On November 29, 2011, text4baby hosted a webinar titled 'Flu Module, Community Impact & Russia Expansion.’ The webinar featured experts from the United States Department of Health and Human Services’ Centers for Disease Control and Prevention (CDC) and the National Healthy Mothers, Healthy Babies Coalition. Speakers gave an update on text4baby – including how subscribers are engaging with the service, the results from a flu module sent to over 100,000 text4baby subscribers, and the impact the service is having on driving health awareness and motivating health-related behaviors. This document gives an overview of the information presented during the webinar.

1. Text4baby Update Webinar:
Flu Module, Community Impact
& Russia Expansion
November 29, 2011

2. Agenda
Introductions, Text4baby Overview
Fall 2011 Flu Module Goals and Responses
• Lauren Sogor, MPH, Campaign Manager, text4baby, National Healthy Mothers, Healthy Babies
Coalition
• Carolyn B. Bridges, M.D., CAPT USPHS, Associate Director for Adult Immunization, Immunization
Services Division, NCIRD, CDC
San Diego Preliminary Findings
• Yvette LaCoursiere, MD, MPH, UC San Diego Health System Department of Reproductive Medicine
Text4baby Russia Expansion
• Susan Can, Director, Corporate Equity, Johnson & Johnson
Question & Answer
All speakers above and the following:
• Sarah Ingersoll, Campaign Director, text4baby, National Healthy Mothers, Healthy Babies Coalition
• Paul Meyer, President and Co-Founder, Voxiva
• Elena Dmitrieva, Health and Development Foundation (implementing partner for text4baby Russia)

3. About the Service
Text4baby is the first national, free-to-end-user mobile health information
service in the U.S., designed to promote maternal and child health.
• Text4baby is an educational program of the National Healthy Mothers,
Healthy Babies Coalition.
• Women who sign up for the service by texting BABY to 511411 (or BEBE for
Spanish) receive 3 free SMS text messages each week, timed to their due
date or their baby’s date of birth.
Sample Text Messages
Need free or low-cost health care for Talk to your Dr. about getting a flu Did you get info from your Dr. on
you & your baby? Your state has shot. Pregnant moms & babies can newborn screening tests? If not, ask
programs to help. Call 877-543-7669 get very sick from flu. For info call CDC for it. Your baby will have these tests
to find out if you qualify. at 800-232-4636.. in the first 48 hours after birth.

4. Text4baby Data:
What We Know So Far
• 258,486 people have enrolled in text4baby since launch (as of
11/28/11)
• Over 24 million text messages have been sent (as of 11/16/11)
• 96% of text4baby users said they would refer text4baby to a
friend (n=12,569; as of 11/28/11)
• 63,434 (46.3%) signed up during first trimester of pregnancy,
based on the due date they entered during registration (as of 11/28/11)
• 136,780 people have signed up to receive pregnancy-focused
messages and 121,209 to receive messages focused on baby’s
first year (as of 11/25/11)

5. Text4baby 2011 Flu Module

6. Fall 2011 Flu Module Goals
• Introduce interactivity by way of “text
reminders” into the text4baby system, in order
to:
–Make the service more attractive
–Increase retention rate among users
• Gather user insights around
–Barriers to obtaining flu shots
–Openness to reminder-based option in the system

7. Fall 2011 Flu Module Overview
103,007 active text4baby users currently in the “Pregnancy” or “New Baby”
protocol received a message asking if they were planning to get a flu shot this
season.
No Yes
9,859 9,470
Didn’t Answer Answered 31% 29%
70,923 32,084
69% 31%
Already Got it
12,755
40%
Respondents Answers

8. Fall 2011 Flu Module Overview
No
not planning
to get it
9,859 9,470
12,755

9. Fall 2011 Flu Module Overview
No
not planning
9,859 9,470
to get it
12,755
I think it may give
me flu
Cost
Don’t think
it’s safe
Don’t need it
Other

10. Fall 2011 Flu Module Overview
No
not planning
9,859 9,470
YES!
to get it
12,755
I think it may give Reminder?
me flu (5,412 respondents)
Cost
Don’t think
it’s safe
Don’t need it
Other

11. Fall 2011 Flu Module Overview
No
not planning
9,859 9,470
YES!
to get it
12,755
I think it may give Reminder?
me flu (5,412 respondents)
Cost
NO YES
46% 54%
Don’t think
it’s safe
Don’t need it
Other

