In the United States, three out of four mobile subscribers use an ordinary cell phone, not a smart phone (comScore, 2010). Although the iPad, Blackberry, and other smart phones have captured the headlines, the humble cell phone without advanced features can be a platform for innovative applications in the child welfare field.
Interventions aimed at parents
A 2008 publication by Bigelow, Carta, and Burke‐Lefever describes a parenting skills training program, administered through cell phones, aimed at parents at high risk for child neglect. The program, called “Planned Activities Training,” is a five‐session face‐to‐face intervention aimed at reducing the risk for child neglect. The authors provided cell phones to parents who did not already have one. To test the effectiveness of cell‐phone based coaching, coaches called about half the parents between the sessions, to reinforce the training. The cell phones ensured that the coaches could reach the parents reliably. The parents who received the cell phone‐based coaching were more likely than the other parents to remain in the training program to the end.
In addition, Burke‐Lefever et al. (2008) offered a telephone‐based intervention to adolescent mothers who were judged to be at high risk for neglectful behaviors. After ensuring that all the participants had cell telephones, the researchers called the parents as often as twelve times. They administered a parenting questionnaire the first three times, and interviewed the parents about their interactions with their children in the rest of the calls. The interviewers asked about activities like bathing, diapering, feeding, and playing. The parents found that these telephone interviews were not intrusive and were less intimidating than paper‐and‐pencil questionnaires. The researchers wrote that the calls were an effective way to stay in touch with parents at high risk of neglect and to spot potentially neglectful behaviors before harm occurred.
The National Healthy Mothers, Healthy Babies Coalition sends text messages to the cell phones of expectant mothers throughout their pregnancy and their babies’ first year. The coalition’s web site, www.text4baby.org, says that the advice in the text messages is designed to provide “pregnant women and new moms with information they need to take care of their health and give their babies the best possible start in life.”
Interventions aimed at children
Survey results from the Pew Research Center suggest that half of American teenagers send at least 50 text messages a day, and almost a third send 100 a day! Moreover, youngsters are more likely to use cell phones for texting than for spoken calls (Stout, 2010). With such wide acceptance of texting among the young, several child welfare workers have developed texting‐based interventions for children.
The web site www.sextextSF.org, for example, is the home of a text messaging service for young people about sexual behavior, relationships, and sexually transmitted disease. The service connects young people to experts via texting. To adolescents, texting for advice and information about sex may be the most acceptable way to ask.
The company Mobile Health Interventions (www.healthtxts.com) offers a range of texting‐based health promotion interventions. Its web site has a page that lists dozens of publications on the effectiveness of texting‐based interventions, including one by Franklin et al (2008) for young people with diabetes. The results for that intervention, called “Sweet Talk,” suggest that texting can help young diabetics with their self‐management activities, such as by ensuring that they monitor their blood glucose.
The web site www.doc2me.com invites patients to sign up to receive customized weekly text messages offering health tips about diet, lifestyle and heart health. The idea is certainly appealing, although the web site does not cite any research on the effectiveness of this service.
In an Interactive Voice Response (IVR) survey, the respondent interacts with a talking computer, not a live interviewer, over the telephone. IVR surveys have several virtues. For example, respondents may be more inclined to respond to sensitive questions when a computer is asking them, rather than a human interviewer. For that reason, IVR surveys can be a method to ask family members questions about substance abuse, HIV/AIDS, and domestic violence.
IVR surveys can be programmed to ask the questions in any number of languages. IVR might be a method to survey respondents who are missed by web surveys, such as indigent respondents. Only 60 percent of those with a household income level of less than $30,000 use the Internet, as opposed to 94 percent for those with household income level of over $75,000, according to findings from the Pew Internet and American Life Project. The disparity for cell phone use is much less pronounced.
But most importantly, IVR surveys can be administered anywhere. Right now, the National Institute of Mental Health has funded a test of a screener for autism, administered as an IVR questionnaire to parents in pediatricians’ waiting rooms. The parents complete the questionnaire using their cell phones, or a cell phone that the pediatrician lends to them. The results are available to the pediatrician the moment that the parent completes the questionnaire. In the same way, IVR surveys can be administered in any waiting room; all the respondents need is a cell phone.
Establishing ongoing lines of communication
The Belgian company Abbit offers a texting system that allows people who are attending a conference to exchange text messages with the conference organizers. With this system, conference‐goers can direct their questions to the organizers. Using text messages, the conference organizers can administer surveys to the people who are attending the conference, and then report the results to them.
However, the most profound impact of cell phones may lie in the way they enhance interaction within a team. Those of us old enough to remember the time before cell phones see how they have transformed communication among managers, office staff, field workers, and other personnel at child welfare agencies. How are you using cell phones at your agency?
Please contact the NRC‐CWDT at email@example.com for further assistance, including peer to peer technical assistance on this topic.
Bigelow, K.M. et al (2008) Txt u ltr: Using cellular phone technology to enhance a parenting intervention for families at risk for neglect. Child Maltreatment, 13, 362‐367.
Burke Lefever, J. et al (2008) Cell phones and the measurement of child neglect; The validity of the Parent‐Child Activities Interview. Child Maltreatment, 13, 320‐333.
comScore (2010) comScore Reports October 2010 U.S. Mobile Subscriber Market Share. Available at:
http://www.comscore.com/Press_Events/Press_Releases/2010/12/comScore_Reports_October_2010_U.S._Mobile_Subscriber_Market_Share Accessed December 13, 2010.
Franklin, V.L., Greene, A., Waller, A., Greene, S.A., & Pagliari, C. (2008). Patients’ engagement with “Sweet Talk” ‐ a text messaging support system for young people with diabetes. Journal of Medical Internet Research, 10, e20.
Stout, H. (2010, May 2) Antisocial networking? New York Times, 1, 10.