Healthy Tomorrow, Today

Although it may be difficult to believe that infant and maternal mortality are still topics of conversation in the 21^st century, Indiana consistently ranks in the top 10 states for both measures. Sadly, most of these deaths are preventable. A contributing factor, according to the 2023 Annual Report from the Indiana Maternal Mortality Review Committee, is the lack of adequate prenatal care. Roughly 40% of live births were covered by Medicaid and 76% of the women who died were on the program, suggesting a strong correlation to socio-economic factors and lack of resources.

Enter McMillen Health. In 2021, the nonprofit, preventive health education center serving northern Indiana introduced Healthy Tomorrow. This free, phone-based app puts pre- and postnatal education literally at the fingertips of women who need it most. It started with a simple inquiry from a local doctor.

In 2018, Fort Wayne pediatrician Dr. Tony GiaQuinta reached out to McMillen Health looking for resources to help pregnant women who suffer from opioid use disorder (OUD). Although the center had little to offer on the topic at the time, it tackled the issue without hesitation.

“Many things we do at McMillen come from a request within the community,” says Sabrina Marquez Straessle, Director of Development and Marketing.

Rather than make assumptions, McMillen leaders partnered with The St. Joseph Community Health Foundation to study the resource needs of not only local health care providers like GiaQuinta, but also (and more importantly) the women themselves. They conducted confidential interviews with mothers and mothers-to-be who had OUD, as well as health care professionals who work with them. What they found was a yawning gap between what the providers thought they offered and what the women felt they received. They just weren’t getting the message.

“The women we spoke with were overwhelmed,” says Marquez Straessle. “They were sick of flyers, brochures and information in formats they didn’t understand. They wanted something they could easily access on their phones.”

The first release of Healthy Tomorrow included 26 short, easy-to-understand videos, each only two to three minutes long. They covered topics centered on how opioid use disorder affects pregnancy as well as the mother’s and baby’s health. The app also included information on neonatal abstinence syndrome (NAS) in newborns.

McMillen Health and local health care providers shared the app locally and adoption quickly took off. Before long, Healthy Tomorrow began to log downloads in locations across the U.S. and even in other countries. Its popularity has allowed McMillen Health to broaden the app’s content to include all types of pre- and postnatal information.

“We’ve been able to expand the app exponentially,” says Marquez Straessle. “It’s no longer just helpful for mothers with OUD.”

Currently, Healthy Tomorrow contains more than 80 low-literacy videos. The app is available in English, Spanish, Burmese, Arabic and Dari-Farsi. It provides pregnant and recently pregnant women with short, welcoming videos on prenatal care, infant development, mental health, recovery planning, and a variety of OUD and maternal and infant health topics. Pre- and post-tests in each category allow McMillen Health to assess whether the material is effective in order to improve the app’s efficacy.

“We want to be able to measure whether people are learning,” says Marquez Straessle. “Through the app, we’ve identified more than a 35% increase in knowledge in various zip codes, one being 46819.”

To further enhance Healthy Tomorrow’s effectiveness, McMillen Health has partnered with the St. Joseph Community Health Foundation and other local organizations to launch a reward system. Users can receive badges for watching videos within the app, which they can exchange for diapers and wipes at various locations including McMillen Health, A Baby’s Closet, Shepherd’s Hand, Pregnancy Center in DeKalb County, Life and Family Services, A Hope Center, Young Mothers of America, and Women’s Care Center of Northeast Indiana.

Video content is constantly being evaluated, with new topics added as needed. It’s really a community effort, says Marquez Straessle.

“We put together professional advisory groups each time we create new content for the app,” she explains. “We make sure that everything is correct and what clients need.”

The app includes a professional guide for use by health care and social services providers. They can follow along with clients using Healthy Tomorrow while also learning communication strategies, motivational interviewing techniques and effective ways to integrate the app into their practice.

“Healthy Tomorrow also includes a chat portal,” says Marquez Straessle. “It’s a space where app users can start to build a community or support system. Healthy Tomorrow isn’t just beneficial for mothers; it’s beneficial for families and caregivers, too.”

Mom & Me Days, in–person events offered by McMillen Health, take the education provided in Healthy Tomorrow to the next level. At these events, parents and children separately learn more about a specific category from the app, such as nutrition, maternal mental health and substance use prevention. Participants learn to cook a meal and leave with the ingredients to recreate it at home. Best of all, says Marquez Straessle, she gets to see the benefits of Healthy Tomorrow in action.

“The thing we hear most often is ‘thank you so much for caring,’” she says. “We believe everyone has the right to know everything about their bodies so they can make healthy choices.” 

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