Update age-based messaging posts and image paths

app/age-related-messaging/2025/11/introduction-to-age-related-messaging/index.md

@@ -1,15 +1,15 @@
 ---
-title: Introduction to age‑related messaging
+title: Introduction to age-based messaging
 description: A new way of providing timely advice and guidance to parents and carers of infants
 date: 2025-11-17
 tags:
-  - age‑related messaging
+  - age-based messaging
   - Digital Child Health
   - Digital Best Start
   - infants
 ---
 
-Age‑related messaging is a project to send messages via the NHS App (and SMS) to parents of newborns.
+Age-based messaging is a project to send messages via the NHS App (and SMS) to parents of newborns.
 
 ## Background
 
@@ -19,19 +19,33 @@ This was under the umbrella of “Digital Child Health”, which has since been
 
 A discovery was carried out in late 2024, from which a series of use cases were formed. One of these use cases involves sending out age‑based, standardised communications to parents of newborns and infants.
 
-## Getting reliable information to parents
+---
+## Getting Reliable Information to Parents
 
 Parents currently access information through NHS sources, health professionals, or peers and social media. However, searching online requires parents to be proactive and to know what to look for and when. Support from professionals is often tied to the timing of routine appointments and may not always be available when needed.
 
-## Extending the reach
+---
+## Extending the Reach
 
-Services such as [Best Start in Life](https://www.nhs.uk/best-start-in-life/) show how timely guidance can be delivered directly to families, but current reach is just 1 to 2 percent of parents.
+Services such as [Best Start in Life](https://www.nhs.uk/best-start-in-life/) demonstrate how timely information and guidance can be delivered directly to parents and carers. Through an opt-in email newsletter, Best Start in Life provides frequent support, delivered weekly until 12 weeks, fortnightly until 40 weeks, and monthly thereafter. Content covers a broad range of topics including vaccinations, sleep, mental health, financial support and signposting. The service also offers tailored content for fathers and same-sex couples.
 
-As a result, many rely instead on informal or unverified sources. While often well‑intentioned, this advice can leave parents without the right knowledge, confidence, or timing to make evidence‑based decisions about their child’s care.
+However, Best Start in Life is only one part of a much wider information ecosystem. Research has highlighted that parents and carers receive information from multiple sources, delivered through a combination of verbal conversations, printed materials and digital channels. This includes information from health visitors, GPs, midwives, NHS services, local authorities, charities and community organisations.
 
-There are also wider benefits to improving early health engagement for both families and services. For example, encouraging parents to register with a GP online saves around nine minutes of administrative time per registration compared with in‑person sign‑ups.
 
-## Messages based on the infant’s age
+### The Information Landscape
+
+Parents often receive information through leaflets, letters, text messages, apps and resources added to the Red Book during appointments and reviews. Local areas have developed their own approaches to parent communication through services such as Just One Norfolk, Growing Healthy North Yorkshire, Essential Parent and up to 40% of health visiting services use ChatHealth, a two-way messaging platform that allows parents to communicate directly with health visitors.
+
+The result is a complex and fragmented information landscape. Information can be duplicated across services, delivered at different times, and sometimes appear inconsistent or contradictory. This can contribute to information overload, particularly during the first few weeks and months after birth when parents are receiving large amounts of advice and support.
+
+
+### Challenges Within the Current Information Landscape
+Parents receive information from many different services and channels, making it difficult to understand what information is being shared, where duplication exists, and which communications are driving meaningful outcomes. As a result, parents may rely on informal or unverified sources when trusted information is difficult to find, understand or access at the right time.
+
+As Age-Based Messaging develops, it should complement existing communications, reduce duplication, deliver measurable value, and support outcomes that matter to parents, the NHS and public health.
+
+---
+## Messages Based on the Infant’s Age
 
 To tackle this, a series of universal prompts will be sent to parents and carers at key stages, that signpost them to key jobs to be done and services relevant to their child. These include but are not limited to:
 
@@ -43,4 +57,20 @@ To tackle this, a series of universal prompts will be sent to parents and carers
 
 These notifications would be delivered at specific intervals in the neonatal and infancy stages of a child’s life, with the intention being to provide reminders to parents and carers at key stages, and signpost them to NHS services.
 
-The team is currently preparing a pilot of age‑related messaging.
+### Public Health-Focused
+
+There are also wider benefits to improving early health engagement for both families and services. For example, encouraging parents to register with a GP online saves around nine minutes of administrative time per registration compared with in‑person sign‑ups.
+
+Some key statistics that have already been collected that we have used to determine the content of our messages include:
+
+- 9% of parents are currently reached by the DHSC Best Start in Life email programme — leaving the vast majority without proactive support
+
+- 75% of parents are not using digital GP registration, limiting early access to services and increasing admin burden
+
+- 46% of parents believe weaning should start at 5 months or earlier (national guidance: 6 months)
+
+- 10% of parents introduce solids before 4 months
+
+- 19% of Healthy Start–eligible parents give their child recommended vitamins
+
+The team is currently preparing a pilot of age-based messaging.

