CHEW 2.0: Expansion of the Children Eating Well (CHEW) Smartphone Application for WIC-Participating Families

Abstract

The overall goal is to adapt, disseminate, implement, and evaluate version 2.0 of the Children Eating Well (CHEW) smartphone application (“Apple”) designed to increase WIC family benefit redemption and improve diet quality and other obesity risk factors among preschool-aged children, while training the next generation of researchers and professionals. Three integrated activities will be carried out: develop and maintain version 2.0 of the CHEW app in English and Spanish, and disseminate it to the WIC program to implement in WIC clinics across Tennessee (Extension); conduct process, outcome, and economic evaluation of the CHEW app implementation in the Tennessee WIC program (Research); and train high school, undergraduate, and graduate students and postdoctoral fellows in the use of technologies for childhood obesity prevention (Education). The WIC program will give the CHEW 2.0 app to around 70,000 WIC families with children ages 2-4 over four years. The process evaluation will assess staff implementation fidelity and satisfaction, uptake of the app by WIC participants (reach), user engagement, and user satisfaction. The outcome evaluation will compare intervention and wait-list control counties on primary outcomes (WIC benefit redemption rate; dietary intake) and secondary outcomes (WIC retention rate, WIC shopping ease, home food environment, child feeding strategies, and obesity risk factors). The economic evaluation will estimate implementation costs, conduct cost-effectiveness analysis, and prepare an economic sustainability plan for Tennessee and future dissemination to other states. Our Cooperative Extension-WIC-researcher partnership integrates students into ongoing content development and represents a mutually beneficial model for disseminating and evaluating interventions with the WIC program.