Prioritization of Features for Mobile Apps for Families in a Federal Nutrition Program for Low-Income Women, Infants, and Children: User-Centered Design Approach.

BACKGROUND: The Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC) is a federal nutrition program that provides nutritious food, education, and health care referrals to low-income women, infants, and children up to the age of 5 years. Although WIC is associated with positive health outcomes for each participant category, modernization and efficiency are needed at the clinic and shopping levels to increase program satisfaction and participation rates. New technologies, such as electronic benefits transfer (EBT), online nutrition education, and mobile apps, can provide opportunities to improve the WIC experience for participants. OBJECTIVE: This formative study applies user-centered design principles to inform the layout and prioritization of features in mobile apps for low-income families participating in the WIC program. METHODS: To identify and prioritize desirable app features, caregivers (N=22) of the children enrolled in WIC participated in individual semistructured interviews with a card sorting activity. Interviews were transcribed verbatim and analyzed using constant comparative analysis for themes. App features were ranked and placed into natural groupings by each participant. The sum and average of the rankings were calculated to understand which features were prioritized by the users. Natural groupings of features were labeled according to participant descriptions. RESULTS: Natural groupings focused on the following categories: clinics/appointments, shopping/stores, education/assessments, location, and recipes/food. Themes from the interviews triangulated the results from the ranking activity. The priority app features were balance checking, an item scanner, and appointment scheduling. Other app features discussed and ranked included appointment reminders, nutrition training and quizzes, shopping lists, clinic and store locators, recipe gallery, produce calculator, and dietary preferences/allergies. CONCLUSIONS: This study demonstrates how a user-centered design process can aid the development of an app for low-income families participating in WIC to inform the effective design of the app features and user interface.

Individual and Household-Level Factors Associated With Caregivers' Intention to Keep Their Child Enrolled in WIC.

OBJECTIVE: Identify factors associated with caregivers' intention to keep their child enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program until age 5 years. METHODS: Baseline data from a longitudinal questionnaire aiming to assess the impact of a statewide intervention to increase WIC retention in Illinois were analyzed in 2018. Data on sociodemographics and household characteristics were collected in 2015 from 174 caregiver/child dyads. Logistic regression was used to identify factors associated with caregivers' intention to keep their child enrolled in WIC until age 5 years (ie, intention). RESULTS: A total of 66% of caregivers stated they were very likely to keep their child enrolled in the WIC program. Breastfeeding and homeownership status were associated with 58% (P =.03) and 72% (P =.02) lower odds of intention among caregivers, respectively. CONCLUSIONS AND IMPLICATIONS: Significant inverse associations among breastfeeding, homeownership, and intention support the need for tailoring state-level WIC retention efforts to specific population characteristics and health behaviors.

Mobile Phone Apps for Low-Income Participants in a Public Health Nutrition Program for Women, Infants, and Children (WIC): Review and Analysis of Features.

BACKGROUND: Since 1972, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) has been proven to improve the health of participating low-income women and children in the United States. Despite positive nutritional outcomes associated with WIC, the program needs updated tools to help future generations. Improving technology in federal nutrition programs is crucial for keeping nutrition resources accessible and easy for low-income families to use. OBJECTIVE: This review aimed to analyze the main features of publicly available mobile phone apps for WIC participants. METHODS: Keyword searches were performed in the app stores for the 2 most commonly used mobile phone operating systems between December 2017 and June 2018. Apps were included if they were relevant to WIC and excluded if the target users were not WIC participants. App features were reviewed and classified according to type and function. User reviews from the app stores were examined, including ratings and categorization of user review comments. RESULTS: A total of 17 apps met selection criteria. Most apps (n=12) contained features that required verified access available only to WIC participants. Apps features were classified into categories: (1) shopping management (eg, finding and redeeming food benefits), (2) clinic appointment management (eg, appointment reminders and scheduling), (3) informational resources (eg, recipes, general food list, tips about how to use WIC, links to other resources), (4) WIC-required nutrition education modules, and (5) other user input. Positive user reviews indicated that apps with shopping management features were very useful. CONCLUSIONS: WIC apps are becoming increasingly prevalent, especially in states that have implemented electronic benefits transfer for WIC. This review offers new contributions to the literature and practice, as practitioners, software developers, and health researchers seek to improve and expand technology in the program.