Despite benefits of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), many eligible children remain unenrolled. This study evaluated responses to an electronic health record (EHR)-embedded federal nutrition program (FNP) participation screening and WIC referral tool implemented within eight clinics during <5-year-well visits. Among 5,385 children, mean age at initial screening was 10.7 months (SD 14.2), 52% newborn-aged, 37% Hispanic, and 88% Medicaid-insured. Among screened patients (n=3,606), 34% were not enrolled in WIC at first screening (n=1,235). Medicaid coverage, academic clinic setting, and non-Hispanic Black or Hispanic race and ethnicity were associated with lower odds of WIC non-enrollment. Among those not enrolled with a documented response to referral (n=819), 59% accepted (n=488); acceptance was higher among non-Hispanic Black and Hispanic patients, newborn-aged patients, those with Medicaid coverage, and those seen in academic clinics. Among referral acceptors with follow-up (n=438), 61% were enrolled at last screening (n=265), with higher odds among newborn-aged patients and those in academic clinics. An EHR-based automated intervention can facilitate screening and referral to WIC. WIC participation at first screening, referral acceptance, and enrollment after referral varied by sociodemographic characteristics, suggesting opportunities to improve equitable access through health system-based approaches.
Published: May 2026
ID #: 283-5026
Journal: JMIR Pediatr Parent
Authors: Montez K, Kay MC, Taxter AJ, Lewis KH
Focus Areas: Early Childhood, Nutrition Policy & Programs
Keywords: Health Care, Women, Infants, and Children (WIC)
Resource Type: Journal Article
State: North Carolina
Age Groups: Pregnant women, infants and toddlers (ages 0 to 2), Preschool-age children (ages 3 to 5)
Related Research
May 2026
Assessing Caregiver Comfort With Linking the Health Care System and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)
Integrating WIC referrals within clinical care may improve WIC uptake, data sharing, and nutrition/health outcomes, but little research has explored family perspectives about information exchange between health care providers and WIC regarding their child’s health. Better understanding family perceptions of information exchange could facilitate improvements in the design of effective, family-centered referral pathways. This study MoreApril 2026
Automating WIC Screening and Enrollment in Pediatric Primary Care
Many eligible families face barriers to WIC enrollment, including administrative challenges (such as navigating eligibility criteria) and logistical issues (such as a lack of transportation to in-person appointments and insufficient time for attending enrollment appointments). Pediatricians in academic medical systems are well positioned to promote WIC enrollment because of the frequency of their well-child visits MoreJuly 2026