[Federal Register Volume 78, Number 19 (Tuesday, January 29, 2013)]
[Pages 6112-6113]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-01728]



Health Resources and Services Administration

Request for Information (RFI): Opportunities To Apply a 
Department of Health and Human Services Message Library To Advance 
Understanding About Toddler and Preschool Nutrition and Physical 

AGENCY: Health Resources and Services Administration (HRSA), HHS.

ACTION: Notice.


SUMMARY: This Request for Information (RFI) solicits ideas and 
information related to ways in which the U.S. Department of Health and 
Human Services (HHS) can work with interested partners to disseminate 
and apply a library of short, evidence-based messages known as 
TXT4Tots. This library of brief informational nutrition and physical 
activity focused messages was developed and tested by the American 
Academy of Pediatrics (AAP) under a cooperative agreement with the 
Health Resources and Services Administration (HRSA). The TXT4Tots 
library is targeted to parents and caregivers of children, ages 1-5 
years, and is available in both English and Spanish. Content for the 
messages was derived from AAP's ``Bright Futures: Guidelines for Health 
Supervision of Infants, Children, and Adolescents,'' which uses a 
developmentally based approach to address children's health needs in 
the context of family and community. The name TXT4Tots describes the 
library of developed messages and does not necessarily imply the need 
for dissemination through mobile, Short Message Service messaging.
    HRSA is issuing this RFI to solicit information and ideas on how to 
effectively incorporate the TXT4Tots library of messages into a wide 
variety of existing public and private programs and products that can 
best meet the needs of parents, caregivers, and child advocates, 
including health care providers. We recognize there are multiple ways 
this can occur and, therefore, are seeking input on how the TXT4Tots 
message library could be maximized to advance understanding about 
toddler and preschool nutrition and physical activity, and the 
interests of potential partners in working with HHS to do so. The 
intent is to build upon current programs, policies, and infrastructure 
to enhance education, disseminate the TXT4Tots message library, and 
leverage existing programs in innovative ways, particularly to support 
outreach to underserved communities where access to health education 
may be limited. The goal is to ensure that the TXT4Tots library of 
messages remains publicly available at no cost for noncommercial 
purposes. In addition to this RFI for written comments, HRSA intends to 
host a short, in-person forum in Washington, DC, to hear proposed 
comments from the public. Participation in the forum will also be 
possible through a dedicated conference call line and webinar 
capabilities. Further details on the forum are described below.

DATES: Written and electronic responses should be submitted to HRSA on 
or before Tuesday, February 19, 2013, at 5 p.m. EST at the address 
listed below.

ADDRESSES: You may submit comments by one of the following methods:
     Electronic responses should be addressed to [email protected] 
using the title ``Response to RFI'' in the subject line.
     Written responses should be addressed to the Department of 
Health and Human Services, Health Resources and Services 
Administration, Attention: Response to RFI, Suite 7-100, 5600 Fishers 
Lane, Rockville, Maryland 20857.
     A copy of this RFI will also be available at www.hhs.gov/open.
    The submission of written materials in response to the RFI should 
not exceed eight double-spaced pages, not including appendices and 
supplemental documents. Responders may submit other forms of electronic 
materials to demonstrate or exhibit concepts of their written 
responses. Any information you submit will be made public. 
Consequently, do not send proprietary, commercial, financial, business 
confidential, trade secret, or personal information that you do not 
wish to be made public. Responses to this RFI will be available to the 
public at HRSA, 5600 Fishers Lane, Rockville, Maryland 20857. Please 
email [email protected] to arrange access.

FOR FURTHER INFORMATION CONTACT: Yael Harris, Ph.D., Health Resources 
and Services Administration, Office of Special Health Affairs, Office 
of Health Information Technology and Quality, 5600 Fishers Lane, Room 
7-100, Rockville, Maryland 20857, or email [email protected].

