Evaluating Telehealth Solutions in WIC: Wisconsin WIC Clients

Study Overview
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Brief Summary
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With funding through the United States Department of Agriculture (USDA) and Tufts University's Telehealth Intervention Strategies for WIC (THIS-WIC) project, Wisconsin's (WI) WIC department will be implementing a new, customized, mobile-friendly nutrition education platform called ONE (Online Nutrition Education) in WI's WIC program. The purpose of this study is to evaluate the impact of the ONE platform. The evaluation will focus on WIC clients as the study population. The Wisconsin WIC department would be implementing this education platform, regardless of the evaluation research. The Wisconsin WIC department is responsible for implementing this new intervention, while the Tufts University research team is responsible for the evaluation of this platform through surveys and analysis of administrative data. An online survey will be used to gauge WIC clients' satisfaction with ONE, and the impact of the telehealth solution compared to usual care on breastfeed duration, dietary intake, attendance at scheduled appointments, attitudes to breastfeeding and nutrition education, and barriers encountered. Survey data will be combined with previously collected data on clients and their families from the WI Management Information Systems (MIS), and aggregate level data from the ONE telehealth solution about ONE utilization.

Detailed Description
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Telehealth can reduce barriers and increase access to care, and it can be applied to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). WIC is a federal nutrition assistance program that helps low-income women with children up to age 5. There is a large volume of research that supports remote patient monitoring, and the most benefits are found when telehealth is used for communication and counseling. The USDA awarded Tufts University a grant to test and evaluate the use of telehealth innovations in the delivery of USDA's WIC program. Tufts University then offered the USDA/Tufts Telehealth Intervention Strategies for WIC (THIS-WIC) grant opportunity to WIC state agencies across the US. THIS-WIC selected 7 WIC State Agencies to receive grants, and the WI state agency is one recipient. The THIS-WIC team at Tufts University is leading the evaluation of these telehealth solutions in collaboration with funded WIC State Agencies. THIS-WIC aims to generate evidence from WI's telehealth solution to inform how the ONE platform supports WIC services compared to usual in-person care. ONE is a mobile-optimized website, meaning that it functions as an app without requiring the amount of memory and data that apps use. WIC clients can experience the ONE platform in either English or Spanish. Evaluation findings will inform stakeholders about the platform's benefits and how viable it is to sustain and adapt ONE more widely. Surveys will be conducted online via the Alchemer survey software platform for intervention and control sites.

Official Title
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Evaluating Telehealth Solutions in WIC: Wisconsin WIC Clients

Conditions
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Telehealth, Nutrition Education, Breast Feeding, Dietary Intake, WIC

Intervention / Treatment
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* Behavioral: Telehealth solution


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: pregnant women postpartum women parent/guardian of a participating infant or child in the WIC program Study participants will be clients at local WIC agency sites where either the telehealth solution is offered or where only usual care is available (control). Exclusion Criteria:

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Study participants will be clients at local WIC agency sites where either the telehealth solution is offered or where only usual care is available (control).
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Telehealth solution<br>Telehealth solution offered | Behavioral: Telehealth solution<br>* Mobile-friendly nutrition education platform<br>|
| No Intervention: Usual care<br>Control | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Satisfaction with the telehealth solution | WIC clients satisfaction with nutrition education offered via the telehealth solution compared to usual care. Data will be collected, and this outcome measure will be assessed via survey completion by study participants. | During the study period, approximately 18 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Breastfeeding duration | Duration of breastfeeding in clients offered the telehealth solution compared to usual care. Data will be collected, and this outcome measure will be assessed via survey completion by study participants. | During the study period, approximately 18 months | 
| Attendance at scheduled appointments | WIC clients attendance at appointments when offered the telehealth solution compared to usual care. Data will be collected, and this outcome measure will be assessed via survey completion by study participants. | During the study period, approximately 18 months | 
| Dietary intake | Impact of the telehealth solution compared to usual care on dietary intake. Data will be collected, and this outcome measure will be assessed via survey completion by study participants. | During the study period, approximately 18 months | 
| Attitudes to breastfeeding and nutrition education | Impact of the telehealth solution compared to usual care on WIC clients' attitudes to breastfeeding and nutrition education. Data will be collected, and this outcome measure will be assessed via survey completion by study participants. | During the study period, approximately 18 months | 
| Barriers encountered in obtaining nutrition education | Impact of the telehealth solution compared to usual care on barriers encountered by WIC clients in obtaining nutrition education. Data will be collected, and this outcome measure will be assessed via survey completion by study participants. | During the study period, approximately 18 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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telehealth, WIC, nutrition education, breast feeding, dietary intake