WIC Outreach Campaign Texting Usage Focus Groups

OMB CONTROL NO.: 0584-0611

EXPIRATION DATE: 11/30/2025

OMB BURDEN STATEMENT: This information is being collected to assist the Food and Nutrition Service in developing a National Outreach Campaign to increase awareness of the health and nutrition benefits associated with specific programs. This is a voluntary collection and FNS will use the information to meet the needs and understand the mindsets of current program participants, as well as those individuals who are eligible but do not participate. This collection does not request any personally identifiable information under the Privacy Act of 1974. According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0584-0611. The time required to complete this information collection is estimated to average 2 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S. Department of Agriculture, Food and Nutrition Service, Office of Policy Support, 1320 Braddock Place, 5th Floor, Alexandria, VA 22306 ATTN: PRA (0584-0611). Do not return the completed form to this address.

Attachment D-2 WIC Non-Participant Focus Group Guide (English)

Focus Group Moderator Guide

Non-Participant Groups:

Target Time ≈ 90 minutes of discussion &

respondents asked to log on 30 minutes before start time

1. Introduction (15 min: 15)

1. Moderator introduction

2. Remind respondents to be in a quiet place

3. If you need to step away, do so briefly and come back as soon as possible

4. Anonymity

5. Rules for participation online (all opinions count, want to hear from all, no wrong answers)

6. Grab a piece of paper and a pen or pencil

7. Research Topic -- We have invited you here because you have a child/children under age 5. We’re going to talk about different methods that programs and brands might share information with you.

8. Introduction – [SHOW SLIDE WITH INTRO PROMPTS]: Please share your first name, the state you live, and who shares your household (people, pets, plants, etc.)

   1. To start things off, give me a word or phrase that you would use to describe your day yesterday. (Quick probe: why did you choose that word?)

   2. Please also share if you are currently expecting or if you are a first-time mom.

2. Brand Communications (25 min: 40)

1. Let’s get started by talking about how you communicate with companies, brands, and providers such as your healthcare providers, government programs, and other service providers? [MODERATOR NOTE: MINIMIZE BRAND CONNECTIONS (INCLUDE ONLY TO GROUND THE RESPONDENTS)].

   1. What are all the ways you engage with healthcare providers, government programs (such as SNAP or Medicaid), products, or brands, ? [IF NEEDED, PROVIDE EXAMPLES]: For example, think about a product or brand you really like. You might follow the company on social media or sign up to receive emails with updates from them. Thinking about service providers or programs, you might sign up to receive appointment reminders, upload documents, or send messages to your healthcare provider or government programs.

   2. [IF NOT COVERED UNAIDED, PROBE]: How are you most likely to sign up to receive information from companies, brands, or programs – email, WhatsApp, text messaging, social media follow/subscribe? [IF NEEDED]: Which apps or programs do you currently use for these communications?

      1. What are the advantages of receiving communications via email? What are the downsides?

      2. What are the advantages and disadvantages of WhatsApp?

      3. What are the advantages and disadvantages of interacting with brands or companies online through their website or social media accounts?

      4. What are the advantages and disadvantages of receiving text messages? What role does texting play in your communication? How does that compare to email or social media?

      5. Apart from receiving texts from programs or providers, have you ever used texts to initiate communication – such as asking a question, requesting an appointment, or signing up for a program or service? What are the pros and cons of this use of texting?

      6. How do you feel about 2-way texting communication with a program or service provider? [IF NEEDED]: For example, you receive a text and have the opportunity to reply, or you send a text and receive a reply from the provider? What are the pros and cons of this?

2. Thinking just about opting in to receive text messages from a service provider, or program – What typically motivates you to enroll in text communications?

   1. How often do you feel that agreeing to receive text messages is required in order to receive a particular benefit vs. a choice you make because you want to hear from them? How do you feel about that?

      1. What kinds of benefits have brands or programs/services offered that felt worth it to sign up for texts?

      2. Have you opted in to receive text messages from any government programs (such as SNAP or Medicaid)? Why or why not?

      3. What would need to be offered from a service provider or program (e.g., your healthcare provider or a government program) to motivate you to enroll?

      4. What brands or programs have you decided not to accept texts from? What led you to say no?

      5. Have you ever signed up and regretted it after? What made you feel that way?

      6. For those programs you have taken the step to unsubscribe, what led you to do that?

I’d like you to think about all of the text messages that you have opted to receive from products, service providers, or programs (not individual people you know).

3. [POLL]: Using this scale of 1 to 5 where 1 means “I open none of this type of text” and 5 means, “I open all of this type of text” – type your rating in the box and submit.

