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									Text4baby
&

Interactive
Mobile

Health
Engagement

Over
     90%
of
Americans
have
mobile
phones


Over
1.5
trillion
text
messages
sent
in
2009

Average
hours
per
day
mobile
phones
are
within

             19
hours

arm’s
reach:






300 million        untapped health behavior       change devices in the US

4.6 billion around the world


   “They’re
the
most
direct,
convenient,
and
dependable
form
of

    communication
we
have.
That’s
why
the
President
and
I
believe

    mobile
phones
have
so
much
power
to
empower
the
consumer

    toward
a
healthcare
system
in
the
future…





   “The
introduction
of
mobile
technology
in
this
move
toward

    electronic
health
records
for
all
Americans
is
a
huge
tool
in
the
tool

    kit
that
allow
us
to
drive
better
care
and
better
outcomes…


   “Mobile
health
has
enormous
benefits
for
individuals
and

    improving
the
health
of
all
Americans…”
    
         
            

    
               
         
         



           
       


        
   
       
         
HHS
Secretary
Kathleen
Sebelius

        
   
       
         
October
29,
2009

Reaching
the
Underserved


 Mobile
phones
are
particularly

 critical
in
reaching
and
engaging

 lower
income
and
underserved

 populations
(e.g.
Medicaid).





                                                               73%

                                      80%

                                                        68%

                                      70%

                                      60%
       53%


                                      50%

                                      40%

                                                                                       25%
                   27%
           27%

                                      30%
                                      19%
                   26%

                                                                                                                                    22%

                                                                                                                      18%

                                                                         17%
                   14%

                                      20%

                                      10%

                                                                                                                                           White

                                       0%

                                                                                                                                           Black

                                               Send/Receive
txt
      Send/Receive
email
     Send/Receive
IM
       Access
internet

                                                                                                                                           Hispanic


                                             Source: Pew Internet & American Life Project Survey, May 2008
Mobile
Health
|
Opportunities



   Health
Plans

    Prevention
&
Wellness

    Disease
Management
2.0

    Post‐discharge
Support

    Adherence

Mobile
Health
|
Evidence


 Diabetes
                                                     Smoking
Cessation

 The
web‐based
intervention
using
SMS
                         28%
of
smokers
receiving
SMS

 messaging
improved
levels
of
HbA1c
                           messages
quit
vs.
13%
of
control

 and
2HPMG
in
type‐2
diabetic
patients
                        group.


 for
the
six‐month
duration
of
the
trial.

                    A.
Rogers
et.al.
Do
u
smoke
after
txt?
Tobacco

 Journal
of
Clinical
Nursing,
June,
2007,
Vol.
16
No.
6,
pp
   Control
2005;14:255‐261.

 1082‐1087
Hee‐Seung
Kim,
Ph.D.,
RN;
Hye‐Sun
Jeong

 PhD,
RN




 For
patients
using
interactive
SMS
                            Weight
Management

 support
service,
mean
HbA1c

 improved
from
7.5
±
1.5%
to
7.0
±
1.1%
                        SMS
trial
participants
had
mean

 (P
=
0.003).
Hyuk‐Sang
Kwon,
et.
al.
Diabetes
                 reductions
of
weight,
waist

 Research
and
Clinical
Practice
Volume
66,
December
2004:
      circumference
and
body
mass
index
of

 Pages
S133‐S137

                                                                1.6
kg
(P
<
0.001),
4.3
cm
(P
<
0.001)

                                                                and
0.6
kg/m2
(P
<
0.001),
respectively.


                                                                NS
Joo,
et
al.

Journal
of
Telemedicine
and
Telecare

                                                                (2007;
13(8):416‐20)

Voxiva
|
About
us




    Founded
in
2001


    Operations
in
13
countries
    US
               India

                                   Mexico

                                   Peru

    Multi‐channel
platform
        Argentina

                                   Canada
      Rwanda

                                   Colombia
    Nigeria

       Public
health
solutions
    Panama

                                   Ecuador

                                                Kenya

                                                Tanzania

       Consumer
health
                         Zambia

       engagement
solutions





    Software
as
a
Service
model

A
suite
of
interactive
mobile
health
services
designed
to
support

behavior
change
and
engage
people
in
managing
their
health





  Content
and
protocols
are
developed
in
partnership
with

              academic
and
industry
leaders

        |

Call To Action
                  (text)   (click)        (call)




User Profile




 Targeted
Messaging
                                Educacional

                                  Content





 Interactivity/
  Community




Administrative
Management
|
•  First
ever
free‐to‐end‐user
mobile
health

   service
in
the
US

•  3
messages/week
through
pregnancy
and

   the
first
year
of
life

•  English
and
Spanish
version

•  Unprecedented
public/private
partnership

•  Over
200
partners

•  T4B
Coalitions
in
40+
States

Text4baby
|
National
Launch
–
February
4,
2010

             |


“Text4baby
is
the
first
free
mobile
health
service
to
be
taken
to

scale
in
the
United
States…



“We
know
that
mobile
phones
hold
tremendous
potential
to
inform

and
empower
individuals.




