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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. NPM 6: Developmental Screening

MCHbest Logo toddler and doctor playing with their noses

Strategy. Text Message-Based Developmental Screening Tools

Approach. Adopt the use of text message-based screening tools in community settings.

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Overview. Innovative uses of mobile phones and text messaging have been implemented to expand the availability of validated, parent-reported developmental screening, especially among low-income populations covered by Medicaid. The use of mobile phones and text messages may be a particularly effective way to reach young families at risk, since 100% of adults between the ages of 18 and 29 years and 92% of all adults with incomes below $30,000 surveyed by the Pew Research Center in January 2018 reported that they owned a cell phone of some kind.1

Evidence. Emerging. There is current, emerging evidence for the use of mobile phones and text messaging to increase parent-reported developmental screening. More research is needed for conclusive results. Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings).

Target Audience. Underserved and low-income families.

Outcomes. Seeking to evaluate ways to increase developmental screening, national automated text message-based screening tools, such as Text4Baby and Baby Steps Text have proven to be both acceptable and feasible tools for supporting parents in tracking and monitoring their child’s development.

Examples from the Field. Access descriptions of ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Using the approach “Support multicomponent interventions led by nurse practitioners to improve access to preventive services for women in health care settings,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):

QUADRANT 1:
Measuring Quantity of Effort ("What/how much did we do?")

  • Number of families participating in an automated text message-based developmental screening program.

QUADRANT 2:
Measuring Quality of Effort ("How well did we do it?")

  • Percent of families participating in an automated text message-based developmental screening program.

QUADRANT 3:
Measuring Quantity of Effect ("Is anyone better off?")

  • Number of children identified and referred to services as a result of the text message-based screening program.

QUADRANT 4:
Measuring Quality of Effect ("How are they better off?")

  • Percent of children identified and referred to services as a result of the text message-based screening program.

Note. When looking at your ESMs, SPMs, or other strategies: (1) move from measuring quantity to quality; (2) move from measuring effort to effect; (3) Quadrant 1 strategies should be used sparingly, when no other data exists; and (4) the most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

Reference:

1 Johnson, P. R., Bushar, J., Dunkle, M., Leyden, S., & Jordan, E. T. (2019). Usability and acceptability of a text message-based developmental screening tool for young children: pilot study. JMIR pediatrics and parenting, 2(1), e10814.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.