Understanding and increasing utilization of a text messaging program for young moms aimed to improve maternal and child health

Background: TextMOMS, a state-funded service for young mothers aged 13-24, allows interested women to text a question about prenatal care, postnatal care, or other aspects of maternal and child health to a medical expert who provides an informative response and can make referrals to local resources. The service was under-utilized during the first seven months of implementation. This presentation describes efforts to discover the barriers and enablers of using the service and subsequent steps taken towards more intentional promotion. Additionally, the specific questions submitted were analyzed to better understand the needs of the young mothers and whether efforts to promote systems changes in the community were addressing those needs. Methods: Pregnant and parenting women in the target population were interviewed about their experiences using the two-way text responder service. Local health department and community organization staff working directly with the target population were interviewed about their experiences promoting TextMOMS. Text message transcripts were grouped according to themes and compared to individual county action plans intended to improve local services, programming, and policies for young families. Results: Two separate text-based services targeting the same population led to confusion about the instructions for use and purpose of TextMOMS. Informing program staff working with the target population about the types of questions submitted to TextMOMS allowed staff to address these topic areas during planning for systems improvement efforts. Conclusions: The results of this evaluation have implications for other public health related text-based services.