Using Text Messaging to Improve Access to Prenatal Health Information in Urban African American and Afro-Caribbean Immigrant Pregnant Women: Mixed Methods Analysis of Text4baby Usage.
Cast your vote
You can rate an item by clicking the amount of stars they wish to award to this item.
When enough users have cast their vote on this item, the average rating will also be shown.
Your vote was cast
Thank you for your feedback
Thank you for your feedback
Journal titleJMIR mHealth and uHealth
Publication Begin pagee14737
MetadataShow full item record
AbstractBackground: The Text4baby (T4B) mobile health (mHealth) program is acclaimed to provide pregnant women with greater access to prenatal health care, resources, and information. However, little is known about whether urban African American and Afro-Caribbean immigrant pregnant women in the United States are receptive users of innovative health communication methods or of the cultural and systematic barriers that inhibit their behavioral intent to use T4B. Objective: This study aimed to understand the lived experiences of urban African American and Afro-Caribbean immigrant pregnant women with accessing quality prenatal health care and health information; to assess usage of mHealth for seeking prenatal health information; and to measure changes in participants' knowledge, perceptions, and behavioral intent to use the T4B mHealth educational intervention. Methods: An exploratory sequential mixed methods study was conducted among pregnant women and clinical professionals for a phenomenological exploration with focus groups, key informants, interviews, and observations. Qualitative themes were aligned with behavioral and information technology communications theoretical constructs to develop a survey instrument used. repeated-measures pre- and post-test design to evaluate changes in participants' knowledge, attitudes, and beliefs, of mHealth and T4B after a minimum of 4 weeks' exposure to the text message-based intervention. Triangulation and mixing of both qualitative and quantitative data occurred primarily during the survey development and also during final analysis. Results: A total of 9 women participated in phase 1, and 49 patients signed up for T4B and completed a 31-item survey at baseline and again during follow-up. Three themes were identified: (1) patient-provider engagement, (2) social support, and (3) acculturation. With time as a barrier to quality care, inadequate patient-provider engagement left participants feeling indifferent about the prenatal care and information they received in the clinical setting. Of 49 survey participants, 63% (31/49) strongly agreed that T4B would provide them with extra support during their pregnancy. On a Likert scale of 1 to 5, participants' perception of the usefulness of T4B ranked at 4.26, and their perception of the compatibility and relative advantage of using T4B ranked at 4.41 and 4.15, respectively. At follow-up, there was a 14% increase in participants reporting their intent to use T4B and a 28% increase from pretest and posttest in pregnant women strongly agreeing to speak more with their doctor about the information learned through T4B. Conclusions: Urban African American and Afro-Caribbean immigrant pregnant women in Brooklyn endure a number of social and ecological determinants like low health literacy, income, and language that serve as barriers to accessing quality prenatal health care and information, which negatively impacts prenatal health behaviors and outcomes. Our study indicates a number of systematic, political, and other microsystem-level factors that perpetuate health inequities in our study population.
CitationBlackwell TM, Dill LJ, Hoepner LA, Geer LA. Using Text Messaging to Improve Access to Prenatal Health Information in Urban African American and Afro-Caribbean Immigrant Pregnant Women: Mixed Methods Analysis of Text4baby Usage. JMIR Mhealth Uhealth. 2020 Feb 13;8(2):e14737. doi: 10.2196/14737. PMID: 32053117; PMCID: PMC7055759.
The following license files are associated with this item:
- Creative Commons
Except where otherwise noted, this item's license is described as ©Tenya M Blackwell, LeConte J Dill, Lori A Hoepner, Laura A Geer. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 13.02.2020.
- Initial outcomes from a 4-week follow-up study of the Text4baby program in the military women's population: randomized controlled trial.
- Authors: Evans WD, Wallace Bihm J, Szekely D, Nielsen P, Murray E, Abroms L, Snider J
- Issue date: 2014 May 20
- Pilot evaluation of the text4baby mobile health program.
- Authors: Evans WD, Wallace JL, Snider J
- Issue date: 2012 Nov 26
- Palliative care experiences of adult cancer patients from ethnocultural groups: a qualitative systematic review protocol.
- Authors: Busolo D, Woodgate R
- Issue date: 2015 Jan
- #BlackBreastsMatter: Process Evaluation of Recruitment and Engagement of Pregnant African American Women for a Social Media Intervention Study to Increase Breastfeeding.
- Authors: Dauphin C, Clark N, Cadzow R, Saad-Harfouche F, Rodriguez E, Glaser K, Kiviniemi M, Keller M, Erwin D
- Issue date: 2020 Aug 10
- Improving Knowledge About Pregnancy for Deaf South African Women of Reproductive Age Through a Text Messaging-Based Information Campaign: Mixed Methods Study.
- Authors: Haricharan HJ, Hacking D, Lau YK, Heap M
- Issue date: 2023 May 22