Mobile Opportunities for Mom Support (MOMS)
A unique mobile phone technology platform, to support breastfeeding moms thru peer counsellors
About You
About You
About Your Organization
Organization Name
Yale University, Robert Wood Johnson Clinical Scholars Program
Organization Website
Organization Country
United States
Country where this project is creating social impact
United States
Is your organization a
Non‐profit/NGO/citizen sector organization
How long has your organization been operating?
More than 5 years
Has the organization received awards or honors? Please tell us about them
References - Please provide two references with a two-sentence biography, email address, and phone number for each
Matthew Davis, MD, MAPP (mattdav@med.umich.edu; phone: 734-936-8832)
Dr. Davis is a primary care pediatrician and internist who conducts a wide range of research projects focusing on how health interventions influence the public (and vice-versa), and who has mentored dozens of fellows like Dr. Harari in a broad variety of project and community contexts. He is a successful physician-investigator at the University of Michigan, having received funding from the Gates Foundation, Robert Wood Johnson Foundation, WK Kellogg Foundation, Centers for Disease Control and Prevention, US Department of Agriculture, and Agency for Healthcare Research and Quality.
Rafael Perez-Escamilla, PhD (rafael.perez-escamilla@yale.edu; phone: (203) 737-5882)
Dr. Pérez-Escamilla is Professor of Epidemiology & Public Health and Director, Office of Community Health, Yale School of Public Health. He is also Director and PI of the Connecticut NIH EXPORT Center of Excellence for Eliminating Health Disparities among Latinos (CEHDL). His public health nutrition and food security research has led to improvements in breastfeeding promotion, household food security measurement and outcomes, and community nutrition education programs worldwide.
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Innovation
Select the stage that best applies to your solution
Idea (you're poised to launch)
How long have you been in operation?
Still in idea phase, but looking to launch soon
The Need: What problem are you trying to solve?
Breastfeeding is the original and best form of nutrition for infants, but due to many barriers only 37% of infants in the world are still being breastfed by 6 months. In the US, only 13% are exclusively breastfed at six months, and even lower among African American infants.
Many mothers who attempt to breastfeed encounter several barriers, including a lack of support at home, absence of family members who have experience with breastfeeding, lack of breastfeeding information from health care clinicians, a lack of time and privacy to breastfeed or express milk at the workplace, and an inability to connect with other breastfeeding mothers. In sum, isolation of breastfeeding mothers is a widespread challenge across countries and communities.
The Solution: What is your solution? Be specific!
Peer breastfeeding counselors have recently observed that many moms will only connect in a text message context to receive breastfeeding support that otherwise would not likely transpire (Institute of Medicine, “Updating the USDA National Breastfeeding Campaign”). We suspect this mode of communication may be preferred by mothers because of its immediacy and familiarity. We propose piloting a novel, mobile phone-based texting support tool to be used by peer counselors as an adjunct to hands-on support they provide breastfeeding mothers.
A project-specific “dashboard tool” will allow participating peer counselors to text breastfeeding mothers via web-enabled software. Mothers will be able to text questions directly to the peer counselors with requests for support. This tool will also allow surveys to be administered to assess mothers’ acceptability of the mobile intervention, breast feeding self-efficacy, and attitudes towards breastfeeding at different points of the intervention.
The Model: Walk us through a specific example of how your solution makes a difference; include your primary activities
Pregnant mothers who specify their intention to breastfeed will be enrolled in the intervention prenatally due to the significant impact of prenatal counselling on breastfeeding outcomes at 6 wks post-delivery. A peer counselor will enroll each participant in the program in a face-to-face meeting, to establish personal rapport and introduce the project.
The program will include 3 time-specific phases of text messages (txtmsgs):
1.PRENATAL –Txtmsgs will focus on how breast milk is produced (emphasizing supply and demand), health benefits to mother & infant, importance of placing the infant to the breast soon after delivery, common problems with breastfeeding and ways to overcome them. Mothers will be able to engage in the dialogue & ask specific questions.
2.POSTNATAL –Upon delivery, mothers will notify their peer counselor in order to receive hands-on support as per current protocol. The peer counselor will then be in contact with each mother again within 72 hrs of discharge and at regular intervals postpartum. During this time, mothers can use txtmsgs for queries & to request hands-on support.
3.PERINATAL –Throughout the project, enrolled mothers will receive txtmsgs from study team, designed to measure mothers’ engagement with the program, knowledge, intentions, and behaviour.
Before enrolment, mothers will also be notified that all transcripts of the texts will be saved, de-identified, and the content will be used for research purposes to identify recurrent breastfeeding concerns and themes that will help tailor future messaging.
The Marketplace: Who are your peers and competitors? Identify others also working to address the needs you are and what differentiates you from them. What challenges could these players pose to your success or growth?
There are no known competitors. Peers for this idea come from 2 groups:
a.Peer breastfeeding counselors–They are the inspiration for this project idea, given their dedication &extraordinary efforts that help mothers in the US and globally succeed in breastfeeding. Peer counselors’ perspectives on the informational preferences of today’s mothers stimulated this idea of using mobile technology to enhance communication between counselors & mothers.
b.Other researchers using txtmsgs–The use of txtmsgs is becoming more widespread in public health & medicine, but it is not known for what behaviors & practices txtmsgs are most effective. Given the time-sensitive window of opportunity for breastfeeding in the mother-infant dyad, we believe txtmsgs may be particularly effective in this setting
This Entry is about (Issues)
Social Impact
Founding Story: We want to hear about your "Aha!" moment. Share the story of where and when the founder(s) saw this solution's potential to change the world.