   1. Personalized Content (i.e. Birthday or child development milestones)

   2. Reminders

   3. Educational materials

4. [SHOW RESULTS]. Let’s talk about the text messages you receive from brands, service providers, or programs that you actually open and read. In general, what kind of information, offers, and content are you most likely to open and read?

   1. What words or topics generally catch your attention the best? Why is that?

   2. How do you feel about texts that are customized with your name?

   3. If you received a link to a website or video in one of these texts, what would most likely interest you enough to follow the link?

5. Thinking about the text messages you receive from brands/companies or programs that you might click to open, but not fully read, what typically makes you close the text without reading?

   1. How much influence does the length of the text have on your interest in reading, if any? Why?

   2. How does the tone of the text (if it’s funny, includes emojis, etc.) impact whether you read it all? Why?

   3. How about the frequency of texts? Are there some brands/companies or programs that text more often or less often than you’d like?

   4. How much impact does including images or links to websites or videos have on sparking your interest to read, if at all? Why?

6. What is an example of a text from a brand, provider, or program that you would be happy and grateful to receive? What do you like about it?

7. On the other hand, what is an example of one you would feel annoyed to receive? What do you dislike about it?

8. For any messages that you might receive and delete without opening – what leads you to make that decision?

   1. How much influence does the sender have on your interest in opening? Are there certain brands, companies, or programs that you usually open and others you usually delete without reading? How do you decide?

   2. How does the information in the first line or two of the text impact whether you immediately delete or click to read?

   3. How much influence would including contact information such as phone numbers to call have on your interest in opening and reading? How about links to a website or information online? Texting a certain keyword back?

   4. What else impacts the decision to open, delete, or unsubscribe?

9. How do you know if a text is coming from an authentic source and isn’t spam?

   1. What do you look for to decide whether you can trust the text itself?

   2. How do you decide if it’s safe to click a link provided?

4. WIC Awareness and Brand Perceptions (15 min: 55)

Now let’s focus on your pregnancy or child(ren) under age 5.

1. When looking for advice and information for your child(ren) or during pregnancy, what are all the sources of information you rely/have relied on? These may include people, books, on-line resources, etc. [Probe if texts, email, social media are not mentioned unaided.]

   1. What makes these the best sources for you?

   2. What types of information related to your child(ren) most interests you? What are some examples of child-related information you receive by text?

2. Are there some types of information you prefer to receive from a particular source?
   If so, please share more about that. [IF NEEDED] For example, are you happy to receive “what to expect” information for your child’s milestone developments like eating solid foods from a brand that sells baby food? Would certain information need to come from your child’s doctor only?

   1. What information, if any, do you feel must come from a particular person or information source? What makes you feel this way?

3. Now I want to shift gears a bit and talk about WIC. By a show of hands, how many of you have heard about the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)?

   1. [FOR THOSE WHO HAVE HEARD OF WIC] What do you know about it?

4. Based on the information you’ve heard, who is WIC for?

1. What, if anything, do you know about what makes people eligible for WIC?

   1. Where would you go to find out?

5. To ensure we are all on the same page, I’m going to share a description of the WIC program and what is needed to qualify. [SHOW INFORMATION ON SCREEN].

To qualify for WIC, you must live in the (STATE) and be a:

• Pregnant woman.

• Mom breastfeeding a baby under 1 year of age.

• New mom who had a baby or was pregnant in the past 6 months.

• Infant

• Child younger than 5 years.

WIC welcomes all parents and caregivers! If you are a dad, grandparent, foster parent or any caregiver of a child under 5 years of age, you may get WIC for your child.

You do not have to be a U.S. citizen to be eligible for the WIC program.

WIC is open to many incomes including working and non-working families. If you are on Medicaid, TANF, SNAP or FDPIR, you can be automatically income eligible. If you do not qualify for these programs, you may still qualify for WIC by meeting the income guidelines for your household.

WIC’s primary benefits and services are the foods available through WIC, breastfeeding support, nutrition counseling, and referrals to other healthcare and community or social services.

1. What is your reaction to this information?

1. What stands out as positive? Negative?

2. What, if anything, surprised you?

3. What remaining questions or concerns do you have about this information, if any?

5. Communications from WIC (20 min: 75)

Let’s focus now on your pregnancy or child(ren) under age 5.

1. I’d like you to imagine for the rest of our discussion that you are planning to enroll in WIC to receive benefits for your child(ren) under age 5.

2. If you were enrolled in a program like SNAP or Medicaid, how would you feel about receiving information from WIC, letting you know about WIC and how to apply? If you were given the opportunity to apply by text for the program, how likely would you be to use that method? What leads you to say that?

