Our goal was to identify strategies aimed at increasing Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) enrollment and participation rates. The WIC program provides many health benefits for pregnant women, mothers, and children. WIC offers nutrition education, formula, fruits and vegetables, and other food to pregnant and postpartum women and their children until they reach the age of five. Despite the availability of this program nationwide, enrollment and participation rates remain low across the country. Several states have tried various interventions to combat this deficiency of engagement with the goal of increasing WIC enrollment and participation. We conducted a scoping review to identify articles based on pre-specified inclusion and exclusion criteria. Two reviewers independently identified and screened articles. Subsequently, three reviewers independently extracted study details and outcomes related to WIC enrollment and participation rate changes. We included 14 studies reporting on 12 interventions from 3945 citations reviewed. Seven of these were published papers, while the others were final reports of USDA WIC Special Grant Projects. All the observed interventions had some success increasing WIC participation. Virtual interventions demonstrated the most success based on preliminary evidence. Successful interventions showed percentage gains in enrollment close to 8% and changes in participation over 9%. Overall, the literature surrounding WIC enrollment interventions reveal a mixed impact on improving participation. Many successful interventions involve an online or virtual engagement component which can provide educational resources on WIC benefits, nutrition, and living a healthy lifestyle. Supplementary Information The online version contains supplementary material available at 10.1007/s10900-022-01131-2.
Background Shared decision making (SDM) in breast cancer care improves outcomes, but it is not routinely implemented. Results from the What Matters Most trial demonstrated that early-stage breast cancer surgery conversation aids, when used by surgeons after brief training, improved SDM and patient-reported outcomes. Trial surgeons and patients both encouraged using the conversation aids in routine care. We will develop and evaluate an online learning collaborative, called the SHared decision making Adoption Implementation Resource (SHAIR) Collaborative, to promote early-stage breast cancer surgery SDM by implementing the conversation aids into routine preoperative care. Learning collaboratives are known to be effective for quality improvement in clinical care, but no breast cancer learning collaborative currently exists. Our specific aims are to (1) provide the SHAIR Collaborative resources to clinical sites to use with eligible patients, (2) examine the relationship between the use of the SHAIR Collaborative resources and patient reach, and (3) promote the emergence of a sustained learning collaborative in this clinical field, building on a partnership with the American Society of Breast Surgeons (ASBrS). Methods We will conduct a two-phased implementation project: phase 1 pilot at five sites and phase 2 scale up at up to an additional 32 clinical sites across North America. The SHAIR Collaborative online platform will offer free access to conversation aids, training videos, electronic health record and patient portal integration guidance, a feedback dashboard, webinars, support center, and forum. We will use RE-AIM for data collection and evaluation. Our primary outcome is patient reach. Secondary data will include (1) patient-reported data from an optional, anonymous online survey, (2) number of active sites and interviews with site champions, (3) Normalization MeAsure Development questionnaire data from phase 1 sites, adaptations data utilizing the Framework for Reporting Adaptations and Modifications-Extended/-Implementation Strategies, and tracking implementation facilitating factors, and (4) progress on sustainability strategy and plans with ASBrS. Discussion The SHAIR Collaborative will reach early-stage breast cancer patients across North America, evaluate patient-reported outcomes, engage up to 37 active sites, and potentially inform engagement factors affecting implementation success and may be sustained by ASBrS.
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