As a physician who has worked in Sub-Saharan Africa for the last three years and now back in the U.S., I have a keen appreciation for the challenges shared in delivering health care across borders. There are many technologies and innovations that are more developed in other countries that we can effectively use to help address healthcare delivery challenges locally. This competition has the spirit of learning from each other. My proposed project was inspired by the innovative use of mobile technology I witnessed while abroad that helped reach isolated individuals.
While in the U.S. or abroad, I have struggled clinically with how best we can support mothers to help them provide optimal nutrition to their infants. As a Robert Wood Johnson Clinical Scholar, I have been tasked with trying to find innovative solutions for the challenges of providing optimal care to underserved communities in the U.S. This competition helps to bring my two worlds together.
Please describe the goal of your initiative; outline what you are trying to achieve
Around the world, breastfed children have clear health advantages over non-breastfed children. Even so, only 37% of the world’s children and 17% of infants in the U.S. are exclusively breastfed for 6 months. Failing to meet a child’s nutritional needs during early life leads to increased illness, increased mortality, and delayed cognitive and motor development. Finding effective, low cost means to help support mothers who breastfeed is essential. Peer counselor breastfeeding programs have been successful globally in improving the rates of exclusive breastfeeding, although progress has been modest. This technology will help support peer counselors in their role and ultimately help to improve the duration of breastfeeding and nutritional status in infants globally.
What has been the impact of your solution to date?
In New Haven, the community of mothers, peer counselors, lactation consultants and pediatricians has been mobilized to help develop the idea for this innovation. Through this effort, different stake-holders have begun discussions that have led to better communication and further ideas of how to support breastfeeding mothers.
What is your projected impact over the next five years?
In the U.S., we will use this innovative approach as an adjunct to help peer counsellors reach breastfeeding mothers more frequently and responsively. In the subsequent phase of this work in the developing world, we envision using this mobile technology to help support and supervise peer counselors (a community health worker (CHW) model) who work in remote areas. CHWs often work in isolation and this tool will allow supervising public health nurses to support CHW living in remote locations. In addition, the survey tool will allow CHWs to record breastfeeding outcomes in the community to help monitor the program. Within 5 years, the intent is to use this tool both in developed and developing countries to support breastfeeding duration.
Winning entries present a strong plan for how they will achieve and track growth. Identify your six-month milestone for growing your impact
Pilot with ~100 pregnant women enrolled and >30% increase in breastfeeding rates at 6 weeks vs historical level
Identify three major tasks you will have to complete to reach your six-month milestone
Task 1
Train peer counselors and lactation consultants in using mobile web-based enabled dashboard tool for text messaging
Task 2
Pilot intervention at two clinics in New Haven, Connecticut
Task 3
Develop surveys & administer them to assess user satisfaction, self-efficacy in breastfeeding, peer counselor feedback
Now think bigger! Identify your 12-month impact milestone
National scale-up and begin to develop global application of tool
Identify three major tasks you will have to complete to reach your 12-month milestone
Task 1
Analyze data and disseminate findings to local and national Women, Infant, and Children program office
Task 2
Expand program to other Women, Infant and Children offices in the state
Task 3
Develop sustainable business plan for expansion and pilot of program in developing countries partnering with UNICEF
Sustainability
Tell us about your partnerships
In the U.S., we are partnering with the Supplemental Nutrition Program for Women, Infants, and Children (WIC) which provides food, nutrition education, breast feeding support for low-income pregnant women and for infants/children < 5 years old. Internationally, we plan to partner with UNICEF due to personal contacts there. We intend to also partner with other cell phone carriers in Botswana, who have historically donated texting for health innovations using mobile technology.
Are you currently targeting other specific populations, locations, or markets for your innovation? If so, where and why?
This technology is currently targeted towards low-income women and infants in the U.S. In time, the hope is to expand this service nationally and internationally. This grant will allow us to gather key data to show investors that this is a viable solution to help improve breastfeeding rates in populations with historically poor breastfeeding duration. The isolation of breastfeeding mothers is a widespread challenge across countries and communities.
What type of operating environment and internal organizational factors make your innovation successful?
This mobile platform is being implemented into an already existing breast feeding peer counselor program which creates a structure to sustain the use of this innovation. The supervision of peer counselors by lactation consultants is already established and provides a venue to train peer counselors effectively. In addition, research support from Yale University will also allow outcome measures to be collected so as to evaluate effectiveness of the program in order to garner future financial support. In addition, contacts on a national level (at the USDA) and internationally (UNICEF) will allow our findings to be disseminated to a wide audience and offer effective collaborative relationships to help implement the service in multiple settings in the future.
Please elaborate on any needs or offers you have mentioned above and/or suggest categories of support that aren't specified within the list
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Comments
Interesting combination of peer counseling and mobile technology, Nurit! I look forward to hearing the results of the pilot.
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