Designing and piloting clinic-based health information technology to improve WIC retention

About This Grant

PROJECT SUMMARY Food insecurity is a significant public health concern and a focus of federal policy and research due to its negative health impacts, including on the physical, behavioral, and developmental health of young children. Food insecurity remains prevalent in the US, with higher rates among Black and Hispanic households and households with children. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a federally-funded locally-administered nutrition program that serves low-income families with children up to 5 years of age. While longer duration of WIC participation is associated with a reduction in household food insecurity, participation drops precipitously after children reach 1 year of age. Clinical and administrative challenges faced by caregivers and pediatric clinicians negatively impact program retention. Health information technology (HIT) tools, when designed with methods that center end-users, have great potential to systematically improve clinical-community integration (i.e. linkages between primary care and community-based resources and programs) and decrease health disparities. Research to date has not studied the use of HIT strategies in pediatric primary care to improve WIC retention. The objective of this innovative study is to design and pilot clinic-based HIT tools to improve integration between pediatric primary care and WIC, with the goal of increasing WIC retention and decreasing disparities in food insecurity. This study aligns closely with current NIH and NIMHD priorities to develop and test strategies to address food insecurity. In this K23 proposal, I aim to: (1) use human-centered design methods to develop clinician-, system-, and family-facing HIT tools to increase WIC retention, (2) test the feasibility and acceptability of the HIT tools through a 1-year single-arm pilot study, and (3) evaluate the implementation of the HIT tools using mixed methods. Through a combination of advanced coursework, workshops, and mentored research experience, I will acquire content knowledge related to HIT, skills in human-centered design, and expertise in implementation science methods. I will conduct this research at Boston Medical Center and Boston University Chobanian & Avedisian School of Medicine, national leaders in health disparities research and clinical-community interventions. This proposal is supported by an accomplished mentorship team with research expertise in health disparities, HIT, human-centered design and implementation science methods, pilot studies, food insecurity, and clinical-community interventions. The combination of training activities and mentored research experiences outlined in this proposal will ensure that I will emerge from this K23 award as an independent investigator with expertise in the implementation of scalable HIT strategies to improve clinical-community integration and decrease disparities in food insecurity for children and families.