Randomized Trial of Text4Baby in the Military Women's Population

The authors implemented a randomized controlled trial to evaluate the text4baby program’s effectiveness in promoting pre-natal care, reduction of health risks, and promoting healthy behaviors.. The study was a randomized design in which pregnant women were randomized to receive text4baby plus usual care or usual care alone. At baseline, investigators recruited pregnant women first presenting for pre-natal care in two groups: first pregnancy and at least one previous live birth. We followed each of these groups (n=943) through their first post-partum appointment. The evaluation protocol included (1) participant self-reported health behaviors targeted by text4baby and (2) participant self-reported medical outcomes targeted by text4baby messages. The evaluation was based on surveys of health behaviors and a review of patient clinical records. On average, participants were age 26 and enlisted or members of military families, 34% of whom were current/former WIC participants. Bivariate comparisons revealed significant increases (p<.05) in daily fruit and vegetable consumption and seeking health information online, and reductions in reported smoking in past 30 days among text4baby participants compared to control. General estimating equation models to evaluate the full data set from baseline to post-partum interview revealed improvements in multiple beliefs about pre-natal prevention and health promoting behaviors, such as avoiding smoking and taking pre-natal vitamins and significant decreases in alcohol use during pregnancy. The areas of weight loss and obesity prevention among postpartum women are promising future research directions. The presenter explores this area and the potential for e-health interventions in the future.