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Low-Income First-Time Mothers: Effects of APN Follow-up

Title Low-Income First-Time Mothers: Effects of APN Follow-up
Principal Investigators
Jean Hannan, PhD, ARNP
Dr. Jean Hannan
Co-Investigators Timothy Page, PhD

Currently Low income, first time mothers with non-complicated, healthy full term newborn deliveries receive little to no routine postpartum support low social support, unmet learning needs, increased stress and difficulty accessing the health care system. Problems will only increase for this group. The 2012 House Budget Committee proposal, hospitals nationwide will undergo $155 billion in federal payment reductions. These budget reductions are forcing hospitals to eliminate many community health care services, especially those in maternal child health. Also, the proposed House Republican health care cuts will have an adverse impact on nearly 30 million low-income children who depend on Medicaid for their health care.   Other changes include budget cuts for the State Children’s Health Insurance Program (SCHIP), budget cuts to various state public health services for low-income families and the federal Medicaid law allowing states to impose cost sharing and premiums on families with children on Medicaid.  In addition, the recently enacted 2006 Deficit Reduction Act states “children born in the U.S. to immigrants will not be automatically be entitled to Medicaid health insurance”. These legislative acts, making access to health care difficult for children are creating major delays for routine and acute newborn health care resulting in increased infant hospitalizations and mortality rates.


Studies using mobile technology such as cell phone use in combination with text messaging have reported improved communication between providers and patients by facilitating quick and direct access, increased patient compliance and direct access regardless of physical location. However, research with cell phones in combination with text messaging has focused primarily on populations with chronic illnesses and /or chronic health problems. Studies on low income mothers using mobile technology (cell phones in combination with text messaging) are almost nonexistent. Thus, the purpose of this randomized clinical trial is to test the effects of a mobile technology intervention on maternal and infant health outcomes, and health care charges between 2 groups of low income, first time mothers and their full term newborns. A control group will receive routine post birth hospital discharge care.  An intervention group will receive routine post birth hospital discharge care plus a 2 way cell phone intervention which includes cell phone contact and texting by advanced practice nurses (APNs). Scheduled APN cell phone calls and cell texting will be done on post hospital discharge days 3,7,14,21, months 1-6.  Both groups will be followed for the first 6 months post birth hospital discharge, a time of high incidence of infant morbidity.

Funded by Grant #SC2HD076043 from the Eunice Kennedy Shriver National Institute of Child Health & Human Development, National Institutes of Health