What is Text4baby? FREE text message service for pregnant patients providing EBM advice 3 times per week duration of pregnancy and up to infants 1 st year of life Improve outcomes for pregnancies with limited prenatal care and well child visits

 Encourages Moms-to-be regarding  regularly scheduled prenatal care  resources during pregnancy  tips for child care  Reminds importance of well child visits

Medicaid pays for pregnancy check-ups & delivery. If income is less an $35,000 (family of 3), U may qualify. Get kids insurance too: Sometimes it takes more than 1 try to quit smoking. It can be really tough. But keep trying for the health of your baby. For help, call Here’s another reason for you to get the flu shot. It helps protect your baby from flu after birth for 6 months. Questions? Call CDC at Starter text 22 nd week 29 th week © National Healthy Mothers, Healthy Babies Coalition.

Are you breastfeeding, Mom? Great job! Breast milk is the best food for baby. Questions? Call the National Breastfeeding Helpline at Your baby may tell you he’s hungry by sucking his hands or smacking his lips. Get more feeding tips from Nat’l Women’s Health Info Ctr: nd week Infant life 13 th week Infant life Peek-a-boo! Good games to play at this age are rolling a ball back & forth, putting blocks in & out of a container and clapping while you sing! 37 th week Infant life © National Healthy Mothers, Healthy Babies Coalition.

Who can enroll?  Any pregnant female with a cellular telephone  Wireless carriers DO NOT CHARGE for these messages  Enroll by texting BABY or BEBE TO  enter EDD or infant’s birthday  Receive starter package first 6 weeks  Stop receiving text messages any time  Text STOP

 Cell phones and text messaging interventions have been shown to IMPROVE 1 :  medication adherence  appointment attendance  asthma symptoms  DM pts, HbA1C levels 1. Moxley, J. Text message hotline answers teen’s questions about sex. July 27, News 14 Carolina web site. hotline-answers-ten-s-questions-about-sex.

 Pregnant patients highly susceptible to “no-show” due to number of visits recommended throughout pregnancy 2  Teenage pregnancies associated with  Increased risk for preterm delivery  LBW  SGA  malformations 2. Gortzak-Uzan L, Hallak M, Press F, Katz M, Shoham-Vardi I. Teenage pregnancy: risk factors for adverse perinatal outcome. J Matern Fetal Med Dec;10(6):393-7.

 Technology savvy patients easier to reach via phone than mailing, calling 3  Over 85% of Americans own a cell phone and 72% of cell users send or receive text messages  More cost effective to remind via text messaging 4  ~ $0.10 per text  ~ $2 per letter  ~ $10 per telephone reminder 3. Text4baby website, 4. Car J, Ng C, Atun R, Card A. SMS text message healthcare appointment reminders in England. J Ambul Care Manage Jul-Sep;31(3):216-9.

Residency clinic populations typically Medicaid or uninsured with poorer appointment compliance Goal was to enroll patients ~12 weeks EGA Integrate existing system to determine improvement in patient satisfaction, education and compliance

 Maintain a patient list via Epic EMR  Pre and post enrollment surveys  Interdisciplinary team (nursing, front staff, providers) approach to enroll  Barriers to enrollment? › Pre-pay text message plans › Languages other than English, Spanish › Time to educate during routine visits

 N=57, 53 enrolled, 4 stopped messages  Pre-enrollment survey (October 2011) › 4 questions › 53 agreed to enroll  Post-enrollment survey (March 2012) › 4 questions › 49 continued for 6 mons (or more)  Patient satisfaction – 92%

Give providers list of text messages sent to Moms – Lists provided at request Offer service at all resident clinics, no cost to residency programs – Promotional brochures, cards free of charge Patients more satisfied and empowered with knowledge about their pregnancy and infant care