JMIR Formative Research · 2 authors, 1 centre
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Only 9% of Wichealth users accessed COVID-19 response resources during the pandemic. Spanish-language users, older users, less educated users, and those with prior lesson engagement were most likely to use the resources. These findings suggest that supplemental information in web-based education systems may require multiple strategies to reach a wider audience.
**Background:** Wichealth is a web-based nutrition education system for families in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). In response to the COVID-19 pandemic, four information resources were added to the user dashboard. Despite consistent availability from April 1, 2020, to October 31, 2021, only 9% (50,888) of eligible users accessed at least one resource. This study aimed to identify user characteristics and behaviors associated with engagement with these emergency resources.
**Methods:** Sociodemographic and behavioral data were collected from Wichealth users who had completed at least one lesson and had a complete profile. The study included 561,827 users (72.9% of 770,290 total users during the period). Logistic regression was used to determine odds ratios (OR) for factors associated with COVID-19 resource access, adjusted for other variables. The model was 79% accurate and explained 66% of variance.
**Key Results:** A total of 50,888 users accessed the resources 66,849 times. Spanish-language users were nearly twice as likely to access resources (OR 1.37, 95% CI 1.29-1.45). Older age groups showed higher likelihood: ages 40-49 (OR 1.06, 95% CI 1.02-1.10) and ≥50 (OR 1.53, 95% CI 1.48-1.58). Lower education levels were associated with higher use: did not finish high school (OR 1.04, 95% CI 1.02-1.07) and high school degree (OR 1.03, 95% CI 1.01-1.04). Users who engaged with their most recent lesson (liking, bookmarking, sharing) were more likely to access resources (OR 1.31, 95% CI 1.28-1.35). Pregnant users (OR 1.15, 95% CI 1.12-1.17) and married users (OR 1.09, 95% CI 1.05-1.12) also showed higher likelihood. Conversely, White (OR 0.79, 95% CI 0.77-0.81) and Black/African American (OR 0.76, 95% CI 0.73-0.78) users were less likely. Users who preferred Wichealth for nutrition education were less likely to use the resources (OR 0.87, 95% CI 0.81-0.94).
**Clinical Implications:** The low overall engagement (9%) suggests that simply making supplemental resources available may not be sufficient to reach the majority of users. Users with prior engagement were more likely to access new resources, indicating that those who use the system only to meet requirements may be left behind. Strategies such as integrating supplemental information into required lessons or using targeted outreach may be needed to increase coverage. The higher engagement among Spanish-language users and older users highlights the importance of tailoring communication and resource placement to different demographic groups.