and follow-up
Diagnosis
Performing diagnostic tests to follow up when a
risk is identified, and
• Follow up messaging on newborn screening
and early intervention services
Treatment
Control, correct or reduce health problems found.
• Encouragement of accessing health services
and following up on health care issues

42. text4baby 42
CHIPRA Measures Text4baby
Immunizations
Childhood immunization status
(by 2nd birthday)
• Encourages immunization based on ACIP
standards and includes messaging on how
to access free and low cost vaccinations
Screening
Weight assessment for
children/adolescents
• Provides messaging on importance of weight
for length measurements and discussions
regarding appropriate weight for length with
health care provider
Well-child Care Visits (WCVs)
WCVs in the first 15 months of
life
• Includes visit prompts reinforcing the
AAP/Bright Futures periodicity of preventive
care visits. Mothers can also use the service
to create prompts to remind them of the
scheduled visit.
Dental
Total eligible receiving
preventive dental services
• Encourages the establishment of the dental
home and 1st dental visit

43. text4baby
Enrollment and Appointment
Reminders

44. text4baby
Help Enroll Patients-Signing up is Easy!
44
1) Text BABY to 511411 (BEBE
for Spanish)
2) Follow prompt to enter due
date or baby’s DOB
4) Receive FREE tips each week
throughout pregnancy & until baby’s 1st
birthday!
3) Enter zip code

45. text4baby
Enroll Patients from Web Enrollment
Button
45
• In addition to SMS enrollment, patients can enroll online at
www.text4baby.org
• If you have access to a computer, consider enrolling patients online
during appointment
• You can add the web enrollment button to your website and track who
signs- up

46. Improve Appointment Attendance:
Use Text4baby Appointment Reminder Service
• Text4baby participants can set up reminders for their appointments
(e.g. prenatal, postpartum, well baby, WIC, dental)
• Moms and parents enrolled in Text4baby with and without
smartphones can receive FREE text appointment reminders
• Moms receive a reminder three days before and morning of
appointment.
46
Mom texts
REMIND or
CITA (Spanish)
Prompts mom to
text appointment
date in mmddyy
format (e.g.,
100214)
Prompts mom to
text description (9
AM Vista DR office,
bring lab results.)

47. Other Important Information for your Patients
47
• Text4baby messages do not include any advertising or spam

48. text4baby
Make it Easy to Promote Text4baby and
Enroll Women
• Train patient-facing staff (scheduler, application
assistant, nurses, etc.) to inform patients about
text4baby and encourage enrollment
• Train appointment schedulers about Text4baby’s
“REMIND” function to provide additional appointment
reminders.
• Place web enrollment button on your website
– Can track enrollments that come from the button on your site
• Show Text4baby video in your waiting room
• Order FREE materials
– Include Text4baby materials in patient packets for pregnant women
and families with infant under age 1.
– Display Text4baby materials on walls in waiting area, offices, and in
other venues where promotional flyers are displayed.
– Include Text4baby material in educational classes, health fairs, and
baby showers resource packets.
– Incorporate Text4baby information in to your ongoing Social
Media efforts (i.e. Facebook, Twitter, etc.)
48

49. text4baby 49
Integrate Text4baby Enrollment in to your
process – SMS Enrollment
Text4baby poster or
tearpad displayed or
available in waiting room
During intake process,
have staff ask if patient is
interested in receiving
FREE text messages
from Text4baby
If yes, show patient how
to enroll by texting BABY
(or BEBE) to 511411 on
mobile phone
Use Text4baby sticker or
make a note on chart that
mom is enrolled in
Text4baby
Appointment
Scheduler/Receptionist
ask if mom is enrolled in
Text4baby, and if yes,
set-up appointment
reminder for next visit
Is patient pregnant or a mom of a baby under 1?

