title: Text4baby program: an opportunity to reach underserved pregnant and postpartum women?
abstract: Text4baby was launched in 2010 to promote healthy pregnancies and babies by the use of text messaging. The primary objective of this study was to assess factors related to the enrollment process and reception of text4baby. A prospective cohort study was conducted in two Women, Infant and Children clinics in Atlanta (April 2010-July 2011). Randomly selected pregnant and postpartum women (n = 468) were queried on cell phone use and instructed on text4baby enrollment. Self-enrollment issues were assessed at one-week follow-up (n = 351, 75.0 %), and message reception and reading patterns at two-month follow-up (n = 209, 44.7 %). Forty-two percent of the women had some college education and 82 % had household income <=$20,000. About half attempted text4baby self-enrollment (162/351), with enrollment success more likely among women with more education (80 % with some college vs. 62 % with less education), with household income above $10,000 (61 % < $10,000 vs. 83 % $10,001-$20,000 and 76 % > $20,000), and among women living in smaller households (77 % 1-3 members vs. 58 % > 3 members) (all p < 0.001). Among the 209 participants in the final follow-up contact, >90 % reported uninterrupted reception and regular reading of messages, and 88 % planned to continue using text4baby. Results also suggested that respondents who were younger (<26 year), less educated and had lower health literacy skills were more likely to have interrupted messages. Despite substantial interest in the text4baby program in an underserved population, innovative ways to help women with significant disadvantages enroll and receive uninterrupted messages are needed.
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Room 3019, Atlanta, GA, 30322, USA. jagazma@sph.emory.edu.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Gazmararian
authors.affiliation: Department of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Elon
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Room 3019, Atlanta, GA, 30322, USA.
authors.forename: Baiyu
authors.initials: B
authors.lastname: Yang
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Room 3019, Atlanta, GA, 30322, USA.
authors.forename: Megan
authors.initials: M
authors.lastname: Graham
authors.affiliation: School of Medicine, Emory University, Atlanta, GA, USA.
authors.forename: Ruth
authors.initials: R
authors.lastname: Parker
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005845:Georgia; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D010353:Patient Education as Topic / Q000379:methods*; D049590:Postpartum Period; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods*; D015397:Program Evaluation; D011446:Prospective Studies; D012959:Socioeconomic Factors; D060145:Text Messaging; D055815:Young Adult