app/age-related-messaging/2026/08/our-opt-out-journey/index.md

@@ -0,0 +1,157 @@
+---
+title: Our Opt-Out Journey
+description: Exploration of how parents understand, manage and control their participation in Age-Based Messaging, including opting out, resubscribing and managing preferences.
+date: 2026-08-14
+tags:
+  - consensual design
+  - unsubscribe
+  - user flow
+  - identity validation
+author:
+  - Ash Finnegan
+
+
+---
+
+The opt-out journey has been a significant area of design work within the Age-Based Messaging (ABM) programme.
+
+While current cohorts are enrolled through a consensual model where participants explicitly agree to receive messages, the long-term ambition is to move towards a national service where eligible parents and carers are automatically enrolled. This reflects the anticipated public health value of delivering timely, evidence-based information throughout a child's early years.
+
+As automatic enrolment increases, to adhere to the principles of consensual design, users must be able to easily stop receiving messages if the service no longer meets their needs. For this reason, the opt-out journey forms a critical part of the service experience, ensuring participants remain in control of their communications.
+
+This work is particularly important because ABM is not delivering traditional appointment reminders or transactional communications. Instead, it provides developmental information, advice and support over a five-year period, creating unique considerations around consent, relevance, engagement and user control.
+
+---
+## User Needs
+
+Through design workshops and research, we identified the following user needs for the opt-out journey:
+
+- As a parent, I want to easily stop receiving messages when they are no longer useful to me.
+
+- As a parent, I want to be able to restart messages if my circumstances or needs change.
+
+- As a parent, I want to understand what I am opting out of and what will happen when I unsubscribe.
+
+- As the NHS, we need to accurately record user preferences and ensure users no longer receive messages once they have opted out.
+
+---
+## Design Constraints
+
+Several constraints influenced the design of the opt-out journey.
+
+### Digital Exclusion
+
+The current journey requires internet access. Users must leave the NHS App message and navigate through a web-based flow before they can manage their subscription preferences.
+
+### Identity Verification
+
+To protect user preferences and prevent accidental changes, users are required to verify their identity before completing the unsubscribe journey. This adds friction to the journey but is currently a necessary security requirement.
+
+### Re-subscription
+
+At present there is no defined route for users to opt back into the service once they have unsubscribed. This presents a challenge given that ABM spans five years and users' information needs are likely to change over time.
+
+### NHS App Constraints
+
+ABM messages are delivered within existing NHS App patterns and components. This limits the extent to which message presentation and preference management can be customised.
+
+### Preference Management
+
+The NHS App previously explored a broader "manage your preferences" capability. However, this work did not progress due to insufficient evidence of user value at the time, limiting available infrastructure for ABM preference management within the apps interface.
+
+---
+## Content Considerations
+
+One of the key design questions centred around language and user expectations.
+
+We explored a number of different approaches, including:
+
+- Opt out - can imply a user previously opted in
+
+- Unsubscribe - suggests a permanent decision
+
+- Manage preferences - implies a greater level of control and ongoing management of communications
+
+Understanding users' mental models and expectations became a key focus of the research.
+
+---
+## Research Approach
+
+Participants were shown ABM messages within the NHS App before being asked to:
+
+- Explain their understanding of the service.
+- Locate and complete the unsubscribe journey.
+- Explain their expectations of an "unsubscribe" journey and how they would expect to rejoin the service if they changed their mind.
+
+The research explored both usability and users' expectations around message preferences.
+
+![Opt out page with a choice to keep receiving messages or unsubscribe](opt-out-screen.png "Unsubscribe screen that was used in testing")
+
+---
+## What We Learned
+
+### Relevance Is the Biggest Driver of Opt-Out
+
+Participants were generally comfortable with receiving messages automatically. The primary reason users said they would opt out was not automatic enrolment itself, but a lack of relevance. Messages perceived as generic, repetitive or not applicable to their circumstances were more likely to result in disengagement or opt-out behaviour.
+
+### Users Expect Preference Management Rather Than a Final Opt-Out
+
+Users expected a greater degree of control and often separated messages into two categories:
+
+- Important NHS information, such as vaccinations, appointments and health-related actions.
+
+- Advice, support and developmental guidance.
+
+- Several participants expressed a desire to receive essential health information while opting out of less relevant content. This suggests that users think in terms of managing preferences rather than simply leaving the service altogether.
+
+### Users Were Unclear About the ABM Service
+
+Many participants believed messages were being sent by health visitors, midwives or GPs. Others associated the messages with Best Start in Life and viewed these as the same service.
+
+As a result, participants often struggled to understand:
+
+- Who owned the service.
+
+- Why they were receiving messages.
+
+- How they would rejoin the service in future.
+
+This lack of service identity created confusion throughout the unsubscribe and re-subscription experience. Users viewed subscription management as reversible and expected they would be able to change their decision as their circumstances evolved.
+
+---
+## Design Decisions
+
+Based on the research, we have prioritised the following areas for further exploration:
+
+As a result, we will:
+
+- Strengthen the ABM service identity and clarify its relationship with Best Start in Life/other communications.
+
+- Improve message content to better communicate the value and purpose of messages.
+
+- Explore preference management options rather than a simple unsubscribe model.
+
+- Investigate pause and resubscription journeys.
+
+- Assess whether message categories/tiers could provide users with greater control.
+
+---
+## Next Steps
+
+We will continue testing service iterations throughout the remaining cohort period.
+
+Alongside this, we will:
+
+- Refine the ABM service proposition and identity.
+
+- Review the relationship between ABM and existing parent-facing communications.
+
+- Develop the content strategy to ensure messaging remains relevant and valuable over time.
+
+- Explore opportunities for preference management and re-subscription.
+
+- Validate whether message categorisation provides meaningful user value without adding complexity.
+
+The long-term goal is to create an experience that balances public health benefits with user autonomy, ensuring users remain informed, engaged and in control throughout their child's journey.
+
+