Vermont’s WIC state agency has a history of pursuing grant opportunities and innovative projects that advance the program’s mission and quality of service. 2019 was no exception, it being the year that Tufts offered up a grant for telehealth intervention strategy proposals from states. Vermont’s particularly creative idea was sparked when the State WIC director read an article about how gaming applications can be used as educational tools. When Vermont applied for the grant, they did so with this unique idea for improving health access using gamified telehealth already in hand. The staff describe the solution as delivering small doses of information in a fun and engaging way that easily works around a client’s busy schedule.
Project Overview
Vermont WIC is developing a game-based telehealth solution to promote breastfeeding. The app will populate with timely and relevant learning materials during the perinatal period to engage pregnant and early postpartum WIC participants through interactive games (example to the right), reflection activities, and digital tracking tools. The goal of this solution is to improve readiness to breastfeed, increase access to breastfeeding services provided by the WIC program, and mitigate nutrition risk; all functionality and resources will be immediately accessible by ensuring the solution is low-bandwidth and mobile phone compatible.
Contracting and Request for Proposal (RFP)
Because game application development is a unique skill set and not available from in-house state technical services, Vermont WIC issued a request for proposals for a vendor. Technical contracts that may involve protected health information require many layers of review and approval beyond the norm; allowing ample time in the project timeline to allow for a successful procurement process became the first of many lessons learned by the Vermont team. Ultimately, Vermont WIC chose their vendor, a locally-based female-run company specializing in serious game design and possessing a strong understanding of motivators that support learning through games, and got to work on app development. Although the vendor had no prior experience with WIC specifically, they were eager and willing to learn about the needs of the agency, quick to understand the project vision, and effective in building a useful educational tool.
Advice for Others
You cannot prepare for everything.
When the team set out to work on this telehealth solution in 2019, there was no way for them to for see the unprecedented global health events that would come. Between demands from the COVID-19 pandemic response and formula shortage, the team has seen their resources being pulled in multiple directions away from this project. While these events could not have been predicted, VT WIC said they wish they had allocated more time. Developing any new technology solution will encounter setbacks on any number of fronts, be it internal game design, coding, or database development; or external testing or contract procurement. The pandemic or formula shortage were, at the end of the day, just another few setbacks that a projected timeline needs to acknowledge are possible. Allocating extra time or “wiggle room” (at least 3-6 months) into the project timelines provide important flexibility and adaptability.
Knock out what you can.
There will be setbacks when developing anything new. Vermont WIC encountered delays in the contracting process, but chose to persevere towards their goal. Time spent in bureaucratic holding patterns provided the team with the opportunity to create detailed plans and hone content documents that would later be translated into the game format. VT WIC described the ease of meeting with the vendor and jumping into game development quickly after contracting due to their preparation.
Create a project team.
VT WIC set out to build an innovative and technologically advanced product. Early into the project, however, they recognized their team’s gap in technical development knowledge. To address this need, they requested and were granted an IT Director from the Vermont Agency of Digital Services to support the technology side of the project. They also hired an additional team member dedicated to the coordination and execution of the telehealth solution. The team attributed much of the project’s success to these decisions and the resulting collaboration between the game developer, WIC staff content experts, state agency-level employees with technological expertise, and an Advisory Council made up of local WIC staff and family partners.
Communication is everything.
With so many moving parts and groups, the success of the app truly hinged on regular and effective communication. A project group meeting with all key stakeholders occurs weekly to make sure that everything is moving forward. In addition, the internal WIC team meets biweekly to ensure that all the tasks are being done and everyone is on the same page. The team says these regular check-ins have led to rapport and trust building across the entire team working on the solution.
Summary
Vermont WIC saw and seized the opportunity to pilot an innovative telehealth solution and, so far, they have encountered success along the journey. The state is undergoing three phases of development and testing: alpha, beta, and final. The app in the alpha development and testing phase contains all of the major systems but is not yet visually set. The beta phase ends with a more polished version of the entire system and will test the app in a more real-world scenario before receiving feedback. Using the insights from alpha and beta testing, a final version will be developed and tested. After this, the 1.0 version will be live for client use. Vermont WIC eagerly looks forward to their pregnant and postpartum participants using the breastfeeding education game app. Vermont WIC hopes the work they’ve done and the solution they’ve pioneered will benefit other WIC agencies interested in interactive gamification. Their dream is that the project’s goal of improving breastfeeding outreach and education will be used among WIC agencies and participants across the country.
The Vermont WIC Team
Amy Malinowski, Public Health Nutrition Specialist, Project Director
Noah Praamsma, Public Health Nutritionist, Project Coordinator
Tricia Cassi, WIC State WIC Breastfeeding Coordinator, Subject Matter Expert
Karen Flynn, State WIC Director
For more information on Vermont WIC please visit their website here
