WARMRegards February 2019 Food Scarcity and Picky Eaters

WARMRegards February 2019 Food Scarcity and Picky Eaters


Welcome to WARMRegards! We’ve recently restarted our popular e-newsletter aimed at helping WIC agencies discover the latest developments in technology, applications, and tips-of-the-trade. It’s our goal to support you in reaching and retaining more WIC clients.


The early childhood years are crucial in establishing good eating patterns. It’s during these years that children either learn to make healthy, nutritious food choices or develop bad eating habits that will follow them well into adulthood. The eating habits they create in their youth can affect everything from their intelligence to their health as an adult.


According to Health and Social Services, another important reason for kids to eat healthy in their early childhood is that this is a time of rapid growth and development for them. Children need access to nutritious, enriching foods, like fruits and vegetables, to support this growth. Healthy eating is linked to better brain and muscle development in children.


The Scarcity of Healthy Food in Low-Income Areas

Unfortunately, as the Food Research and Action Center reports, children from low-income households are at a disadvantage due to the scarcity of fruits and vegetables available to them. Some barriers to accessing nutritious food options in low-income areas include:

  • Lack of farmers’ markets or stores with fresh produce.
  • Unavailability of vehicles to complete regular grocery shopping trips.
  • The higher price of nutritious food items.
  • Lower-quality produce being sold in low-income neighborhoods.
  • A greater availability of fast-food restaurants.


It can be easy to assume that parents who don’t give their children healthy foods are bad parents, but it’s important to look more closely at the situation. Without good options for fresh, quality produce nearby, busy and/or low-income parents might be tempted to opt for unhealthy options or fast food just to feed their children. And if these parents don’t have the ability to get to a grocery store that sells healthy foods at an affordable price, they’ll have no other option.


You can help combat this food scarcity by ensuring your clients are aware of food packages, farmers’ markets, and food vouchers that will enable them to gain access to fresh fruits and vegetables at a lower cost. You can remind clients at their appointments or reach out to them using an outreach platform which will send notifications letting them know about these programs.


When Kids Become Picky Eaters

Children who don’t have access to healthy food options may develop an aversion to them as they get older and can become picky eaters with a taste for low-nutrition items and junk food. When the damage is already done, the best thing you can do is help your clients reach their picky eaters and find creative ways to introduce nutrition into their children’s diets.


WIC Works suggests a few things parents can do to cope with picky eaters.

  • Give children ownership by allowing them to pick their fruits and veggies.
  • Have children help make meals so they feel invested.
  • Offer a choice — instead of telling them they’re having broccoli, ask if they’d prefer broccoli or cauliflower.
  • Eat family meals together so mealtime becomes enjoyable.
  • Prepare the same foods for the whole family so children get used to eating what everyone else is eating.


Children are creatures of habit and, if they’ve been given relatively unhealthy foods for most of their young lives, they won’t be adventurous eaters. ChooseMyPlate.gov, from the USDA, has some tips for introducing new foods.

  • Have children try new foods in small portions and be patient as they try them out.
  • Start with one new food at a time so children don’t feel overwhelmed.
  • Try the new foods out first so the child can look to you as a role model.
  • Provide new foods at the beginning of a meal, when the child is most hungry.
  • Offer new foods several times — sometimes it just won’t take on the first try, but the child might develop a taste for it over time.


There are many sources available to help parents deal with a picky eater. You can help your clients by pointing them in the right direction and offering nutrition advice from specialists, when needed.


Here are some sources you can point your clients to:

Your website can include a section with advice and tips to get picky eaters to eat more. Here, you can provide a link to quick videos that busy moms can watch to get the information they need when it’s convenient for them


For moms who need a little extra help getting their children to eat healthy foods, be sure to provide counseling with nutrition experts. This counseling can be offered at your clinic or at a satellite office your clients can easily get to. However, as we’ve talked about in previous newsletters, some moms won’t be able to get to your clinics very often due to transportation or financial issues. This is where your smartphone app will come in handy. You can set up secure, encrypted chats with nutrition counselors so moms who are unable to make in-person visits can still get the one-on-one help they need.


