How WIC Provides Nutrition Education Online

The USDA’s Special Supplemental Nutrition Program for Women Infants and Children (WIC) contributes to the health and wellness of more than 8 million women and children every year.

In 2017, we joined forces with WIC-Community Medical Centers (CMC) in California as part of a Telehealth (“TeleWIC”) research study to understand the impact of virtual care programs via a “WIC Video Visits” program.

Healthie is proud to partner with the WIC program’s clinic sites. WIC is utilizing Healthie’s telehealth and technology platform to deliver nutrition education and enable their social mission, “safeguarding the health of low-income women, infants, and children up to age 5 who are at nutrition risk, by providing nutritious foods to supplement diets, information on healthy eating, and referrals to health care.”

The Problems that WIC Faces

1. Declining participation rates

Many WIC centers around the country are reporting a decline in participation in their programs. “There has been much focus on this issue at both the national and state level [across WIC clinic sites]. However, the consensus is mixed about what exactly is causing this decline in WIC participation. In 2011, an estimated 1.85 million women, infants, and children were eligible for WIC benefits in California in an average month, but were not receiving WIC. We need new ways to reach WIC families.” -Andrea Weiss RD, CLE

2. Interest expressed in remote services

A 2011 USDA Special Project Research, looked at how WIC households in the Western Region States (including California) used social media and the internet; studies found that in WIC households, nearly all participants owned cell phones with texting capabilities. Additionally, more educated mothers were more likely to use the internet to schedule and change their WIC appointments, or to log on to use online nutrition education resources.

Most importantly, the same research showed very clearly that WIC participants are eager to interact with WIC online rather than having to use the telephone or schedule in person appointments at clinic sites. Further focus groups revealed that these participants want to receive more nutrition education through online classes and perceive WIC counseling through video chat just as useful as in-person counseling sessions.

3. Barriers to longitudinal care

Not only were the participants struggling, but the WIC centers hired RDs and IBCLCs that were facing 60-90 minute commutes each day, in addition to inclement weather, like floods and rain.

For mothers with young children, many of whom work full time or have highly demanding schedules, making time to come into the clinic can be extremely difficult. They may not have the access to proper transportation routes, or simply the time to spend commuting with children to the clinics.

Solutions to Client Engagement Problems

At Community Medical Centers, innovation to bolster child retention and improve long-term relationships with mothers has become centered around technology, and its ability to improve engagement, track outcomes, and help this WIC center “stay ahead of the curve.”

Andrea says, “Contrary to some common assumptions, research shows that current WIC participants – across all income levels and ethnicities – are just as ‘wired’ as the rest of their generation. Therefore, as this new generation becomes parents, incorporating technology in care is more important than ever for WIC programs across the country.”

Implementing Healthie into CMCs in California

Thankfully, the opportunity came along for these WIC centers to bring telehealth to their clinics.  In 2016, CDPH/WIC announced a funding opportunity of over $4m for a three year period through the creation of Innovation Strategies Mini-Grants.  

Mini-grants were a way for local agencies to identify, implement, and evaluate innovative methods in their communities that would improve the recruitment, retention, and re-engagement of eligible WIC participants.  

The intent of these strategies was to meet the changing needs of WIC participants, increase the perceived value of WIC, improve access to and/or improve the delivery of WIC services.  The specific CMCs working with Healthie had two goals of their own:

1. Increase child retention in our agency
2. Streamline processes utilizing technology

They believed that by utilizing technology and implementing innovative processes to make it easier for families to meet WIC requirements, they hoped to see the child retention in their WIC program increase.  

The goals set by the CMC led them to Healthie: HIPAA-compliant and perfect for hosting telehealth appointments on phones or computers. The CMC-WIC providers planned to use Healthie’s telehealth platform in a pilot program to understand the impact of remote care on community engagement, healthcare outcomes, and to examine ways to bolster the program efficacy.  Providers would utilize HIPAA-compliant video calls with patients in the network to decrease the barriers for access to care and increase the convenience of appointments. CMC-WIC patients would be able to benefit from cutting edge features in the Healthie mobile app that include visual diet logging, educational document sharing, text messaging, and tracking of custom metrics set by providers.  

For mothers with young children, many of whom work full time or have highly demanding schedules, telehealth appointments allow valuable time and cost savings by eliminating commutes.  The platform’s goal-setting tools and educational features will allow for increased accountability and self-monitoring throughout the patient network, and provide opportunities for better health outcomes in the long term.  WIC joins other nonprofit organizations, like Baraka Community Wellness, that leverage Healthie to reduce nutrition disparities and improve outcomes in at-risk communities.

After collecting baseline data and getting set up with Healthie, CMCs were ready to go live with their first client in March of 2018.  Read more about the specific steps taken in our TeleWIC case study.

The video appointment process was as follows:

1. An email was sent to participants to register on the Healthie platform, and they were walked through the process of downloading and signing in on the mobile app.
2. A call/text was sent to confirm the appointment, and the participant was to upload the necessary documents to the platform prior to the appointment.
3. At appointment time, participants receive a notification on their phone, and connect to the appointment via Healthie!
4. Appointment is completed per protocol.  Handouts and resources are reviewed with the clients and then sent through the platform to participants.

Results of Telehealth Integration and Implications

As the Community Medical Center’s Program in California has started to prove, there is inherently a heavy reliance on technology, particularly amongst the millennial generation. As a result, WIC programs only stand to benefit by embracing such technologies. By partnering with Healthie to provide WIC nutrition education and breastfeeding support resources via telehealth, or video conferencing, WIC in the State of California has been able to “take charge with expanding technology, while still being able to maintain WIC program integrity.”

Thirty-five WIC families enrolled in the “WIC Video Visits” in the first two months of launch alone, with more families joining the program daily. The goal of the WIC Video Visits program is to boost WIC program enrollment, prove WIC’s relevance in the next generation, and foster a new sense of community, online. Already, Andrea reports that including Healthie’s technology in care has improved convenience, flexibility, efficiency, and marketability too.

As we can see, over the course of a year, there was a positive trend in the percentage of kept video appointments, while office video visits kept remained relatively stagnant.  When asked if they would like to continue doing all of your appointments via video visits, and if it was more convenient to have the appointment virtually, 100% of the participants answered yes to both questions.  They rated Healthie as very easy to use, as well.  

However, the true success of this project doesn’t rely on the numbers, but rather the feedback from the participants.  

• It’s more convenient because I have a full-time job. Being able to work without going to the WIC office every month makes balancing everything a little easier.
• It’s simple and easy to use. It’s also very helpful because I don’t have to find a babysitter or have a grumpy/sleepy baby with me at the appointments.
• I really love this. After having my second child it’s not as easy as it used to be going out. Really convenient for us mothers. Thank you, WIC!
• It’s a great advancement you have in place. I love it for the convenience of not having to pack my children every time we need to meet.
• I love having the flexibility to come in or do my appointment virtually.

The next phase of WIC Video Visits or “TeleWIC” is all about growth and expansion. We look forward to continuing to bring telenutrition to WIC centers as a core part of programming.

As Andrea says, “The time has come for WIC to take a bold, proactive step forward and integrate these modern technologies. Now is the time to learn about, test and implement forms of telehealth, including videoconferencing, in WIC agencies.”

If you are interested in speaking with Andrea Weiss RD, CLE or the Healthie team to learn more, please contact us: hello@gethealthie.com.