    Instructions for Participating in Public Forum: An in-person forum 
will take place on February 20, 2013, from 1-3 p.m. EST. Opportunities 
for public comment will be made available the day

[[Page 6113]]

of the event for those attending in person. The meeting will take place 
at the Hubert Humphrey Building, 200 Independence Avenue, Room 800, 
Washington, DC 20201. In-person attendees should allow time to get 
through security and will be personally escorted. In order to 
participate by webinar, please register at the following link: https://www3.gotomeeting.com/register/769306734.
    After registering, individuals will receive a confirmation email 
containing information about joining the webinar on the day of the 

Background Information

    As the lead federal agency charged with providing health and human 
services to all Americans, the challenges facing HHS are tremendous. We 
are working every day to give Americans the building blocks they need 
to live healthy and successful lives. In the last few years, the use of 
mobile health as a tool to improve individual and family health as well 
as improve patient-provider communication has grown tremendously. 
Personalized tools and the ability to get instant access to information 
have empowered individuals to be more engaged in managing their health. 
According to a Pew Charitable Trusts study conducted in 2012, 
approximately 85 percent of American adults own a cell phone and 53 
percent of these individuals have a smart phone, allowing them access 
to their email, the internet, and health care applications from any 
location. Research shows that one in three cell phone users have used 
their phone to look up health information and, among those with 
smartphones, more than half report using their cell phone to gather 
health information. The use of cell phones for health information is 
highest among those who self identify as caregivers and those of 
childbearing age. Research conducted by the AAP in 2011 indicated that 
many parents of young children would value timely information related 
to nutrition and physical activity and agree that having this 
information transmitted via their mobile device would be desirable. A 
group of physicians who participated in a focus group with the AAP 
indicated that they would consider referring parents and caregivers to 
a resource that could provide reliable, trust-worthy information on 
healthy eating and physical activity for young children. Other 
modalities besides mobile text messaging to communicate health 
information can include, but are not limited to, video games addressing 
children's health, online games and programs around childhood health, 
online communities focused on pediatric health, email and/or phone 
reminders, personalized information on patient portals, mobile health 
applications, and physician tear pads.
    This RFI builds on efforts to engage stakeholders in the 
integration of innovative health education strategies. The intent is to 
build upon existing platforms and outreach models for pediatric health, 
and support parents and caregivers of young children ages 1-5 years.
    The complete message library will be made available to the public 
on February 20. Below are some examples of the messages contained 
within the library:


    1. We know you're a family on the go, but try to only eat fast food 
once a week. If eating fast food today, try grilled chicken or pick 
fruit as a side.
    2. 100% fruit juice has sugar that damages teeth as much as soda. 
Limit to 4-6 oz daily. Try water with fruit slices instead.
    3. Fighting a picky eater can be a real challenge, have your picky 
eater help you make the meal. Let them set the table or stir the 


    1. Snacking on the run? Keep cheese sticks, apple slices, and whole 
grain crackers on hand. 2-3 snacks a day prevent hunger temper 
    2. You are a great role model. Show your preschooler the healthy 
choices you make by snacking on fruits and veggies together.
    3. Let your child pick healthy snacks at the grocery store. Watch 
this video for a fun idea to do with snacks after the store: bit.ly/

Physical Activity

    1. Activity idea! Play freeze dance. Put on your child's favorite 
music and take turns turning it off and on!
    2. Activity idea! Play Follow The Leader! Let your child be the 
leader too--march, crawl, or dance for fun.
    3. Being a parent is a busy job. Try adding exercise to your day by 
taking the stairs or parking the car away from the store entrance.

Information Requested

    In addition to the general solicitation of comments above, we are 
also asking the following questions for the public to consider in the 
context of the preceding discussion within this document:
    1. What are potential vehicles of communication for disseminating 
the TXT4Tots message library?
    2. How could the TXT4Tots library of messages be integrated into 
current or new programs or platforms?
    3. How could the TXT4Tots library of messages be incorporated into 
public and private (national, state, local, and tribal) programs and 
    4. How could HHS work with partners to leverage the message 
    5. What are situational opportunities for engaging stakeholders 
that might lead to behavior change as a result of incorporating the 
TXT4Tots library into current or new programs?

    Dated: January 23, 2013.
Mary K. Wakefield,
[FR Doc. 2013-01728 Filed 1-28-13; 8:45 am]