Getting kids to eat healthy is a two-step process. First, parents need access to affordable, fresh produce without having to travel far to get it. Second, parents need easy, go-to strategies to get their kids interested in healthy food and combat any poor eating habits that may have already been established. As always, information is key — make sure your clients have access to information about getting fresh produce and getting their kids to eat that produce.


By Shela Ward


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WARMRegards Dec. 2018: Breastfeeding & the Achievement Gap

WARMRegards Dec. 2018: Breastfeeding and the Achievement Gap in Low-Income Families


Welcome to WARMRegards! We’ve recently restarted our popular e-newsletter aimed at helping WIC agencies discover the latest developments in technology, applications, and tips-of-the-trade. It’s our goal to support you in reaching and retaining more WIC clients.


The first few years of a baby’s life are the most crucial when it comes to growth and development. During this critical time, babies need nourishment of both their bodies and their minds – and parents are the most vital source of that nourishment. Unfortunately, a child’s socioeconomic status can be a big determiner of their health and achievement both during childhood and later into adulthood.


The disparity between economically advantaged children and economically disadvantaged children is obvious. According to the California Breastfeeding Coalition:

  • 71% of parents with a college degree read to their babies every day
  • 33% of parents without a college degree read to their babies daily
  • 68% of higher-income parents breastfeed
  • 38% of lower-income parents breastfeed


What is the Achievement Gap?

Children from low-income families typically hear roughly thirty million fewer words in the first three years of life than children from higher-income families. Because babies’ brains are little sponges, soaking up everything around them, exposure to words makes a big difference in a child’s verbal skills.


The California Breastfeeding Coalition says that, by the time they are three years old, children from economically advantaged households know 1,100 words, whereas children from economically disadvantaged homes know only 500. That’s less than half! And this word gap continues to grow as children age.


The word gap, which becomes an achievement gap as the child enters their school years, can be attributed to many factors. The National Education Association (NEA) identifies family income level as one of the contributing factors. Tied in with this is the time parents are able to spend reading to their children.


Parents of low-income families tend to spend a lot of time working, particularly at odd hours, leaving them little time to engage with their children and support learning through reading to their children. These families might also experience a dearth of after-school activities and organizations that increase word exposure and enhance learning in children. Rather than placing their child in an educational preschool, these parents are more likely to rely on less-expensive daycares or babysitters for childcare.


How Does Breastfeeding Fit In?

When a mother breastfeeds, she tends to engage more with her child, talking to the baby as it nurses and exposing it to new words and ideas. But much like with words, there is a breastfeeding gap as well. Mothers from low-income households are less likely to breastfeed than higher-income mothers. This is a double-whammy to the child because the child is missing out on that important engagement with mom as well as the nutritional benefits inherent in breastfeeding.


A child’s nutrition at home is identified as another of the contributing factors of the achievement gap by the NEA. Because breast milk is naturally designed to have all the nutrients a baby needs, and is specifically designed for that particular baby’s needs, children who do not breastfeed do not benefit from the irreplaceable hormones, antibodies, enzymes, and growth factors in breast milk. Formula is not capable of reproducing the same benefits as breast milk.


Breastfed babies are shown to get sick less often and less severely. They also have lower mortality rates and lower levels of stress, depression, and anxiety.


Closing the Gap

The best way to close the gap is to prevent it from the beginning. This means working with the low-income mothers your clinic serves to educate them about the achievement gap and the health and developmental benefits of breastfeeding.


An article on the topic by NPR suggests parents not only talk to their children, but engage with them on a regular basis. If the child is showing an interest in something, parents should ask questions about it and encourage a dialogue. This helps children develop not only their listening skills, but their speaking skills as well.


