A Mixed-Methods Study of Perceived Implementation Challenges for WIC Online Ordering and Transactions.

BACKGROUND:Federal food assistance programs are working towards online grocery shopping. Online ordering in Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is emerging following successful implementation in Supplemental Nutrition Assistance Program (SNAP). OBJECTIVE:To identify anticipated challenges, potential solutions, and expected costs of WIC online ordering. DESIGN:Cross-sectional, mixed-methods, web-based, survey research. SUBJECTS AND SETTING:Data were collected from December 2020 to January 2021. Purposeful and snowball sampling included WIC stakeholders involved in developing processes and systems required for WIC online ordering. Respondents represented diverse geographic areas, levels of intraorganizational authority, and WIC benefit card types. STATISTICAL ANALYSES PERFORMED:The research team used a rapid analysis and lean coding approach to identify emergent themes from open-ended survey responses. Descriptive statistics were used to describe the distribution of responses across themes and stakeholder types. RESULTS:Respondents (n = 145) described 812 anticipated challenges within 20 themes grouped into five topic areas: rules and regulations; shopping experience; security, confidentiality, fraud, and WIC State agency processes; training, assistance, and education; and equitable access and buy-in. Addressing anticipated regulatory issues were among the few concrete potential solutions described. The two most frequent costs reported were increased staff time and start-up and ongoing technology costs. CONCLUSIONS:This study identified several, critical anticipated challenges and considerations that will help prepare WIC state agencies for opportunities to expand online ordering to WIC participants.