50. text4baby

51. text4baby
FREE Promotional Materials and Resources
Available to Support your Efforts
• All promotional materials
(available in English and
Spanish) are shipped free of
charge.
• Some items available for
purchase:
– “Ask me about Text4baby” pins
– Lip balm
– Bibs
• Visit Text4baby.org to:
– Order materials. You will need
to create a username and
password to login.
– Download tip sheets, tool kits,
videos, and other training
materials
51

52. text4baby
Q&A
52

53. Today’s Presenters:
Aaron T. Ebata, PhD is an Associate Professor and
Extension Specialist in the Department of Human
and Community Development at the University of
Illinois at Urbana-Champaign (UIUC). He received
his B.S. degrees in Biology and Psychology from the
University of Hawaii and completed his M.S. and
Ph.D. degrees in Human Development and Family
Studies from Penn State. Dr. Ebata's research and
outreach interests focus on applying research to
develop and evaluate programs that promote
healthy parenting practices. He has collaborated on
research on military families following reintegration
and currently focuses on technological applications
for outreach. Dr. Ebata serves as the director of the
Autism Program at UIUC, which provides
consultation, resources, and training for families
with individuals on the autism spectrum, as well as
for professionals who serve them. A former
elementary and preschool teacher, Dr. Ebata is the
father of two teen-aged sons.
Pat Tanner Nelson, Ed.D. is an Extension Specialist
and a Professor in the Departments of Human
Development and Family Studies and Applied
Economics and Statistics at the University of
Delaware. Pat is a Certified Family Life Educator with
the National Council on Family Relations. She
received her doctorate in Family and Community
Education from Teachers College, Columbia
University, a graduate degree in Family Life Education
(Michigan State University) and B.S. in Human
Ecology (Kansas State University). Dr. Nelson focuses
on parent education and support, family stress
management, and work/family integration. She is a
co-team leader for eXtension Just in Time Parenting, a
national interactive resource that strives to bring high
quality, research-based information to families at the
time it can be most useful and make the biggest
difference in their lives.
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PHOTO
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54. Engaging Parents
“Just in Time”
eXtension Just in Time Parenting
Community of Practice
Aaron Ebata, Ph.D & Pat Tanner Nelson, Ed.D.

55. Today’s Overview
• What is JITP and how does it work?
• Why is JITP important?
• Just In Time Parenting (JITP) electronic version
• Evaluating the use and
impact of JITP
• How YOU can use JITP
55

56. • Connecting and engaging the public with
university knowledge and research to
address youth, family and community
needs.
• Extending knowledge, changing lives
Cooperative Extension
4/23/2014 56
• Educational partnership
with 70+ land-grant
universities

57. What is “Just in Time
Parenting”?

58. • Pulls together key messages from research
about how to help kids grow up healthy and
ready for success
• Provides small bits of information delivered at
the most teachable moments – keyed to parents
and child’s needs and development (“age-
paced”)
58

59. Goals of JITP
•Catch parents at a time when they are open to
learning and need information
•Foster developmentally appropriate
expectations
•Promote and reinforce practices that support
the healthy development of children
•Provide strategies for coping with the stresses
of raising children and managing family life

60. When your
child is You get
2 month 2 month issue
12 month 12 month issue
1 month 1 month issue
How Does it Work?

61. JITP starts prenatally….
• Prenatal – age 5
– Prenatal (1 per trimester)
– Newborn (1)
– Months 1-12 (monthly)
– Years 2-5 (bimonthly)
• Provides information to support positive development
– Basic information on child development & milestones
– Guided activities and tips for promoting healthy development
– Strategies for coping with stress
– Support for seeking additional information

62. Early Innovations
• Print information mailed directly to parents
• Birth – age 3
• Multiple versions developed and maintained by
Cooperative Extension in individual states
• Consistent evidence of impact

63. Current Innovations
• Automated electronic delivery (English) with print
version for traditional delivery (English, Spanish)
• Prenatal – age 5
• A single national version developed and maintained
by a collaborative network
• Early evidence of impact

64. Who developed JITP?
• A team of faculty and educators from
over 20 land grant universities
nationwide –
• combining their efforts to create one
up-to-date, evidence-based national
parenting engagement tool.
64

65. Parents Who Use JITP:
• Rate JITP as more useful than any other
source of information.
• Have age-appropriate expectations and feel
reassured about their child’s development
• Report more positive parenting behaviors
and provide more stimulating learning
environments for their children.
• Can identify emerging problems and find
appropriate help.