Your clinic can help new mothers learn to engage with their babies by setting up seminars where mothers can learn these strategies and how conversing with their babies can have lifelong benefits. You can use your website or a smartphone app to distribute easy-to-read information that gives moms some simple statistics about the achievement gap as well as strategies for engaging their children on a daily basis, even with a busy schedule. Encourage mothers to talk to their babies every chance they get: during feedings and changings, while in the car, etc.


You can also distribute information about how breastfeeding gives mothers an easy path to engagement, while also ensuring babies are healthier and better-fed. An encrypted chat app can even allow mothers to have one-on-one conversations with nutritionists or other specialists at your clinic, giving mothers the opportunity to ask specific questions and get personalized help and feedback instantly.


Mothers from a poverty background likely grew up in circumstances where they received little engagement as a child, so they aren’t aware that this can be harmful to their own babies. Your first line of defense in closing the achievement gap is educating these mothers on the importance of intellectual engagement with their children and the role breastfeeding plays in a child’s development.


By Shela Ward


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WARMRegards Nov 2018 – WIC in Rural Areas

WARMRegards Nov 2018 – WIC in Rural Areas


Welcome to WARMRegards! We’ve recently restarted our popular e-newsletter aimed at helping WIC agencies discover the latest developments in technology, applications, and tips-of-the-trade. It’s our goal to support you in reaching and retaining more WIC clients.


One of the most common barriers to WIC client retention is difficulty finding transportation to WIC clinics and keeping appointments. It would stand to reason, then, that WIC participation in rural areas would be lower than in metropolitan areas, because rural areas lack access to the public transportation options that are readily available in cities. However, that’s not the case.


The Food Research and Action Center (FRAC) discusses a study by the University of New Hampshire that shows that WIC participation is actually slightly higher in rural areas (46%) than it is in metro areas (42%). The study defines metropolitan areas as those with at least one Census Bureau-delineated urbanized area with a population greater than 50,000. Areas that do not meet that standard qualify as rural areas.

Why Rural Areas Need More Outreach

Although WIC participation by income-eligible families is slightly higher in rural areas, poverty rates are also higher in rural areas, promoting a greater need to reach families. In rural areas, poverty in families with children under the age of six is 26.6%, while in metropolitan areas, it’s 20.4%.


Not only is general poverty an issue in rural communities, but food insecurity is as well. Feeding America shares some pretty disturbing statistics: 2.4 million rural households deal with hunger. Roughly 75% of U.S. counties that face food insecurity are rural, with 86% of counties with child food insecurity being rural. A study published in the Journal of the American Diabetic Association backs this up as well: an analysis of 23 families in rural Appalachia found that 60% were food insecure and 30% experience hunger as a result of that insecurity.


These high rates of poverty and food insecurity can have negative consequences on the health of pregnant women and children. That’s why WIC outreach in these communities is so important. According to the FRAC, signing up more eligible families for WIC can:

  • Improve dietary health in women and children.
  • Lead to better health later in life, including lower rates of adulthood obesity.
  • Improve birth outcomes by lowering preterm births and increasing birth weights.
  • Reduce food insecurity.
  • Enhance economic stability.

What’s Stopping Rural Families from Participating in WIC?

The obvious barrier to WIC participation is transportation, but there are other factors in play as well. Not only is getting to a WIC center difficult due to long distances, but finding a store that is eligible to receive WIC benefits is more difficult as well. Families might have to travel hours to other towns to be able to redeem their benefits, and many feel that the trip is not worth it. In fact, the USDA states that 26% of WIC participants exit the program after their child turns one because they don’t feel the food packages are worth the trouble getting them, and 10% leave because of scheduling and transportation issues regarding getting to WIC appointments.


We can deduce from this information that the two main issues families face in regards to WIC participation are transportation and the value of WIC services.

What Can You Do to Overcome These Barriers?

Promoting the value of your services is essential in reaching potential WIC participants in rural communities. Families in rural areas might be more apt to participate if they know that WIC is a part of the U.S. Department of Agriculture. They might also need lists of eligible stores to redeem benefits, as well as information about the WIC food package. Knowing what the food packages contain and how these packages can benefit the overall health of their children may prompt parents to seek them out more regularly. It is crucial that parents know the many health risks associated with food insecurity.


