P3D261: Food Insecurity and the Impact of Protocoled Screening for WIC Enrollment in the Military

Purpose/Objectives: The Supplemental Nutrition Program for Women, Infants, and Children (WIC) is an invaluable resource for pregnant, postpartum, and breastfeeding women, infants, and children up to five years old. WIC enrollment during pregnancy has been shown to decrease the likelihood of NICU admissions by 23%, risk of preterm birth by 29-48%, low birth weight by 23-36%, and perinatal death by 22-31%. Despite its value, there is not a protocolized method to ensure military families are screened for WIC eligibility. In addition, a previous quality improvement project at WRNMMC demonstrated that a large proportion of pediatric and obstetric providers (31%) were unaware of the WIC program. The project also highlighted that even for providers who were aware of WIC, the majority (74%) were not comfortable discussing the benefits of WIC, discussing WIC eligibility requirements, or guiding families through the enrollment process, a potential missed opportunity to connect at-risk families to a helpful resource in a timely manner.

Our project evaluated families presenting to WRNMMC pediatric and obstetric clinics for food insecurity, WIC awareness, enrollment, and eligibility.

Design/Methods: We recruited families with children less than 5 years old or active pregnancies at the WRNMMC pediatric or obstetric clinics in July 2022. We utilized an electronic survey to collect demographic information, determine knowledge of the WIC program, and source(s) of knowledge. We screened for food insecurity using the validated Hunger Vital Sign screening questionnaire. This study was approved by the WRNMMC IRB.

Results: 437 families who presented with children < 5 year old and/or active pregnancies were screened; 362 (83%) were aware of the WIC program, however less than 10% learned of WIC from Military Treatment Facilities. Greater than 40% of families learned of WIC through friends and family or online/social media groups. 100 of 437 families screened (23%) were eligible for WIC, with 70 of those families (70%) unaware of their eligibility. 54 of 437 families screened (12%) were positive for food insecurity, with 17 of these 54 families (31%) also being unaware of their WIC eligibility.

Conclusion/Discussion: Despite proven efficacy in improving neonatal and childhood outcomes, WIC remains an underutilized resource for at risk military families. Our results support the data regarding low military enrollment in the WIC program. Our 1-month screening protocol resulted in a 230% increase in WIC enrollees, with approximately $430,000/year in newly discovered food supplementation benefits for eligible families at WRNMMC. These results highlight the need for a formalized processes to educate and screen for WIC eligibility, and assist with enrollment, in obstetric and pediatric military treatment facility clinics. Next steps in our ongoing project include a direct mixed methods study of military families to develop sustainable interventions to improve WIC enrollment and decrease food insecurity in military communities.