(LB03-07-25) Optimizing Telehealth in WIC: Staff and Client Experiences Across Three States

Objectives: Evaluate implementation of telehealth services in the Special Nutrition Program for Women, Infants, and Children (WIC) in Georgia (GA), Michigan (MI), and Wisconsin (WI) in the USDA-funded Telehealth Strategies for WIC project.

Methods: A mixed-methods evaluation used quasi-experimental (GA, MI) and randomized controlled (WI) designs to examine staff and client experiences with telehealth for nutrition education and breastfeeding support. Staff completed surveys and interviews in the first and last quarter (early and late phase) of a 12 to 18-month (2022-2023) telehealth implementation period. Clients at intervention and comparison agencies completed a survey following their appointment. Logistic regression analyzed factors associated with satisfaction and modality preference. Qualitative data from staff interviews provided contextual insights.

Results: In both phases, staff had positive attitudes towards telehealth and recognized its potential to address clients’ scheduling and transportation constraints. Staff satisfaction with telehealth ranged from 66% to 84% and preference for telehealth modality ranged from 31% to 48%. Staff satisfaction was higher in the late phase, among those with pre-COVID travel, and those providing breastfeeding support. Staff preference was lower in MI and WI (vs. GA) and higher among those providing nutrition education. During interviews, staff noted facilitators to boost staff use and client satisfaction: integrating telehealth with the WIC Management Information System; adopting user-friendly designs; and providing robust training and technical assistance.

Most clients from intervention and comparison agencies were satisfied with their most recent appointment. Over 90% of clients from intervention agencies expressed a preference for receiving future services through telehealth. While factors associated with client satisfaction and modality preference varied, internet connectivity was associated with both satisfaction and preference.

Conclusions: WIC staff and clients expressed satisfaction with and preference for telehealth for WIC services. Variations in service models, technological challenges, and demographic factors influenced experiences. This study provides insights for optimizing telehealth implementation in WIC programs.

Funding Sources: USDA, FNS