For small, rural WIC clinics, it can be difficult to help participants with transportation issues. If possible, mobile offices or satellite clinics can help clients get to their appointments more often. You can even reach out to local community centers to provide services at these locations, making it easier for clients to attend.


The best way to overcome transportation issues is to reduce the amount of times participants will need to travel. Minimize the amount of in-person clinic visits required so clients don’t need to travel to WIC clinics so often. You can use technology to assist you in this – for example, provide nutrition education via online classes or a mobile app. For clients in extreme rural areas without access to the internet, you can provide a paper mail-in copy as well. Allowing clients to complete their nutrition education requirements without having to travel hours to a clinic ensures they’ll be more likely to continue with the program.


A strong online presence is also a great way to disseminate information that’s important for moms of young children. You can provide easy-to-understand information and quick videos about crucial topics like food insecurity, breastfeeding, and nutrition.


A mobile app can also help with communicating with rural moms. Rather than having to come in to the clinic to speak with a member of your staff, a secure mobile app allows moms to chat one-on-one without risking the security of their private health information. They can ask questions and get answers and feedback directly from nutrition experts without having to deal with transportation and scheduling issues.


To recap, though WIC participation is slightly higher in rural areas, the need for WIC services is more crucial due to higher levels of poverty and food insecurity. You can help by:

  • Keeping clients informed of the benefits of WIC.
  • Providing mobile clinics.
  • Reducing the number of necessary in-person appointments.
  • Providing nutrition training and important information online or by mail.
  • Setting up a mobile chat app for easier communication.

Shela Ward

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WARMRegards Oct 2018 -Reaching Millennials and Gen-Z

WARMRegards Oct 2018 -Reaching Millennials and Gen-Z


Welcome to WARMRegards! We’ve recently restarted our popular e-newsletter aimed at helping WIC agencies discover the latest developments in technology, applications, and tips-of-the-trade. It’s our goal to support you in reaching and retaining more WIC clients.


Pew Research Center defines Millennials as those born between 1981 and 1996. Those born from 1997 on are considered part of Generation Z. With the oldest Millennials being well into their 30s and the oldest members of Gen-Z beginning to have children of their own, it’s crucial for WIC agencies to find ways to reach out to and communicate with this next generation of moms.


What Do We Know About Millennial and Gen-Z Moms?

The California WIC Association states that an outstanding characteristic of the next generation of moms is that they are more digitally connected than ever. These moms have grown up in a world that is constantly changing – and also a world where knowledge and communication are right at their fingertips. Considered “digital natives,” these generations have been immersed in technology from a young age.


Millennials are the first generation to grow up with technology like smartphones and the Internet. Before them, people were introduced to these technologies well into adulthood. As digital natives, Millennials and Gen-Zers are extremely connected. They have multiple social media accounts, and they use these accounts to make important decisions, says Steadfast Creative. In fact, Gen-Zers have spent their entire lives in a world with cell phones. Many have had a smartphone since they were in elementary school. They know nothing other than a digitally connected world.


Another important thing to know about the new generation of moms is that they’re working more than moms ever have. Pew Research Center has found that 70% of moms with children under 18 are in the labor force, as of 2015. In 1975, that number was only 47%. Also distinguishing these moms is that, in 40% of these cases, the mom is the breadwinner of the family. In 25% of homes, moms are doing it on their own, functioning as single parents. In other words, moms today are busy. That, coupled with their comfort with modern technology, makes the digital space the best way to connect with Millennial and Gen-Z moms.


Connecting to Moms in an Overly-Connected World

In 2016, 82% of births were to Millennial mothers. California WIC suggests that this means WIC agencies need a new approach for reaching moms, describing this approach as “viral.” Millennial and Gen-Z moms want ownership and direct involvement in the services that they use, and they seek peer opinions when deciding on participation.


