Text Messaging to Improve Preventive Health Attitudes and Behaviors During Pregnancy: A Prospective Cohort Analysis.

OBJECTIVE: To delineate the effects of text messages sent to pregnant women to promote preventive health beliefs and behaviors. STUDY DESIGN: A prospective cohort analysis was performed among women who participated in a randomized, controlled trial aimed at improving preventive health. Participants (158 pregnant women enrolled from 2010-2012) received 12 weekly text messages encouraging preventive health behaviors (tobacco cessation, condom use for disease prevention, nutrition optimization, seat belt use, breastfeeding). Pre- and postintervention surveys assessed preventive health beliefs and practices. RESULTS: At follow-up, participants agreed that receiving text messages changed their beliefs about targeted preventive health behaviors: smoking (50%), sexually transmitted disease prevention (72%), prenatal vitamins (83%), seat belt use (68%), nutritious foods (84%), and breastfeeding (68%). Many participants reported more frequent engagement in target behaviors at follow-up than at baseline: decreased tobacco use (among 41% of smokers), more consistent condom use (among 7% of sexually active participants), more prenatal vitamin intake (32%), more frequent seatbelt use (32%), more frequent healthy food intake (41%), and intention to breastfeed longer (21%). CONCLUSION: Pregnant women receiving text messages promoting preventive health reported improvements in targeted beliefs and behaviors, suggesting that text messaging may be used for health promotion during pregnancy.