12. Fall 2011 Flu Module Overview
No
not planning
9,859 9,470
YES!
to get it
12,755
I think it may give Reminder?
me flu (5,412 respondents)
Cost
NO YES
46% 54%
Don’t think
it’s safe
Don’t need it
178
Other OCT • NOV • DEC • JAN

13. Flu Module Responses
Number of Respondents to Flu Shot Survey (Q1) by State
3000
2669
2455 2482
2500
2169
Number of Respondents
2000
1513
1500 1367 1397 1380
1304
933 947
1000 814 857 801 837
770 760
641 648 661
415 407 486 553
532
414 488 473 498 451
500 361 314 347
270 199 254 239 270 263
169 158
144 114 112 110 145
21 77 71 9 68 60 35 0
0
State/Territory Name
For the most part, the response totals mirror the overall text4baby enrollment
(states with highest # of enrollees also had more respondents)

14. Flu Module Takeaways
• Overall response rate was high (~30%)
– User base is engaged and willing to respond to questions of this nature
• Almost 70% of respondents (~22,000 individuals) seem to think
a flu shot is a good idea: They have already gotten it (31.8%) or
are planning to (29.5%)
• Responses from text4baby mirror similar studies focused on
pregnant women and flu conducted by CDC:
– April 2011 survey (n=1,457)
• 20% said they were concerned about safety for the baby
• 17% worried that the shot would cause flu
• Values are almost identical to text4baby’s results
– November 2010 survey (n=1,396)
• ~45% of respondents had already been vaccinated against flu
• Very close to ~40% of text4baby respondents who said they already got
their flu shot

15. Informing Broader Strategy
• High response rate indicates:
– Interest from users to engage more with program, even on
controversial health topics such as vaccination
– Text4baby users are reading their messages, reinforcing the value of a
mobile health service to disseminate critical health information within
minutes
• Quick “ping-pong” interaction is beneficial because it:
– Provides rich data within minutes (days at the most) to program staff
– Allows for immediate reinforcement of key health concepts based on
user response (e.g., overcoming barriers identified by the user)
– Allows for real-time changes in promotional strategy and long-term
content development
• Text4baby can and should continue to introduce interactive
modules like this one to further engage the audience
• Planned for 2012: reminder option for well-baby and prenatal
visits

16. San Diego Evaluation Findings

17. San Diego Preliminary Findings
Initial evaluation suggests that text4baby is:
• Increasing users’ health knowledge
• Facilitating interaction with their health providers
• Improving adherence to appointments and immunizations
• Improving access to health services
Reported that text4baby helped them remember an appointment
64.1% or immunization that they or their child needed (n=122)
Reported that text4baby messages informed them of medical
75.4% warning signs that they did not know (n=122)
Reported talking to their doctor about a topic that they read on a
71.3% text4baby message (n=122)

18. San Diego Preliminary Findings
Underinsured participants are improving their access to
health services and health information services as a
result of text4baby messages
Reported that they called a service or phone number that they
38.5% received from a text4baby message (n=122)
…of participants without health insurance reported calling a
53.3% service number

19. Text4baby Russia

20. Text4baby Russia
• Text4baby Russia to launch on December 20th, 2011
• Text4baby Russia is made possible through a public-
private partnership convened by Johnson & Johnson.
The partnership includes USAID, The Russian Ministry
of Information, the Kulakov Center, the National
Healthy Mothers, Healthy Babies Coalition, and Voxiva
• @text4babyRussia

21. Text4baby: Recent Activities

22. Text4baby in 2011
• National, State & Local Partnerships Expanded
– Over 690 partners from all 50 states have signed MOUs to
help promote the program
– EHR Association Agreement
• State Enrollment Contest
– Participants from all 50 states
– Winners announced at the American Public Health Association
Annual Meeting in Washington, DC. (Winning states:
DE, NH, NC)
• Text4health
– Secretary Sebelius (U.S. Department of Health & Human
Services) announced text4health taskforce recommendations
– Text4baby to play a prominent role as a model on which HHS
is basing future activities

23. Upcoming Evaluations
• Mathematica Policy Research, 4 TBD communities &
national
• Madigan Army Medical Center/George Washington
University, Seattle, Washington
• George Washington University, Fairfax County, VA
• Emory University, Atlanta, GA
• UnitedHealth Community and State, TBD
More Information Available Through:
• Text4baby Slideshare: http://slideshare.net/text4baby
• Text4baby Tuesday e-Newsletter http://eepurl.com/h9h3

24. Press/Media Contact
Arlene Remick, MPH
National Healthy Mothers, Healthy Babies Coalition
Office: 703.797.1945
Cell: 703.850.8590
E-mail: aremick@hmhb.org