“Text4baby
represents
an
extraordinary
opportunity
to
expand
the

way
we
use
our
phones,
to
demonstrate
the
potential
of
mobile

health
technology,
and
make
a
real
difference
for
moms
and
babies

across
the
country.”




                   U.S.
Chief
Technology
Officer


                          Aneesh
Chopra

Text4baby
|
Message
Content


 Content
                       Sample
Messages

  
Health
Care
Access

  
Immunization
                  You’re not alone. If you    A seat belt protects you
  
Nutrition
                     need help, call             & your baby. Shoulder
                                   1-800-311-BABY              belt goes between your
  
Prenatal
Care
                 (2229) for free or low-     breasts & lap strap
  
Drugs
and
Alcohol
             cost health care & your     goes under your belly
                                   local WIC program.          (not on or above).
  
Emotional
Wellbeing
                                       Wear it every time.
  
Smoking
Cessation

  
Labor
&
Delivery

  
Breastfeeding

  
Mental
Health

  
Car
Seat
Safety

  
Safe
Sleep

  
Oral
Health

                                   Congratulations on          Keeping your baby’s
  
Pregnancy
Symptoms
            your baby’s birth!          mouth clean is
  
Exercise
                      Baby's 1st doctor’s visit   important even before
                                   should be 2 to 3 days       she has teeth! Wipe
  
Developmental
Milestones
      after leaving the           her gums each day
                                   hospital. Ask your          with a wet washcloth or
                                   doctor when to              use a soft baby
                                   schedule it.                toothbrush.
Content
developed
by
HMHB
in

collaboration
with
HHS,
CDC,

NICHD,
HRSA,
BabyCenter,

physicians
and
nurses.

Text4baby
|
Evaluation


 National
Evaluation

 George
Washington
University
is
coordinating
a
large
scale
evaluation
of

 text4baby
in
collaboration
with
the
federal
government
(CDC,
HRSA
&

 CMS).


Participants
are
being
recruited
through
federally
funded

 community
health
centers.

The
controlled
study
will
look
at
changes
in

 participants
knowledge,
attitudes
and
behavior

as
well
as
selected
health

 outcomes
(e.g.
birth
weight).




 Health
Plan
Evaluations

 A
number
of
health
plans
are
collaborating
with
text4baby
to
conduct

 claims‐based
evaluations
of
the
program
to
determine
whether
the

 program
has
an
effect
on
metrics
such
as
pre‐natal
and
post‐natal
visits
as

 well
as
outcomes
such
as
birth
weight
and
NICU
days.