66. Greater impact among
first-time parents, as well
as the youngest, poorest
and least educated

67. Parent Voices
• “I think it's great you are reaching out to the community to
educate parents. It is very much needed.”
• “JITP is helpful and easy to understand.”
• “My only suggestion is to send JITP more often. I always look
forward to receiving the issues.”
• “I think this publication was very useful for myself as a single
parent.”
• “Make sure that young parents sign up for this newsletter
before leaving the hospital after having a baby. They need
help and advice and this newsletter is the right source of
information.”

68. Early Experiences Matter
1) Early experiences affect brains and bodies
2) Physical and mental well-being are nourished by:
i. a stable and responsive environment of relationships
ii. safe and supportive physical, chemical, and built
environments
iii. sound and appropriate nutrition
Center on the Developing Child, Harvard University

69. Why Does JITP Matter?
 Parents want and need information
 Families play a key role in shaping health and
success throughout life
 A parenting gap is contributing to a widening
inequality and opportunity gap
 U.S. educational standards are being raised to meet
the needs for a highly literate, knowledgeable and
skilled workforce
 Equal opportunity for all?

70. Why Electronic Delivery?

71. Poll

72. Today’s parents are….
• Less likely to attend
traditional programs
• Seeking information
online
• Using mobile devices to
access the internet
• Increasingly using social
media

73. Sources of Parenting Information
Parents w/ Children Under 10 Years (Florida)
0
10
20
30
40
50
60
70
80
90
100
Mothers
Fathers
Radey, M., & Randolph, K.A. (2009). Parenting sources: How do parents differ in
their efforts to learn about parenting? Family Relations, 58, 536-548.
%reportinguse

74. Metzler, Sanders, Rusby, &
Crowley, 2011
Preferences for Parenting Information
Parents of 3-6 Year Olds (National)

75. Pew Internet and American Life Project, 2012, 2013
 46% of American adults
owned smartphones (33% of 14-
17 year olds)
 Smartphone use highest for:
 18-34 year olds
 Blacks and Hispanics
 74% of 12-17 year olds access
the internet on mobile devices
As of February 2012Mobile Access Growing

76. Smaller Income Differences
Among the Young

77. Devices Used for Online Access
Rural Parents of 1 & 2-year Olds
0
5
10
15
20
25
30
35
40
45
50
Desktop Laptop Tablet Phone
Read Email Look on Web
%reporting“mostoreverytime”

79. 0 20 40 60 80 100
Online classes, webinars
Listen to podcasts
Discussion boards
Read blogs
Use Twitter
Emailed newsletters
Watch or share videos
Look up information
News, weather, events
Use Facebook etc
Text by phone
Daily Weekly Monthly Never
Frequency of Online Activities
Rural Parents of 1 & 2-year Olds

80. Digital Divide?
• Younger and unmarried
parents more likely to use
internet for parenting
information
(Radey & Randolph,
2009)
• Younger, poorer, less
educated report getting
more out of website for
parents (Steimle &
Duncan, 2004)

81. Delivering JITP 2.0 Electronically
Mobile Ready, Ready for Sharing
JITP.extension.org

82. How Does JITP Work?
Subscribe
Monthly email
reminders
Monthly
eNewsletters
Invitation to
provide
feedback
Online survey

83. Email reminders

84. Web-based “eNewsletter”

85. Responsive Design
iPad
Samsung Galaxy iPhone 5

86. Download PDF for Printing

87. PDF versions

88. Social Sharing

89. Facebook Twitter

90. Monitoring Use and
Evaluating Impact

91. Poll

92. Website Statistics (2012)
• 111,057 visits from 75,969 individuals from 150
countries
• Top 5 were: US, India, UK, Philippines, and
Canada
State Frequency
% Visits that
were new
California 5135 68
Iowa 3932 37
New York 3729 70
Texas 3539 71
Illinois 3515 62

