RESUMEN
BACKGROUND: Little is known about text messaging's influence on child retention in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). OBJECTIVE: This study aimed to evaluate the influence of WICBuzz, a WIC agency drip marketing texting campaign, on retention and participation compared with a comparison WIC agency and to assess WIC participants' perceptions of the campaign's added value. DESIGN: A quasi-experimental design, with pre- and postimplementation measurement, was used to compare innovation and comparison groups' outcomes. Outcome evaluation integrated quantitative analysis of WIC management information system data and survey data of WICBuzz recipients' perceptions. PARTICIPANTS/SETTING: Data obtained for baseline (2019 calendar year) and implementation periods (March 1, 2020, to February 28, 2021), included WIC participation for children who were WIC active at the beginning of each period. WIC agency sample sizes were 6780 to 7452 children from 5189 to 5832 households (baseline) and 4599 to 5004 children from 3186 to 4297 households (implementation). INTERVENTION: WICBuzz, a drip marketing text message campaign with targeted nutrition education and WIC brand awareness messages was the intervention. The comparison agency received standard WIC care. MAIN OUTCOME MEASURES: Main outcome measures included recertification (re-enrollment during the implementation period), timely recertification (within 60 days of prior certification's termination), retention (WIC active at the study period's end), household WIC participation (continuous benefit issuance), and WICBuzz recipients' WIC perceptions. STATISTICAL ANALYSES PERFORMED: Statistical analysis included propensity score weighting and difference-in-difference modeling. Thematic analysis using a deductive approach was used to analyze the process evaluation findings. RESULTS: The influence of WICBuzz on outcomes included 6.7% (95% CI 3.8% to 9.5%) higher recertification, 7.4% (95% CI 4.5% to 10.3%) higher retention, and 10.9% (95% CI 8.0% to 13.8%) higher participation compared with the comparison agency. Most WICBuzz recipients reported added value regarding WIC knowledge and perceptions. CONCLUSIONS: WIC text message campaigns can improve participation and retention and improve participant perceptions of WIC's value.