Text4baby
|
Enrollment



                    27,898
total
enrollees

                   97%
would
recommend

                    the
service
to
a
friend

Text4baby
|
Selected
Outreach
Partners

                                                                                  Local
 Health Plans                                                                     Bethlehem Health Bureau (Bethlehem, PA)
 Alameda Alliance for Health                                                      BJK People’s Health Centers (St. Louis, MO)
 AmeriHealth Mercy Health Plan                                                    Catoosa County Board of Health (Ringgold, GA)
 AmeriHealth Mercy of Indiana, LLC d/b/a Hoosier Alliance                         Central Counties Health Centers, Inc. (Springfield, IL)
 Blue Cross Blue Shield of Minnesota                                              Central Virginia Health Services, Inc.
                                                                                  Community Health Center of Southeast Kansas
 Blue Cross Blue Shield of Michigan                                               Comprehensive Health Investment Project (CHIP) of Virginia,
 CareFirst Blue Cross Blue Shield.                                                Community Health of Central Washington (Yakima, WA)
 CareOregon                                                                       Cudahy Health Department (Cudahy, WI)
 HealthCare USA                                                                   Early Learning Coalition (Pensacola, FL)
 Keystone Mercy Health Plan                                                       El Nido Family Centers (Mission Hills, CA)
 Medica                                                                           Erie County Department of Health (Erie, PA)
                                                                                  Erie County Health Department (Sandusky, OH)
 MDwise, Inc.
                                                                                  Four Corners Health Department (York, NE)
 Neighborhood Health Plan                                                         First 5 LA (Los Angeles, CA)
 Passport Health Plan                                                             Ford-Iroquois Public Health Department (Watseka, IL)
 Select Health of South Carolina, Inc.                                            Golden Valley Health Centers (Merced, CA)
 Southern Health Services, Inc./CareNet                                           Good Beginnings (Claremont, NH)
 Wellpoint                                                                        Health Department of Northwest Michigan
 National
                                                                        Health Masters Club (Orlando, FL)
                                                                                  Healthy Mothers, Healthy Babies Coalition of Palm Beach County (FL)
 U.S. Department of Health and Human Services
                                                                                  Healthy Start Coalition of Santa Rosa County, Inc. (Milton, FL)
 U.S. Department of Defense Military Health System                                Heart of Georgia Healthy Start Coalition
 Alere Women’s and Children’s Health                                              Infant Toddler Family Daycare (Fairfax, VA)
 American Academy of Pediatrics                                                   Inova Health Care Services (VA)
 American College of Nurse-Midwives                                               Hope Whispers Community Organization, Inc. (Canton, OH)
 American Public Health Association                                               Keystone Service Systems, Inc./Capital Area Head Start (Harrisburg, PA)
 Association of Maternal and Child Health Programs                                Lily’s Kids, Inc. (Middletown, CT)
 Association of Women’s Health, Obstetric, and Neonatal Nurses                    Lower Hudson Valley Perinatal Network
                                                                                  Maryland Family Network (Baltimore, MD)
 BirthNetwork National                                                            Maternity Care Coalition
 Juvenile Products Manufacturer’s Association                                     Mobile County Health Department (Mobile, AL)
 March of Dimes                                                                   Nassau County Department of Health Perinatal Services Network (Hempstead, NY)
 National Association of County and City Health Officials                         Nevada Immunization Coalition
 National Association of Pediatric Nurse Practitioners                            New York City Department of Health & Mental Hygiene
 National Business Group on Health                                                Northeast Missouri Health Council
 National Center for Parents as Teachers                                          Northern New Jersey Maternal-Child Health Consortium/Reproductive Health Access Information Network
                                                                                  Parents Plus, Inc. (Milwaukee, WI)
 The National Crittenton Foundation                                               Pennsylvania Perinatal Partnership
 National Healthy Start Association                                               Penobscot Community Health Care (Bangor, ME)
 National WIC Association                                                         Primary Plus Women’s Center (Vanceburg, KY)
 Omnia Education                                                                  Regence Health Network, Inc. (Amarillo, TX)
 Planned Parenthood Federation of America                                         Rooks County Health Department (Stockton, KS)
 Postpartum Support International                                                 Sanders County Health Department (Thompson Falls, MT)
 Preeclampsia Foundation                                                          Smart Beginnings – Martinsville and Henry County (VA)
                                                                                  South County Community Health Center (East Palo Alto, CA)
 State                                                                            Southeast District Health Department (Auburn, NE)
 Alabama Department of Public Health                                              University Community Health Services (Nashville, TN)
 Association of Perinatal Networks of New York                                    University of Kansas Institute for Educational Research and Public Service
 Center for Maternal and Child Health, Maryland Department of Health and Mental   University of Texas Medical Branch
 Hygiene                                                                          West End Women’s Health Center (Nashville, TN)
 Florida Department of Health                                                     West Virginia Perinatal Partnership
                                                                                  Whitney M. Young Health Center (Albany, NY)
 Healthy Mothers, Healthy Babies -The Montana Coalition
                                                                                  Wirt County Health Services Association, Inc. (Elizabeth, WV)
 Illinois Maternal and Child Health Coalition                                     Wisconsin Women’s Health Foundation
 Missouri Department of Health and Senior Services                                Women’s Services of Wyandotte County (Kansas City, KS)
 The Oklahoma Healthy Mothers, Healthy Babies Coalition
 Virginia Department of Health
 Wisconsin Department of Health Services
Text4baby
|
Health
Plan
Options


    Outreach
Partner

     Promote
national
text4baby

    service
with
members.


    Customized
T4B

     
Unique
registration
code
to

    identify
plan
members.

     Customized
messages.

     Robust
tools
for
data
access

    and
analysis.


    New
Modules

     
Smoking
Cessation

     
C‐section
Post
Discharge

     Gestational
Diabetes

            Thank
you

            For
a
copy
of
this
presentation

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