1. Early Elective Deliveries and Social Media Maternal Affinity Group April 24, 2013

2. Social Media Apps to Help Pregnant Women  There are several great Social Media Apps for pregnant women  Average person looks at phone once/6.4 minutes or 150x/day.  87% of adults age 18-29 in the U.S. have cell phones.  72% of adults with cell phones send and receive text messages.  99% of text messages are read.  90% are read within 3 minutes.

3. Slide 1  Adult female texters send/receive 15 texts per day vs. men @ 10.  79% of Medicaid recipients text.  People of color more likely to text than white counterparts.  Low-income Americans text more than higher-income. Source: Amanda Lenhart. Cell Phones and American Adults. Washington, DC: Pew Research Center; 2010

4. Role of Text Messaging Televox study showed text, voicemail or email:  87% said more helpful, than in- person conversations with healthcare provider.  30% said increased feelings of trust in their provider.  51% felt more valued as a patient  35% said improved their opinion of their provider  34% reported feeling more certain about visiting that healthcare provider again. - Televox, Technology Beyond the Exam Room How Digital Media is Helping Doctors Deliver the Highest Level of Care. October 2012

5. Program Summary  Text4baby is a free program of the non-profit National Healthy Mothers, Healthy Babies Coalition (HMHB). The founding sponsor is Johnson & Johnson. The White House Office of Science & Technology and the Department of Health & Human Services are among the over 900 partners who are actively promoting the service.  Text4baby is the largest national mobile health initiative reaching over 500,000 moms since launch three years ago.

6. Program Summary  Text4baby is available in both English and Spanish.  We reach low-income and young women, particularly Hispanic or African-American.  Successful model of public-private partnership and transparent, data-driven, customer service.  Moving towards institutionalization as a critical free public health utility.

7. How Text4baby Works

8. Messages on Critical Issues  Smoking Cessation  Breast Feeding  Health Care Access  Diabetes  Nutrition  Oral Health  Immunization  Prenatal Care  Disabilities  Family Planning  HIV/AIDS Prevention  Violence Prevention  Physical Activity  Safety & Injury Prevention  Mental Health  Substance Abuse Prevention  Developmental Milestones  Labor & Delivery  Car Seat Safety  Safe Sleep  Exercise

9. Text4baby Alerts Moms of Urgent Health News, Recalls, Outbreaks, etc.  Tylenol recall, May 2010  Pertussis outbreak CA (CDC), July 2010  Similac formula recall, September 2010  Sleep positioners warning (FDA), October 2010  New car safety seat guidelines (AAP), March 2011  Deadly hot cars (Safe Kids), July 2011  Benzocaine warning (FDA), August 2011  Window falls prevention (AAP & CDC), September 2011  Warning about crib bumpers (AAP & CDC), October 2011  Carbon monoxide poisoning (CT & MA) in response to power outages, November 2011  Warning about button batteries (Safe Kids), December 2011  CMS enrollment (CMS), February 2012  Medicine safety (CDC), March 2012  Pertussis - 7 states (CDC), April 2012 and 44 states (CDC), June 2012  Hurricane Sandy Refrigerated Food – 12 states, November 2012

10. Important and Relevant Messaging Text4baby provides accurate health info to pregnant/new moms, including messaging to mothers about reducing non-medically necessary deliveries before 39 Weeks  Text4baby layers the approach by providing information starting at 27 weeks and reinforcing at weeks 36 & 38.  Content is presented via text message, links to mobile pages, links to external partner sites (AWHONN & March of Dimes) and video.  Fetal development is our # 1 mobile page in pregnancy.  We are looking for future ways to enhance the 39 weeks content.

11. More than 900 Promotional Partners

12. Reaching Women Who Most Need It  Text4baby is reaching women early in their pregnancy: Of users who signed up for pregnancy messages, over 47% enrolled during the first trimester.  Text4baby is reaching women in high-poverty areas: A higher percentage of users live in zip codes with the highest levels of poverty compared to the overall U.S. distribution.  6% use the text4baby service in Spanish.

13. Reaching Women Who Most Need It  At minimum over half (56%) are current Medicaid recipients who can benefit from our Medicaid re- enrollment messages.  More than 13% report being uninsured  Nearly half of users San Diego evaluation reported their household income was $20,000 or less.  50% of users are referred from Health Service Provider (23% Doctor/Nurse; 16% Health Department; 12% Health Plan)

14. External Results

15. Text4baby Supports HENs Messages align with Patient Safety Areas of Focus:  Preventing Early Elective Deliveries (39 weeks)  Preventing Obstetrical Adverse Events  Text4baby is an effective and low cost initiative to help improve patient safety and more.

16. Text4baby Supports HENs  Proposed Ideas for Collaboration:  Become a t4b partner: www.t4b.org/partnersgetinvolved www.t4b.org/partnersgetinvolved  Include t4b as a standard practice of outreach and care.  Integrating t4b enrollment feature into hospital system (e.g. Electronic Health Records).  Text4baby can provide access to specific – enrollment data to track outreach efforts.

