Project Profile: Healthy Families Mobile Phone Pilot

The Aim of the Healthy Families workgroup:
Ensure healthy lives and well being for people of all ages. Allow all families to thrive by eliminating all barriers to safe housing, employment, education and nutritious food. Some identified barriers include limited transportation, unintended pregnancy, limited communication, poverty, and lack of affordable, quality child and elder care.

The Plan:
First initiative: Pilot project for expanding communication infrastructure for socially vulnerable families.

The TLC Family Resource Center serves families in Claremont and reports difficulty engaging and retaining families in evidence-based early childhood home visiting programs. One challenge is that some families in transition do not have a stable phone number or internet access. This makes communication difficult. This project distributed mobile phones with internet access and phone cards to improve communication, retention and service delivery to socially vulnerable families.

Rationale:

Providing phones and phone cards has three main purposes:

1. Phones are a communication method to remain in contact with families.

2. Phone and phone cards are an incentive for families to remain engaged in services. Phones and phone/data cards will be provided for free to families retained in selected services.

3. Phones provide an opportunity for delivery of evidence-based services through the mobile device (one example is a program called VROOM)

This topic was chosen as our first initiative because we believe it could be spread and scaled to a range of agencies in our region serving vulnerable families. It also has potential to improve service delivery to the first families served by multiple agencies from the initial phases. There are already some state and federal resources for accessing free or low cost mobile phones, and this group hoped to build upon those existing efforts to best serve families in our region. In order to use the phone as an incentive to stay enrolled, it required purchasing the phones and cards.

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What we did:

TLC families offered enrolling pregnant women in two home visiting programs the option to have a mobile phone provided by the program. The smart phones had unlimited calling, text and data plans which could be extended by a phone card provided to the family during a visit each month. TLC family also provided staff members with phones to remain in text contact with the participants. We developed three simple monthly measures presented here: the counts of phones and cards distributed to families and counts of families enrolled in each of two programs. We collected these measures for six months before the program began in July 2016 and continued measuring through December 2017.



Enrollment climbs from 18 to 35 families in two home visiting programs in 18 months after the mobile phone program begins.





“Just saw [client] in Newport. Has a one month old. Has a phone but we gave her a card. Her [boyfriend] is abusive and won’t give her any money for phone, and she has no transportation, so the phone is her lifeline. I did a depression screening and she scored extremely high. She admitted to wanting to harm herself. Using her phone she was able to call [West Central Behavioral Health (WCBH)] and speak to them and get an apt for the next morning. She then used to phone to call [Dartmouth-Hitchcock Medical Center] and get an apt to see her midwife and get medication. I gave her a card with emergency numbers on it, including the number for Turning Points Network and WCBH, both of which she can call 24/7. Using my phone (from this program) I can text her daily and check in and see how she’s doing and that she’s connecting with WCBH..”

—staff member

“[Client] was able to text me yesterday to let me know that her baby was born…”

How does this initiative connect to other regional efforts and health indicators?

The Greater Sullivan Country Public Health Network identified Healthy Families as a 2015 priority area.  Although teen birth rates in New Hampshire are the lowest in the United States, teen birth rates in Sullivan County were higher than most of New Hampshire.  The teen birth rate in Sullivan County fell from 43 per 1000 females 15-19 years old in 2008 to 19 per 1000 females 15-19 years old in 2014.  Early childhood home visiting programs, such as the ones at TLC Family, have been shown to reduce rapid repeat pregnancies, a risk after a first teen birth.

source: Health Indicator Warehouse – National Center for Health Statistics

source: Health Indicator Warehouse – National Center for Health Statistics

This project was made possible by funding from Dartmouth-Hitchcock Medical Center through the Greater Sullivan County Public Health Network.