2. 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

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

4. Medicaid pays for pregnancy check-ups & delivery. If income is less an $35,000 (family of 3), U may qualify. Get kids insurance too: 877- 543-7669 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 800-784-8669 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 800- 232-4636 Starter text 22 nd week 29 th week © National Healthy Mothers, Healthy Babies Coalition.

5. Are you breastfeeding, Mom? Great job! Breast milk is the best food for baby. Questions? Call the National Breastfeeding Helpline at 800- 944-9662 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: 800-994-9662 2 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.

6. 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 511411  enter EDD or infant’s birthday  Receive starter package first 6 weeks  Stop receiving text messages any time  Text STOP

7.  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, 2010. News 14 Carolina web site. http://charlottenews14.com/content/local_news/triad/628581/text-message- hotline-answers-ten-s-questions-about-sex.

8.  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. 2001 Dec;10(6):393-7.

9.  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, http://www.text4baby.org/index.php/about 4. Car J, Ng C, Atun R, Card A. SMS text message healthcare appointment reminders in England. J Ambul Care Manage. 2008 Jul-Sep;31(3):216-9.

10. 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

11.  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

12.  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%

13. 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