mhealth evaluation & text4baby doug evans september 20, 2010
TRANSCRIPT
mHealth Evaluation & Text4Baby
Doug Evans
September 20, 2010
Evaluation Overview
● Text4baby is a brand● Based on behavior change theory● Short-term effects on brand equity, KAB● Intermediate effects on behavior● Long-term impact on maternal and newborn
health
Theory of Behavior Change
● T4B messages are a cue to action for low-income mothers (Glanz, Lewis and Rimer, 2002)
● Role of social influence and diffusion of information in text messages within the target population
● Social Cognitive Theory: Psychosocial factors (self-efficacy, social modeling) mediate effects of messaging on behavior (Bandura,
2004)
Evaluation conceptual model
Evaluation at 30K Feet● What is the level of exposure to the text4baby brand
among the target audience? ● What is exposure among selected population groups?● Does it work to change health behaviors?● How does it work (what processes)?
Subscribers – late July 2010
Process evaluation questions
● Who subscribes?– What are their demographic & health profiles?
● What are mothers reactions/receptivity to messages? – Are they perceived useful, credible?
– Are there differences in perceptions between messages or categories?
– What are health care provider (HCP) reactions?
– Are text4baby messages consistent with HCP provided information?
Process evaluation methods
● Mobile surveys– Interviewer administered by mobile phone– IVR (automated)
● In-depth interviews● Focus groups
– Qualitatively assess how messages received, used, intended/unintended effects
Outcome evaluation questions
● Do text4baby subscribers also use the www.text4baby.org Website?
● Are subscribers more likely than non-subscribers to use other health information sources (helplines, etc.)?
● Are subscribers more likely to form positive pre-natal care and health promoting attitudes/beliefs?
● Are subscribers more likely to engage in behaviors targeted by messages?– Campaign has behavioral objectives embodied in the
messages – are they achieved?
Outcome evaluation methods
● Randomized experiments
● Comparison of sites (hospitals, clinics) promoting text4baby v. those not
● Control for mothers who visit non-promoting sites but still subscribe
● Mobile surveys, typically interviewer administered
● Electronic Health Record abstraction
Conclusions
● Build an mHealth evidence base
● Develop a theoretical framework for mHealth
● Imagine in 5 years someone wanted to do a meta-analysis of mHealth
● What would need to be in place to do that analysis coherently?
● Text4baby is a big step in building the evidence base and future mHealth theory
Thank you!
● Doug Evans
● The George Washington University