However, reaching moms can be a challenge. More than 90% of Millennials use the Internet on a daily basis, and they are bombarded with advertisements, information, and social interaction. You want to make sure any outreach doesn’t get lost in the clutter of information Millennials and Gen-Zers are sifting through every day.


Personalized virtual spaces are a great way to provide moms with WIC information and necessities, while also allowing them to avoid in-person visits when they can. These moms are busy, and they prefer to conduct their business virtually as opposed to face-to-face. Personalized WIC services can be catered to their interests and needs, utilizing the technology they’re already comfortable and familiar with.


The National WIC Association says that 87% of Millennials report that their phones never leave their sides throughout the day. Millennials and Gen-Zers spend hours of their day on social media sites, with 84% using Facebook regularly. As a WIC agency, you can use this to your advantage. Create a Facebook page for your clinic, if you don’t already have one, and use it to market yourself to young moms. You can tout the benefits of WIC participation, give parenting and nutrition tips, and start a dialogue with interested moms, all using the social media they’re comfortable with.


Online Support and How Millennial and Gen-Z Moms Benefit From It

Online support is crucial to the new generation of moms. They look to their social media accounts for guidance on momming decisions and support from others who have been there. In fact, this article by Elizabeth King shows that online support may be a contributing factor in the rising breastfeeding rates among Millennials. In her article, King shares statistics from the CDC stating that in 1971, breastfeeding rates were at a low 24%, while in 2010, they’d jumped to 77%. This can be attributed to the support of online communities making new mothers feel comfortable with breastfeeding and teaching them the benefits of breastfeeding.


Using an online platform to offer information about important topics like breastfeeding, nutrition, and the benefits of using WIC can help you reach moms who are unsure of where to start, but turn to their smartphones for information. When you create your virtual WIC space, be sure to include helpful videos on these topics, as well as links to support resources mothers can use.


You can also provide one-on-one support via a secure, encrypted app. While it can be tempting to provide texting services between clients and staff, we would caution you to choose a more secure form of interaction so you can protect your clients’ private health information. Encrypted apps are an easy way to provide one-on-one support and feedback without compromising private health data.


The key to reaching the next generation of moms is keeping information easily accessible. For these moms on-the-go, digital resources and virtual appointments are crucial to reaching and maintaining WIC clients.

By Shela Ward



WarmRegards 08/2018 WIC Services and Infant Feeding Practices

WarmRegards 08/2018 WIC Services and Infant Feeding Practices


Welcome to WARMRegards! We’ve recently restarted our popular e-newsletter for WIC agencies so we can once again bring you the latest developments in technology, applications, and tips-of-the-trade to support you in reaching and retaining more WIC clients.


This month, we’d like to look at parallels between WIC services and clients’ feeding practices, as well as what WIC clinics can do to promote healthy infant feeding practices.


The USDA’s WIC Infant and Toddler Feeding Practices Study compiles years of data to shed light on the association between WIC enrollment and breastfeeding, infant nutrition, and weight status of children up to two years of age. The second study, reported in April 2018, lists several findings:

  • WIC mothers return to work or school by about seven months postpartum, at which point fully employed mothers breastfeed significantly less than part-time or unemployed mothers.
  • WIC children develop self-feeding skills at the expected rates for infants.
  • WIC children receive a varied diet consisting of fruits, vegetables, meats, and dairy, but also consume more candy and sweets.
  • With the exception of Vitamin D, nutrient levels in WIC children meet or exceed recommendations.
  • WIC children exhibit a concerningly high weight-for-length status consistent with low-income children.


Overall, these findings show that WIC is working. WIC mothers are balancing work and breastfeeding and WIC children are receiving the nutrition they need to make developmental progress. However, there is still work to be done. The study shows that WIC children consume high levels of overly sweetened or salty foods, something that could be attributed to low-income lifestyles and the accessibility and affordability of these snacks. WIC children are also falling short on their Vitamin D intake. The high weight-for-length ratio seen in WIC children suggests a higher susceptibility to overweight or obese status later in life.