3. If the WIC program planned to send information to you periodically, how would you prefer to receive these messages (text/email/phone calls/other)?

   1. What works well about these methods of delivery? What are the downsides?

   2. If the WIC program had an app available, what are the advantages and disadvantages of downloading and using the app?

   3. Is there certain information that makes the most sense to be received through a particular method? If so, share more about that.

4. What type of information would you expect to receive from this program?

   1. What would you like to receive in texts from WIC? What makes sense, and feels like a good fit?

   2. On the other hand, what would not fit well coming via text from WIC?

5. Given what you know about WIC today, what would you hope to understand about the program in order to make the decision to apply? [MODERATOR NOTE – IMPORTANT SECTION. PLEASE PRIORITIZE]

   1. Why is this important to understand when you decide whether to apply to the program?

   2. How do you feel about receiving this type of information through text messaging?

   3. Would you like the program details and other important information to be texted to you, or would you prefer to access this online or provided via a phone call?

   4. Would you prefer to start tan application via text, or receive a phone number to call or a link to click to apply online? Why is that?

6. [IF RELEVANT]: For those moms expecting a baby (or thinking back to your most recent pregnancy)what types of information do/did you receive about pregnancy and newborn topics, if any?

   1. What would you find most useful, if anything?

   2. When you think about what WIC might send to expectant mothers, what type of information would you expect to receive from the program?

   3. What feels like a good fit with the program?

   4. What type of content might not fit as well with WIC?

      1. What makes you say that?

7. [SHOW POTENTIAL TEXT COMMUNICATIONS RANK EXERCISE]: I have a list on the screen that includes potential text communications you might receive from WIC. I’d like you to choose the 3 most important items to you.

   1. Application Information

   2. Information about WIC benefits

   3. Eligibility Information

   4. Locations of WIC Agencies in your state/surrounding area

   5. Ability to start the application process via text

   6. Appointment reminders

   7. Ability to schedule appointments

   8. Ability to ask questions

   9. Reminders of available benefits

   10. Nutrition tips, recipes, and meal solutions

   11. Testimonials from current participants

8. [SHOW RESULTS]: Let’s look at the options that rose to the top. Those who ranked ____ at the top of your list, what is it about that idea that appeals to you?

   1. What, if anything would you like to add that could build on/improve this idea?

   2. [REPEAT FOR TOP 3]

   3. [FOR ITEMS IN THE TOP 3-4]: How often would you like to receive text communications on this subject? What makes that the right frequency for you?

9. We didn’t choose the bottom options, but what would you say are the least important offerings? What is it about that idea that was not as interesting to you?

   1. What, if anything about that, would improve or make this a better idea?

   2. [REPEAT FOR 3-4, TIME PERMITTING]

10. What’s missing from this list? What other ideas for services, content, or links would you recommend for WIC text communications with participants?

    1. In what ways would that benefit you?

11. For those receiving texts from other brands, companies, or programs, tell me about the sign-up process. Were these simple opt in checkboxes to accept all texts, or have you been given an opportunity to choose between any options? For example, sometimes they give you an option of checking multiple items that an organization communicates with you on.

    1. What were the options you were provided, if any?

    2. [IF NOT MENTIONED, PROBE]: Were you given topics of interest to choose from? Did you have any options for how frequently you would receive texts?

12. [FOR ALL]: what would you like the sign-up process for WIC text communications to include?

    1. How important are options, if at all?

    2. What options would you like to have?

6. Text Cadence and Frequency (10 min: 85)

1. Now that we’ve covered the “what” (information, content, topics) that a WIC texting program might include, let’s talk about the “when”.

2. If enrolled in WIC Benefits, how often would you like to receive texts from the WIC program?

1. What makes that sound like the right frequency?

3. When you are/were preparing to enroll a new baby, how soon before their due date would you like to receive enrollment information and instructions?

   1. How many reminder texts would you like to receive, and how often?

   2. What other emails regarding enrollment would you like to receive? (For example, a confirmation of your new baby’s enrollment once finalized)

7. Wrap-up (5 min: 90)

Thank you for all of the information you have provided.

1. WRITE: While I check with my colleagues to make sure they do not have any additional questions, please look at the screen and answer the question in the poll and press submit.

   1. [SHOW RESULTS ON SCREEN]

   2. In your own words, what is the most important things for WIC to keep in mind when creating or improving text communication with their participants?

Thanks again! To thank you for your time, you will receive a $75 incentive as a token of appreciation. Have a great evening.