WIC Nutritionist Perspectives on Opportunities and Challenges Regarding Care Coordination With Primary Care Providers for Early Childhood Obesity Prevention

• Published in: Journal of Patient-Centered Research and Reviews 2016-08, Vol.3 (3), p.219
• Main Authors: Lutcher, Shawnee, Savage, Jennifer S, Mowery, Jacob, Bailey-Davis, Lisa, Hess, Lindsey B, Marini, Michele
• Format: Article
• Language: English
• Subjects: Supplement
• ISSN: 2330-0698; 2330-0698
• DOI: 10.17294/2330-0698.1386

Background/Aims: Economically disadvantaged children experience disparities in obesity rates despite having numerous points of contact with the broader health care community, namely primary care and the Woman, Infants, and Children (WIC) federal assistance program. Our purpose was to evaluate the perspectives of WIC regarding the potential to coordinate community-based care with the primary care. Methods: We used a semi-structured interview guide to gather perspectives of WIC nutritionists (N = 35), including state program leaders, through seven focus groups in a Mid-Atlantic state. Investigators used a grounded-theory approach to independently open-code transcripts. Next, categories were identified and emerging themes reported. Results: Key themes include: a) WIC is challenged by a clutter of feeding messages from health care, media, family and friends; b) Coordinating care across sectors could enhance patient-centeredness and outcomes; and c) Health information technology strategies are but one piece of a coordinated care system. WIC nutritionists, experts in feeding education, described their role in care but perceive limited power and influence to resolve conflicts in messaging that function as barriers to learning. Bidirectional data sharing (e.g. measured weight and length, immunizations) would be a first step forward toward coordination of care between sectors. Core educational messages, parent written consent, time-sensitivity, defining the scope of practice, relationship building and training are additional issues to be addressed to coordinate care. Conclusion: WIC perceives opportunity for exponential benefits in reducing message conflict by coordinating care for mother and child-centered needs. Health care provider and patient perceptions should be explored.