March 26, 2014
Erica - Text4baby - Grand Rounds

Erica Doxzen presenting Text4baby findings

The Center’s very own Erica Doxzen, a graduate assistant, recently presented “Examining Text4baby: Findings from a two-stage study conducted by the Horowitz Center for Health Literacy” during the University of Maryland’s Behavioral and Community Health Grand Rounds. She  shared the main findings of the pilot evaluation thus far. Here are some fast facts and a quick overview:

  • Text4baby is the first free national text service for prenatal and maternal mothers
  • The National Healthy Mothers initiative, Johnson and Johnson, and the Healthy Babies Coalition are three of several partners on the pilot
  • There are currently 690,000 enrollees to date!

Infant mortality is associated with access to maternal healthcare, health-related knowledge, and health literacy. The text4baby program, currently the largest national texting health initiative, seeks to address these factors and change health behavior; however, no research has been conducted examining the theoretical underpinnings framing the text message content itself and motivations behind production, aspects that may directly impact the success of the program. In addition, no formal evaluation of the service has been conducted in the Maryland/District of Columbia (DC)/Virginia region.

To address these gaps, the Horowitz Center for Health Literacy conducted a two-stage study, including 1) a content analysis and in-depth interviews to examine the use of theory in the text4baby text messages, and 2) a pilot evaluation of the text4baby service with pregnant women in the DC metro region.  The first stage of the study found that the inclusion of theory in the development of the message content was negotiated due to character limits and content requirements, yet theoretical constructs from Social Cognitive Theory, Health Belief Model, and the Theory of Planned Behavior were present in the text messages.  The second stage of the study identified the importance of audience segmentation in the development and implementation of mass health campaigns, and the usefulness of the Situational Theory of Publics in this process.  Findings from both stages of the study, as well as implications for future research and practice were presented.

Great job Erica!

If you want to know more please email Erica at