Childhood obesity has increased rapidly in recent decades. Risk for obesity increases sharply after age 5 and is greater in limited-resource families. USDA's Special Supplemental Nutrition Program for Women, Infants, and Children ("WIC Program") serves 9.3 million limited-resource, nutritionally at-risk mothers, infants, and children under age 5 in the U.S. WIC provides free supplemental healthy foods, nutrition education, breastfeeding support, and healthcare referrals. WIC improves diet quality among low-income children, but participation in the program drops as children age, particularly at ages 2-4. New strategies are needed to increase the use of WIC benefits and consumption of WIC foods, to reinforce WIC nutrition education between quarterly visits, and to effectively use technology in WIC nutrition education. The Children Eating Well (CHEW) smartphone application ("app") developed by our team addresses these needs. The vast majority of WIC participants use smartphones. The CHEW app is designed to increase use of WIC benefits through easy-to-use WIC shopping tools and to increase consumption of WIC foods through built-in nutrition education tools. In addition, the app could potentially help encourage families to stay in the WIC program longer.When we tested a prototype version of the CHEW app, it was positively received by WIC participants. The Tennessee WIC program now wants to use the CHEW app in WIC clinics across the state. We first plan to enhance the features of the CHEW app, then we will roll it out in WIC clinics across the state of Tennessee, reaching over 70,000 families with 2-4 year-old children. The overall goal for this five-year project is to evaluate the impact of the CHEW app on increasing the use of WIC benefits, improving diet quality, and reducing other obesity risk factors among preschool-aged children from limited-resource families. In addition, we will estimate the costs of implementing the CHEW app and how cost-effective it is for the WIC program to use it. Our long-term goal is to later adapt the CHEW app for WIC programs to use in other states across the country. In addition, we will train high school, undergraduate, and graduate students and postdoctoral fellows to become the next generation of childhood obesity prevention researchers and professionals.

Douglas Schmidt
Shelagh Mulvaney
United States Department of Agriculture
Lead PI
Douglas Schmidt