JMIR Publications

ABSTRACT

Background:

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a federal nutrition assistance program for low-income, food-insecure mothers and young children in the United States. Despite its intended goals, many eligible individuals forgo WIC benefits, in part due to administrative burden – onerous experiences encountered when navigating public benefits programs. In response, a range of digital interventions and policy waivers were introduced during the COVID-19 pandemic, but their effectiveness in reducing access barriers remains unclear.

Objective:

This study examined the effectiveness of digital interventions for WIC by analyzing user reviews of WIC smartphone apps utilized by local agencies. Specifically, it investigated (a) how obstacles to WIC access manifested in daily interactions with these apps, (b) how user experiences changed after the onset of the COVID-19 pandemic, and (c) how these changes were associated with program satisfaction.

Methods:

An original dataset of user reviews (N = 28,212) was compiled for 26 WIC smartphone apps between 2013 and 2024. Structural topic modeling identified eight key themes in the reviews and assessed changes in user experiences following COVID-19. A mixed-effects analysis was conducted to examine the relationship between identified themes and app ratings.

Results:

The structural topic modeling showed that WIC apps were largely effective in reducing access barriers and improving participation. Pre-COVID-19 reviews most often cited frustrations such as account authentication issues, insufficient customer support, document upload difficulties, and unsuccessful troubleshooting after updates. Although some technical challenges persisted, post-COVID-19 reviews reflected greater appreciation for features that alleviated obstacles, including program tracking, shopping and benefit redemption, and ease of use. Mixed-effects analysis indicated that topics more prominent in post-COVID-19 reviews were significantly associated with increased satisfaction: topics related to program tracking (B = 0.20, SE = 0.06, P = .001), shopping and redemption features (B = 0.18, SE = 0.07, P = .01), and ease of use (B = 0.10, SE = 0.05, P = .04) predicted higher app ratings. In contrast, topics reflecting administrative burden and access obstacles prior to COVID-19 were not significantly associated with app ratings.

Conclusions:

User-centered digital interventions can improve WIC access and participation by reducing administrative burdens and enhancing service delivery.