(P22-037-23) Improving the Diet Quality of WIC-Participating Women Using Digital Food Environments: Study Protocol

Objectives: The primary aim is to assess the feasibility and acceptability of an online grocery shopping cart prefilled with items prescribed by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) (intervention group, IG) compared to individually selecting items (control group, CG) to improve WIC benefit redemption and diet quality (DQ) of grocery purchases using a pilot randomized-controlled mixed methods trial. The secondary aim is to explore barriers, facilitators, and attitudes driving online grocery shopping decision-making.

Methods: We will recruit 25 Rhode Island WIC participants who are >18 years and primary food shoppers, speak English or Spanish, have internet, and no special dietary needs. We will use Gorilla Shop Builder to design a simulated store. At baseline, participants will complete a sociodemographic questionnaire and a simulated shopping episode (SSE) to assess grocery purchase DQ. Participants will be asked to shop as if using their monthly food benefits and to buy WIC and non-WIC items to last 10 days in their household. After a week, participants will be randomized to the IG or CG and complete a second SSE. The IG will have a modifiable cart pre-filled with WIC items providing 100% of the benefits proposed on the 2022 food package revision, except for fruits/vegetables and milk, and will be personalized based on the items selected during the first SSE. The CG will select their items individually. Both groups will have a list of their assigned benefits, and WIC items will have a WIC label. We will conduct qualitative interviews after the second SSE to better understand their food shopping decisions online vs. in-person, and perceptions, barriers, and facilitators of online food shopping. Feasibility and acceptability will be measured using validated scales. Grocery purchase DQ and WIC benefit redemption will be evaluated with Grocery Purchase Quality Index 2016 scores and % of maximum allotted amounts for each food group, respectively.

Results: N/A

Conclusions: By testing the feasibility and acceptability of modifiable a WIC pre-filled cart in a simulated environment, this study can inform a full-scale efficacy trial to improve benefit redemption and grocery purchases DQ in real-life settings during the implementation of WIC online food shopping.

Funding Sources: Supported by Dr. Alison Tovar’s discretionary research funds