Abstract
BACKGROUND: In Los Angeles County (LAC), California, the demand for Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) services increased during the COVID-19 pandemic, concurrent with the shift to fully remote WIC service delivery in March 2020. Technologies for facilitating remote services were critical for accommodating increases in participation during the COVID-19 pandemic. OBJECTIVE: The objective of this study was to quantify patterns of remote-service utilization and to determine whether use of remote services (phone, interactive texting, e-mail, online education, video appointments) was associated with higher rates of recertification among WIC participants early in the COVID-19 pandemic. DESIGN: Cross-sectional survey with administrative data for follow-up PARTICIPANTS AND SETTING: This study used data from the 2020 LAC WIC Survey and WIC administrative data to evaluate remote service utilization across LAC WIC agencies (unweighted n = 3,510; weighted n = 3,540). MAIN OUTCOME MEASURES: Recertification on WIC, determined by the issuance of a food package in the first 2 months after the end-date of the prior certification period. STATISTICAL ANALYSIS: Survey data were merged to WIC administrative data to determine whether participants completed a recertification; the association of utilization of each remote service with the odds of recertification among WIC-participating children 0 to 3 years of age was assessed with multivariable logistic regression. RESULTS: Most survey respondents reported using phone appointments (95.5%), interactive texting (77.3%), e-mail (60.1%), and online education (71.2%) to access WIC services during 2020, and over 82% of children successfully recertified. Interactive texting utilization was associated with 27% higher recertification odds (95% confidence interval, 1%-59%); associations between all other remote services and odds of recertification were not statistically significant. CONCLUSIONS: These results suggest that WIC investment in interactive texting technological infrastructure, and appropriate staff training, can help local WIC agencies successfully reach and provide high-quality services to WIC participants.