Direct Digital Referrals From Prenatal Care and WIC Enrollment Among Pregnant Individuals: A Randomized Clinical Trial

Top Things to Know

By embedding direct digital referrals, healthcare systems can use FIM infrastructure to connect patients with evidence-based nutrition benefits at scale.

Nutrition professionals can amplify program engagement.

EHR-enabled referrals to WIC and nutrition services can reduce barriers to accessing healthy food and nutrition education during pregnancy.

Summary of Conclusion/Findings

This randomized clinical trial evaluated whether electronic health record (EHR)-enabled direct digital referrals from prenatal care to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and/or a registered dietitian nutritionist (RDN) could increase WIC enrollment among income-eligible pregnant individuals. Among 240 enrolled participants, WIC enrollment was significantly higher among those receiving a direct digital WIC referral (78%) compared with those receiving only written WIC information (65%). Participants referred to an RDN also had higher WIC enrollment rates (78% vs 65%), suggesting that nutrition counseling may help connect patients to nutrition assistance programs. The combined WIC plus RDN referral model achieved the highest enrollment rate (81%), compared with 54% in the usual-care control group. RDN-supported models were also associated with significantly better WIC retention and benefit utilization, roughly doubling retention and adherence compared with models without RDN support. Overall, the findings demonstrate that integrating digital referrals and nutrition services into prenatal care can substantially improve connection to WIC and may help address nutrition-related social needs during pregnancy.