WIC agencies can implement responsive feeding programs to help mothers and children maintain healthy lifestyles and avoid the pitfalls of low-income eating habits.


Encouraging Responsive Feeding

The most important thing a WIC agency can do for child nutrition is keep mothers informed. A responsive feeding program, consisting of short educational videos and information mothers can watch and access on their devices at home, can teach mothers how to respond to their child’s hunger in a healthy way.


Responsive feeding is demand-based feeding. A good responsive feeding program should clue mothers in to the cues they should look out for that their child is actually hungry, not just distressed or wanting attention. Once the child is being fed, mothers should engage with their child during feeding and pace feeding according to signals given by the child, stopping when the child is full, not when the food runs out.


At the 2018 California WIC Association Conference, Dr. Alison Ventura discussed the implications of feeding children in the absence of hunger. When children are fed for reasons other than hunger (child is fussy, food is available, etc.), children are more likely to be at risk for obesity later in life. It is during this important developmental time that children establish self-regulation skills and learn how to recognize that they’re full. Difficulties recognizing satiety often lead to overeating in later childhood and adulthood.


Make sure that your clinic is providing mothers with information and support about breastfeeding and bottle feeding, as well as responsive feeding techniques. For breastfeeders, information should include:

  • Latching and positioning
  • Recognizing hunger and fullness cues
  • Common breastfeeding problems


Formula feeders should be provided with information on:

  • Positioning
  • Recognizing hunger and fullness cues
  • Common signs of overfeeding
  • Paced bottle feeding


Benefits to Breastfeeding

The American Academy of Pediatrics states that breastfeeding is unequivocally better for babies than bottle feeding. Breastfed infants tend to:

  • Consume lower volumes than bottle-fed infants
  • Gain weight less rapidly
  • Gain less weight in the first two years of life
  • Get sick less often


This is because breastfeeding promotes responsive feeding. With breastfeeding, there is no visible amount of food, so mothers feed until the child begins to resist feeding, indicating they’re full. There is also valuable skin-to-skin contact and eye contact that engages the mother and keeps her from distractedly overfeeding.


Complications with Breastfeeding

Women who do not breastfed may make that choice based on a variety of reasons, though a common factor is prenatal obesity. Women with obese BMIs are more at-risk for a variety of pregnancy-related concerns and are less likely to breastfeed (2018 California WIC Conference).


You can provide valuable nutrition counseling to obese mothers to help them maintain a healthy weight and a healthy pregnancy. Be sure to focus on the prevention of risks, not on the prevention of weight gain and size. You can work with the mothers to focus on nutritious food choices based on cultural foods and favorite foods, while reducing non-nutritious snacks and oversized portions. Review food labels with mothers to discuss serving sizes and reasonable calorie intakes.


Nutrition counseling can be provided to mothers right at your clinic. However, some mothers may not have the time to attend nutrition counseling or may not be able to get to a clinic regularly. In these instances, a secure chat app may be a great way to communicate with mothers one-on-one in a safe environment, allowing you to respond to questions and provide information. You can also provide short, informative videos on your website that mothers can access from their devices at home.


A healthy mother is more likely to breastfeed, resulting in a healthier child. While WIC mothers are breastfeeding at a good rate, there is always room for improvement. Be sure to discuss breastfeeding often with your clients and provide them with easy-to-understand resources.


By Shela Ward


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WarmRegards Blog – 08/2018 Texting for Peer Counseling Programs

WarmRegards Blog – 08/2018 Texting for Peer Counseling Programs

Welcome to the WarmRegards Blog. This blog is supplemental to the popular WarmRegards WIC e-newsletter. Our next issue, “Helping WIC Clients Access Fresh Healthy Foods,” will be released on Thursday, August 23.

