Multi-sector perspectives on opportunities to increase WIC enrollment through community healthcare partnerships

Participation in Special Supplemental Nutrition Assistance Program for Women, Infants, & Children (WIC) improves health outcomes for birthing people and their children, including reduced preterm birth and low birth weight, and lower rates of nutritional deficiencies for mothers and children.

This qualitative descriptive study explored opportunities to increase WIC enrollment in two New England states through community healthcare partnerships. We conducted key informant interviews with a semi-structured interview guide, purposively sampling current WIC participants (N = 10), clinical providers and staff (N = 17), and WIC staff (N = 6). We used a combination of deductive and inductive thematic analysis.

Our study revealed that across multiple perspectives - WIC-eligible participants, healthcare providers, clinical staff, and WIC staff - respondents were supportive of increasing WIC enrollment through community healthcare partnerships. Individual-level barriers included limited or inaccurate understanding of eligibility and benefits and perceived stigma, while organizational-level barriers included inconsistent and inefficient integration of WIC referral in clinical settings, lack of clarity about healthcare and WIC staff roles, and scheduling, communication, and other logistical challenges. Facilitators included trusted relationships with healthcare providers and WIC staff, consistent messaging about WIC benefits, and direct assistance with WIC enrollment. Participants advocated for enhancing patient and provider awareness of and education on WIC services, automating the integration of WIC discussions into clinical workflows, and strengthening coordination between WIC and healthcare organizations.

Across participant groups, we identified broad support for improving WIC engagement through community-healthcare partnerships. Through analysis of multi-sector perspectives organized by socio-ecological model domains, our results highlight systemic gaps and corresponding opportunities to improve awareness of WIC services and streamline WIC referrals through healthcare-based interventions at the organizational and community levels.