Interview: SmartParent Text-based Messaging System
Photo by Richard Jaimes on Unsplash
We spoke with Dr. Patricia Janssen, Professor at UBC Faculty of Medicine’s School of Population and Public Health, Founder of the SmartParent text-based education program for parents during pregnancy and early parenthood, and Alisa Henry (Revelstoke), who offers community communications support for the program.
In the March 2022 edition of the Keeping in Touch newsletter, we wrote about the original SmartMom program to support mothers with text-messaged information during each week of their pregnancy, and the launch of the SmartParent program to continue that support for parents from the birth of their child through to the first year of life. The two programs have since been merged under the SmartParent branding and have been adopted by all of the British Columbia health authorities.
Dr. Janssen was asked originally by Northern Health in 2017 to develop a prenatal education program that would be accessible to parents living in rural and remote areas.
Since then, over 18,000 parents have enrolled in the program. Operating costs are paid by the health authorities.
Ongoing evaluation of the program indicates increased parenting knowledge, and improved maternal, fetal and newborn outcomes in addition to significant improvement in mental health outcomes, and parenting confidence. However, Dr. Janssen notes, it is still early days for the evaluation and they are continuing to collect data. Whilst close to 2,000 participants have now used the more recently introduced post-natal supports for parents up to the first year of the child’s life, it is too early to look at any outcomes yet for that aspect of the program. The current target groups are young parents, and people in remote areas .
On a personal note, the writer was visited recently by a young, expectant mother who lives with her partner in a socially isolated situation and asked her about the pregnancy and parenting support she is currently receiving. She has connected with a local CPNP program and is now receiving the SmartParent text messages, which she told me emphatically that she is finding to be a great help in reducing anxiety and increasing confidence. She really likes the format; it feels comfortable to her and to her partner and acts as a starting point for discussions and shared decisions.
One of the challenges that has been identified is that it can be hard to reach practitioners in rural areas to help spread the word and connect parents to the program.
· Consultation is ongoing to see how to best widen the reach and to learn what works for people, for example, how many people can’t access the program (especially on-reserve) because they don’t have internet access. A downloadable version has been developed that doesn’t require internet access to assist people in that situation.
· The team are looking into how to connect to people who haven’t been accessing tests during pregnancy.
· For teen parents, the team is investigating whether their support people should also be receiving the program. Ideally the teen parent should be able to receive the information in a face-to-face modality.
· The team is exploring how to increase awareness among care providers (particularly physicians, midwives and public health nurses), e.g. via newsletters, social media, health authority outreach sources.
Parents using the program can opt to receive additional message streams to tailor the program to their own needs:
· ALCOHOL - Reducing alcohol intake
· SMOKING - Managing tobacco intake and vaping
· NEW - Being pregnant and new to Canada
· AFTER35 – Expecting your 1st baby over 35 years of age
· EATING - Healthy eating and weight during pregnancy
· LOSS – Support if you had a past or current pregnancy loss (miscarriage, stillbirth) or infant loss
· SAFETY - Safety in relationships
· VBAC - Learning about vaginal birth after a previous Cesarean section
· MENTALHEALTH - Anxiety and depression during and after pregnancy
· RHNEG - Having Rh-negative blood (type A-, B-, AB-, or O-)
So far, the top opt-ins subscribed to have been: weight management, mental health/depression, and violence in the home. In the difficult circumstance of experiencing a loss during pregnancy, parents can text the word LOSS to the program to stop receiving the pregnancy texts and, if desired, to access messages connecting them to support resources.
The success of SmartParent in B.C. has led to enquiries about expanding the service to other Canadian jurisdictions. The program has recently launched in Nova Scotia. In a press release on June 25th, Dr. Janssen noted, “SmartParent is Canada’s first prenatal and parenting education program delivered through text messaging. It overcomes barriers of rural and remote location, lack of instructors, and cost, to deliver messages to mobile devices when they are needed. We worked with the BC Ministry of Health and health authorities to develop the program and have had over 18,000 participants in BC to date.”
The press release notes that, funded by IWK’s Catapult Fund, SmartParent is being offered as a one-year pilot program in Nova Scotia this year. Before SmartParent, there was no provincially administered program for prenatal education in Nova Scotia, according to Dr. Melissa Brooks, OBGYN and medical advisor for the Reproductive Care Program of Nova Scotia. While people can easily look up prenatal information on the Internet, the information available can be overwhelming and difficult to navigate. Expanding SmartParent to Nova Scotia addresses a critical need for accessible, reliable prenatal and parenting education in the province.
When we spoke to Dr. Janssen in our interview, she noted that, whilst there are numerous parenting apps available online, it can be hard for prospective parents to know how to choose. What makes SmartParent stand out is that it is rigorously evidence-based and endorsed by the Society of Obstetricians and Gynecologists of Canada and the Canadian Pediatric Society.
Dr. Brooks, speaking about the Nova Scotia launch, commented, “We are very pleased to offer this program in Nova Scotia where we have seen over 400 enrollees in the first month.” While the pilot will assess the program’s success in reaching expectant parents in Nova Scotia, it is crucial to recognize the potential impact of this initiative on public health. SmartParent not only aims to improve health outcomes for both parents and infants but also strives to reduce the anxiety and uncertainty that often accompany pregnancy and early parenthood.