93. How Visitors Get to JITP
 15% from mobile devices
Search
engine
49%
Email
reminders
27%
Links from
websites
24%

94. Newsletter Views
by Age Groups
2,013
35,862
15,645
10,164
0
5000
10000
15000
20000
25000
30000
35000
40000
Expectant
Parents
Parents of
Infants
Parents of
Toddlers
Parents of
Preschoolers

95. Email Subscribers
Status 2013
Since Initiation
(July 2008)
Registered 1,592 8,180
Current active subscriptions: 4,897

96. % Who Opened Emails

97. % Who Clicked on Link

98. Usefulness of Sources of Information
JITP Parents of 1 & 2 Year Olds
0 20 40 60 80 100
Texting programs
Online classes
Online videos
Smartphone apps
TV programs, DVD
Social networks/media
Classes or workshops
Online parent community
Printed brochures, newsletters
Childcare providers
Support or playgroups
E-mailed newsletters
Books, magazines
Websites
Just in Time Parenting
Doctors, healthcare pros
Extremely Slightly-Moderately Not useful Not Used

99. Implications
• Electronic delivery systems and
technological applications are an
important way for reaching a large part of
today’s parents
• But print and mail or hand-delivery may
still be important for those who have the
most to gain from the program
• JITP provides the “ready-to-go” content
that allows educators to use BOTH
methods

100. • Our goal: Each family is getting the
messages they need – in the format that
is most convenient for them -- at the
most teachable moments.
• JITP is purposefully linked to trusted
professionals who regularly interact
with families.

101. How YOU Can Use JITP?
 Promote JITP directly to your clientele
 Link to the JITP website from your website
 Use social media as a tool
 Work with partner agencies to promote
print or electronic delivery
 See more at: extension.org/parenting
JITP.extension.org

102. Take These Points Home
 Colorful, attractive design
 Research-based, free from ads
 Time-frame (pre-natal – age 5) includes critical
growth periods
 4th – 6th grade reading levels
 Available in electronic (English) and print (English
and Spanish) versions
 A great way to engage parents and add value to your
current programs

103. Contact Us!
• Information on how to deliver print version:
Pat Tanner Nelson
University of Delaware
ptnelson@udel.edu
• Information on electronic delivery:
Aaron Ebata
University of Illinois at Urbana-Champaign
ebata@illinois.edu

104. • Webinar participants who want to get 2.0 NASW CE Credits (or just
want proof of participation in this training) need to take the post-test
provided at the end of the webinar
– CE Certificates of completion will be automatically emailed to participants upon
completion of the post-test.
– Questions/concerns surrounding the National Association of Social Workers
(NASW) CE credit certificates can be emailed to this address:
MFLNmilitaryfamilyadvocate@gmail.com
– Sometimes state/professional licensure boards for fields other than social work
recognize NASW CE Credits, however, you would have to check with your state
and/or professional boards if you need CE Credits for your field.
• To learn more about obtaining CE Credits, please visit this website:
http://blogs.extension.org/militaryfamilies/family-development/professional-
development/nasw-ce-credits/
CE Credit Information

105. This material is based upon work supported by the National Institute of Food and Agriculture, U.S. Department of Agriculture,
and the Office of Family Policy, Children and Youth, U.S. Department of Defense under Award Numbers 2010-48869-20685 and 2012-48755-20306.
Next Webinar:
May 29, 2014 @ 11:00 am Eastern
Fathers, Work & Family Life
https://learn.extension.org/events/1454

106. Military Families Learning Network
This material is based upon work supported by the National Institute of Food and Agriculture, U.S. Department of Agriculture,
and the Office of Family Policy, Children and Youth, U.S. Department of Defense under Award Numbers 2010-48869-20685 and 2012-48755-20306.
Find all upcoming and recorded webinars
covering:
Family Development
Military Caregiving
Personal Finance
Network Literacy
http://www.extension.org/62581