For over four decades, research has shown that the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is one of the nation’s most successful and cost-effective nutrition intervention programs.
WIC plays an important role in improving birth and child health outcomes, as well as reducing prevalence of households with food insecurity, according to the Center on Budget and Policy Priorities (https://bit.ly/3Rp16Xt).
Despite its benefits, WIC is highly underutilized. Participation has trended downward nationwide, particularly for children ages 1-4 years, according to the U.S. Department of Agriculture.
The AAP Washington, D.C., Chapter (DC AAP) team, led by DC AAP Secretary Janine A. Rethy, M.D., M.P.H., FAAP, and Karen Ganacias, M.D., examined the barriers to enrollment and retention of WIC benefits in the district, with support from the AAP Building Pediatrician Capacity to Address Food Insecurity Collective Impact. The chapter then used what it learned to collaborate on a health information technology (IT) framework to help pediatric providers refer families to WIC and communicate with the district’s WIC staff.
Barriers to WIC participation
DC AAP, in collaboration with DC WIC, conducted surveys with pediatric providers and focus groups with WIC participants. Results showed a gap in pediatric provider knowledge of WIC resources, eligibility and means to refer. Eligible families expressed frustration with not feeling heard by their provider or WIC staff about their child’s needs, particularly regarding prescriptions for formulas and special dietary needs.
To gain more context for some of these concerns, DC AAP and the MedStar Georgetown research team conducted structured interviews with DC WIC staff on their communication and referral practices with providers.
One of the main themes was that WIC staff thought a more streamlined, centralized channel of communication would improve client satisfaction and utilization. Additionally, most WIC staff thought that a secure electronic platform for referrals from providers would make tracking and communication easier.
Implementing online platform
DC AAP, the MedStar Georgetown team and DC WIC then collaborated to build and implement a solution that could be scaled across DC and replicated around the country.
The team chose the FindHelp online platform to facilitate secure referrals and communication between pediatric providers and DC WIC. The platform allows providers to refer patients to local WIC agencies (and other community-based organizations), as well as receive updates and communication about shared patients. The platform can be embedded in the electronic health record or used as a freestanding online portal.
The MedStar team built a health IT framework and workflows for referrals and tracking for a community pediatrics clinic. Plans are underway to train and educate DC AAP members to use the platform as well as to build awareness of WIC resources, eligibility and the importance of provider referrals.
“Pediatricians are in a unique position to improve WIC enrollment, which can have a significant impact on child health outcomes,” Dr. Rethy said. “This strong cross-sector collaboration between DC AAP, DC WIC, MedStar Georgetown and FindHelp has created a scalable health IT framework for sustainable, enhanced WIC utilization and stakeholder experiences.”