Pew Research from Feb 2018 reports that 94% of people age 18-29 and 89% age 30-49 own a smartphone. Obviously electronic communication via smartphone is the method of choice by most WIC participants. It’s an effective tool to engage moms with the goal of increasing breastfeeding rates and WIC participation.

In one study, 353 women were tested to see if weekly text intervention, from 24 weeks gestation to 6 months in age, increased the rates of moms exclusively breastfeeding. At 6 months, the intervention group had almost tripled EBF rates (43%) compared to the control group (15%).

USDA data indicates that moms who are exclusively breastfeeding at six months are more likely to remain on WIC once the child turns one.

A study posted by Colorado WIC Texting for Retention shows that using a texting service to reach out to WIC participants on a routine basis improves retention rates. These studies underscore the value of using text messaging to improve breastfeeding rates, client engagement, and overall WIC participation.

Once participants have received your broadcast text messages, which are designed to be informative and generate engagement, what is the safest way to continue the two-way conversation?

Obviously training protocols are put in place so that peer counselors and other WIC staff understand the necessity of safeguarding client privacy at all times. Peer counselors know they cannot give lactation advice by text: “Use text messages only for simple, quick notes to check in with mom. Discuss specific questions or concerns by phone or in person.” (KY State WIC Texting Policy for Peer Counseling)

Why is it important to ensure that peer counselors never give personal advice by text? Discussing anything personal in nature regarding someone’s current health status (PHI: Protected Health Information) by text is a violation of HIPAA and subject to penalties up to $50,000 per violation.

The HIPAA Journal addresses the technical safeguards over texting. (“When is Texting in Violation of HIPAA?”)

  • Data transmitted beyond an organization´s internal firewall should be encrypted to make it unusable if it is intercepted in transit.

“Standard ‘Short Message Service’ (SMS) and ‘Instant Messaging’ (IM) text messages often fail on all these counts. Senders of SMS and IM text messages have no control over the final destination of their messages. They could be sent to the wrong number, forwarded by the intended recipient or intercepted while in transit. Copies of SMS and IM messages also remain on service providers´ servers indefinitely.

“There is no message accountability with SMS or IM text messages. For these reasons (and many more) communicating PHI by standard, non-encrypted, non-monitored and non-controlled SMS or IM is texting in violation of HIPAA.” (HIPAA Business Journal, 2018)

When using a standard two-way conversational texting platform, can you be assured, 100%, that your staff and peer counselors will never discuss anything deemed to be PHI?

Will a HIPAA-compliant, two-way text platform prevent that risk?

HIPAA states that a covered entity must take appropriate measures to protect PHI. A company can ensure their systems storing the client conversations are secure, but that security is gone once the message leaves the texting platform. It travels through normal SMS messaging channels through the carrier to the text recipient.

Unless that conversation with PHI is encrypted, there is no way to protect the PHI. Any system stating they have HIPAA-compliant texting is misleading. Only you (not the system) have control over the unencrypted text messages you are sending and if they are violating any rules about protecting PHI.

“The HIPAA encryption requirements for transmission security state that covered entities should ‘implement a mechanism to encrypt PHI whenever deemed appropriate’.” (HIPAA Journal, 2018)

Although WIC is exempt from HIPAA, many agencies operate as a hybrid entity covered by their departments as a covered component. How can WIC agencies ensure they are safeguarding participant data to avoid hefty penalties?

 Carefully assess text messages to ensure they do not contain PHI. Keep messages more informative and educational in nature.

  1. Appointment reminders are allowed as long as the message does not state the participant’s health condition. Avoid words like prenatal, diabetic, etc.
  2. If your state requires, collect written authorization before sending messages.
  3. Advertise a method to opt out of texts.
  4. Keep texts 160 characters or less, including spaces, and send no more than 3 per week. (Tcpablog.com)
  5. Only use encrypted chat platforms for two-way conversations, which allow for user authentication and secure sign on.

By just implementing a few protections, as identified above, communicating with WIC moms through text and secure chat apps can be an extremely effective method to improve breastfeeding rates and overall WIC retention.

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