"What Matters to You?": A Participant-Centered Approach to Needs Identification and Referral to Community Resources

ObjectiveReferral to social and health services is a core process of the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). We evaluate the feasibility and acceptability of a referral innovation implemented at two New York City WIC sites. This program aimed to improve retention by increasing WIC's perceived value by addressing unmet needs of WIC families. The two main components were needs assessment via conversation and a closed-loop referral process for WIC families with children aged 6-9 months and 18-21 months.DesignReferral outcomes from Unite Us and program data were tracked and assessed using descriptive univariate analyses. We conducted 29 in-depth interviews with caregivers and six focus groups with WIC and CBO staff. Qualitative data were analyzed using thematic framework analysis.ResultsFrom February 2020 through January 2021, 1,675 WIC caregivers participated in a conversation about their family's needs. Four hundred sixty-one caregivers were referred to at least one service. 95 received services or benefits. In interviews, caregivers viewed referrals to other services positively but were not aware WIC could address needs holistically. In focus groups, WIC staff liked the conversation script but highlighted barriers to making referrals. CBO partners valued network participation as it increased their reach to new families.Conclusions and ImplicationsOur approach facilitated targeted referrals for WIC participants. It is an acceptable enhancement of the WIC referral process with potential to strengthen WIC as a community provider. What is Already Known on this Subject?The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) provides nutrition education, nutrition supplementation, breastfeeding support, and referrals, and is associated with improved health outcomes for participating families.What does this Study Add?This manuscript describes the approach of and stakeholder perspectives on a novel approach to referral-making at one WIC agency. This innovation aimed to improve the existing process with closed-loop coordination through an online referral platform. The study adds to the limited research on WIC referral processes in general.