Association for Public Policy Analysis & Management

Historically, the U.S. has provided little support for the psychosocial needs of new parents, with the exception of home visiting programs, which generally target only the most at-risk mothers due to their cost. NurturePA is a Pittsburgh-based non-profit attempting to fill this support gap with a scalable, low-cost approach: text-based mentoring of new parents beginning at birth. NuturePA recruits new parents during their post-partum hospital stays and pairs them with a trained volunteer mentor who is also a parent. Mentors answer parents’ questions, suggest strategies and activities to promote child development, and attend to potential signs of maternal depression or anxiety. Prior work in behavioral economics on older populations suggests text-based engagement may be efficacious in supporting positive child academic outcomes (Castleman & Page, 2015, 2016; York & Loeb, 2014). This approach has yet to be evaluated in the 0-3 space.

We examine the text exchanges of NurturePA mother-mentor pairs to understand the implementation of the program to date. Specifically, our research questions were: How many mothers stayed engaged for a year? How frequent was mothers’ communication with mentors? What topics were discussed? How could mentors improve their interaction with mothers?

Methods

Our sample includes 191 mothers engaged in the program for at least one year (as of March 2016). Mothers in the sample who reported their age (N=113) were 30.7 years old, on average (SD=5.7). The sample is 56% White, 6% African American, and 38% ethnicity unreported. Half are first-time mothers, and just over half continued communication with their mentor for at least a year.

We examined text exchanges (sets of texts comprising a conversation) according to their frequency, length, and content. We coded text exchanges for several characteristics, including topic (e.g., sleeping, feeding, maternal health, all of which have more detailed subcodes), whether or not the mother was experiencing a problem, and mentor response.

Results

To date, we have focused on a subsample of mothers (N=28). Within the subsample, mothers and mentors engaged in an average of 83.4 exchanges, or 1.6 per week (SD=31.3). The average number of conversational turns within each exchange was 2.7 (SD=2.9). Finally, the average time between exchanges was 9.6 days (SD=13.7).

Child-development topics comprised 34% of mother-mentor exchanges; maternal well-being-focused topics, 5%; and relationship-building check-ins, 40%. The content of the former exchange categories fell into two broad types. The first were light-touch, standard questions -- concerns such as scheduling naps that are not “make-or-break” in terms of supporting children’s healthy development. The second were more complex, consequential issues, such as maternal mental health issues and child developmental delays. In both cases, we observed mentors acting as a filter of information and advice, a source of emotional support, and a link to relevant resources in their area.

At APPAM we will present results for the full sample (N=191) and will present findings regarding how interactions could be improved. We will place findings in the context of the potential efficacy of text-based interventions. We also will discuss measurement benefits and challenges inherent to the NurturePA model.