Abstract
Objective
To develop, implement, and assess implementation outcomes for a developmental monitoring and referral program for children in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
Methods
Based on Centers for Disease Control and Prevention’s Learn the Signs. Act Early. campaign, the program was developed and replicated in two phases at 20 demographically diverse WIC clinics in eastern Missouri. Parents were asked to complete developmental milestone checklists for their children, ages 2 months to 4 years, during WIC eligibility recertification visits; WIC staff referred children with potential concerns to their healthcare providers for developmental screening. WIC staff surveys and focus groups were used to assess initial implementation outcomes.
Results
In both phases, all surveyed staff (n = 46) agreed the program was easy to use. Most (≥ 80%) agreed that checklists fit easily into clinic workflow and required ≤ 5 min to complete. Staff (≥ 55%) indicated using checklists with ≥ 75% of their clients. 92% or more reported referring one or more children with potential developmental concerns. According to 80% of staff, parents indicated checklists helped them learn about development and planned to share them with healthcare providers. During the second phase, 18 of 20 staff surveyed indicated the program helped them learn when to refer children and how to support parents, and 19 felt the program promoted healthy development. Focus groups supported survey findings, and all clinics planned to sustain the program.
Conclusions
Initial implementation outcomes supported this approach to developmental monitoring and referral in WIC. The program has potential to help low-income parents identify possible concerns and access support.
Data Availability
Data and links to materials are available upon request.
Code Availability
Not applicable.
Notes
Implementation manual available upon request from the first author. An updated online implementation manual is available at https://www.cdc.gov/ncbddd/actearly/wic-providers.html.
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Acknowledgements
Special thanks to Katie Dunne for contributions to initial program design and implementation, and to Missouri WIC leadership and Eastern District staff for their program contributions and dedication to children’s healthy development.
Funding
This study was supported by Health Resources and Services Administration (HRSA) Grant H6MMC1059-03-01 with supplement from the Centers for Disease Control and Prevention (CDC), 2010–2012; Disability Research and Dissemination Center (DRDC) through Cooperative Agreement Number 5U01DD001007 from CDC, 2014–2016. Contents of the publication are solely the responsibility of the authors and do not necessarily represent the official views of HRSA, DRDC or CDC.
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JF provided conceptualization and oversight for program development/evaluation, and wrote the manuscript with input from all authors. LF, MC, and KG contributed to program design. LF coordinated on-site program implementation and evaluation. MC and WM contributed to data collection and data analysis.
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The authors have no conflicts of interest.
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All aspects of program evaluation in this project were reviewed and approved by the University of Missouri Health Sciences Institutional Review Board.
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Informed consent was waived since all assessments were voluntary and anonymous.
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Farmer, J.E., Falk, L.W., Clark, M.J. et al. Developmental Monitoring and Referral for Low-Income Children Served by WIC: Program Development and Implementation Outcomes. Matern Child Health J 26, 230–241 (2022). https://doi.org/10.1007/s10995-021-03319-9
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DOI: https://doi.org/10.1007/s10995-021-03319-9