17. Social media has fundamentally changed the way we consume and share information

18. Facebook.com/MarchofDimes; Facebook.com/nacersano: 370,000 likes and growing daily on the national page (English) Millions reached on a monthly basis with March of Dimes content Localized chapter Facebook pages in all 50 states and PR reach over 100,000 users

19. twitter.com/marchofdimes twitter.com/marchforbabies twitter.com/babytips twitter.com/nacersano twitter.com/nacersanobaby twitter.com/teamyouth Combined nearly 70,000 followers and growing daily

20. Monthly real-time chats in English and Spanish on topics related to having a healthy pregnancy and a healthy baby. #pregnancychat — pregnancy-related chats in English #preemiechat — preemie-related chats in English #nacersano — pregnancy-related chats in Spanish #nacersanobaby — baby-related chats in Spanish Chats are two-way content-specific conversations 2012 statistics (combined English and Spanish) o 2,583,197 average people reached o 32,458,282 average impressions

21. LinkedIn.com March of Dimes Group has over 2,000 members

22. Blogs: News Moms Need, March for Babies, Nacersano: March for Babies blog got over 100,000 page views during the March for Babies season News Moms Need gets close to 160,000 page views a year

23. Pinterest.com/MarchofDimes 21 boards with 443 pins 1,400 followers

24. www.marchofdimes.com/Cinemama - Our new iPhone app that serves up educational content while allowing users to track and photograph their pregnancy and share progress socially www.marchofdimes.com/Cinemama My9months app- Our new iPad app that provides educational content at your fingertips My9months app

25. www.MarchofDimes.com/PeriStats - Developed by the March of Dimes Perinatal Data Center, Peristats provides access to maternal and infant health data for the United States and by state or region, including more than 60,000 graphs, maps and tables www.MarchofDimes.com/PeriStats

26. BabyQ: Social media app for moms-to-be  BabyQ helps guide pregnant women on how to nurture their growing child to reach their full potential.  Their mission is to guide women to make better choices to increase the lifelong emotional, physical, and intellectual growth of their child.  Their mission is to improve birth weights, reduce preterm delivery, and decrease childhood diseases like autism, asthma, obesity and diabetes.   Brennan, Mike. "Docs develop app to help pregnant women." MiBiz: West Michigan Business News and Information. Technology, 7 Apr. 2013. Web. 12 Apr. 2013. http://mibiz.com/item/20541-docs-develop-app-to-help-pregnant-women. http://mibiz.com/item/20541-docs-develop-app-to-help-pregnant-women

27. BabyQ: Social media app for moms-to-be  Moms-to-be answer a 24 question survey and receive custom maternal and fetal health tips via SMS text messages. Moms-to-be use the tips and goals to improve their babyQ and re- take the survey every two weeks to receive new goals and messages.  BabyQ helps you understand how your Lifestyle, Exercise, Nutrition, and Stress (LENS) habits affect your baby during pregnancy.  Brennan, Mike. "Docs develop app to help pregnant women." MiBiz: West Michigan Business News and Information. Technology, 7 Apr. 2013. Web. 12 Apr. 2013. http://mibiz.com/item/20541-docs-develop-app-to- help-pregnant-women.http://mibiz.com/item/20541-docs-develop-app-to- help-pregnant-women

28. BabyQ: Social media app for moms-to-be  BabyQ helps you understand how your Lifestyle, Exercise, Nutrition, and Stress (LENS) habits affect your baby during pregnancy.  The scoring system is based on analysis of more than 39,000 pregnancies and recommendations from the World Health Organization and the American College of Obstetricians.  Brennan, Mike. "Docs develop app to help pregnant women." MiBiz: West Michigan Business News and Information. Technology, 7 Apr. 2013. Web. 12 Apr. 2013. http://mibiz.com/item/20541-docs-develop-app-to- help-pregnant-womenhttp://mibiz.com/item/20541-docs-develop-app-to- help-pregnant-women

29. BabyQ: Social media app for moms-to-be  BabyQ is the first and only pregnancy App designed by doctors, that gives mothers a babyQ score.  BabyQ is available on the App Store for iPhones and other social media outlets like Facebook, Twitter, and RSS Feed.  Mothers-to-be can update their score and receive additional maternal and fetal health tips and information by visiting the babyQ website located at http://babyq.com/. http://babyq.com/  Brennan, Mike. "Docs develop app to help pregnant women." MiBiz: West Michigan Business News and Information. Technology, 7 Apr. 2013. Web. 12 Apr. 2013. http://mibiz.com/item/20541-docs-develop-app-to-help-pregnant- women.http://mibiz.com/item/20541-docs-develop-app-to-help-pregnant- women

30. What have you heard from the presentation that motivates you to use social media in the efforts to reduce OB Adverse Events? How would you encourage utilizing this resource in your HEN or Hospitals? What have you heard that creates opportunity to reach the goal of preventing OB adverse events? Discussion