Digital Referrals Improve WIC Enrollment During Pregnancy, Help Enhance Maternal and Perinatal Health Outcomes: JAMA
USA: A randomized clinical trial has found that direct digital referrals from prenatal care providers to the Women, Infants, and Children (WIC) program and to Registered Dietitian Nutritionists (RDNs) significantly increased WIC enrollment among pregnant individuals. These digital referral pathways offer practical and scalable approaches to address health-related social needs during pregnancy, improve access to nutritional support services, and potentially enhance maternal and perinatal health outcomes.
The findings suggest that integrating digital referral systems into routine prenatal care could increase participation in essential nutrition assistance programs.
Published in JAMA Network Open, the study by Lisa Bailey-Davis from the Center for Women’s and Children’s Research, Geisinger College of Health Sciences, Danville, Pennsylvania, and colleagues evaluated whether electronic health record (EHR)-enabled referrals to WIC and/or Registered Dietitian Nutritionists (RDNs) improve WIC enrollment compared with providing written information alone.
In the four-arm randomized clinical trial, 240 WIC-eligible pregnant individuals from a large Pennsylvania health system were enrolled in 2024 and followed for six months. Participants (mean age, 29.2 years; mean gestational age, 17.8 weeks) were randomly assigned to receive either written WIC information alone, a digital WIC referral, written WIC information plus an RDN referral, or digital referrals to both WIC and an RDN, while continuing routine prenatal care. WIC staff and RDNs contacted referred participants to facilitate enrollment and care.
Key findings
- Direct digital referrals to WIC increased enrollment to 78%, compared with 65% among participants who received written information without a digital referral (P = .04).
- Participants receiving referrals to Registered Dietitian Nutritionists also had higher WIC enrollment (78%) than those who did not receive RDN referrals (65%) (P = .03).
- WIC enrollment was 54% among participants who received only written information.
- Enrollment increased to 75% with digital WIC referral alone, 76% with RDN referral plus written WIC information, and 81% when participants received digital referrals to both WIC and an RDN.
- The highest enrollment rate was observed in the group receiving combined digital referrals to both WIC and RDN services.
The researchers acknowledged that WIC enrollment was primarily based on participant self-report, which may have introduced reporting bias. They also noted that the single-center design and reliance on EHR-enabled referral infrastructure may limit the generalizability of the findings.
Overall, the study suggests that integrating EHR-based digital referrals into routine prenatal care can improve WIC enrollment and expand access to nutrition support services during pregnancy. The authors recommend further research across diverse healthcare settings to assess broader implementation and its impact on maternal and infant health outcomes.
Reference:
Bailey-Davis L, Mackeen AD, Herb Neff KM, et al. Direct Digital Referrals From Prenatal Care and WIC Enrollment Among Pregnant Individuals: A Randomized Clinical Trial. JAMA Netw Open. 2026;9(6):e2620138. doi:10.1001/jamanetworkopen.2026.20138
Next Story