Retaining diverse adults with diabetes in a long-term trial: Strategies, successes, and lessons learned

Feasibility and acceptability of a personalized, pre-filled online grocery cart to improve benefit redemption and diet quality of grocery purchases among participants of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)

Most participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) do not fully redeem their benefits due to barriers like transportation, confusing product eligibility, and unclear labeling. Online food shopping enables choice architecture to promote benefit redemption and maximize diet quality. We conducted a mixed-methods pilot randomized-controlled trial to assess the feasibility and acceptability of a pre-filled online grocery shopping cart to improve WIC benefit redemption and diet quality of grocery purchases. Rhode Island WIC participants (n = 24, mean age 29.4 ± 1.1 years, 75% Hispanic, 54% had never grocery shopped online) completed a baseline questionnaire and a simulated shopping episode (SSE), buying WIC and non-WIC items. After a week, we randomized participants into the intervention (personalized, modifiable carts pre-filled with 100% of the 2022 proposed WIC packages) or control (selected their items individually) groups before the second SSE. Both groups had WIC labels. We assessed feasibility using process data and percent agreement to feasibility questions, and acceptability via percent agreement to acceptability questions and post-intervention qualitative interviews. We conducted exploratory analyses to examine differences within and between groups at each timepoint for percent WIC benefit redemption and diet quality of grocery purchases, evaluated using the Grocery Purchase Quality Index-2016 (GPQI-2016) scores. Quantitative study measures suggest that the intervention was feasible and that the personalized, modifiable pre-filled cart was acceptable. These findings were supported during qualitative interviews, where participants highlighted time-savings, flexibility, and WIC labels as facilitators of WIC online shopping. Exploratory results showed significant increases in mean percent redemption of most WIC food categories and non-significant moderate increases in most GPQI-2016 scores. These measures are vital for the future adaptation of a full-scale efficacy trial in real-life settings.

Re-Consenting Pediatric Research Participants as Legal Adulthood Approaches: Lessons from the SPARK Autism Study

To explore issues surrounding re-consenting youth in longitudinal studies as they reach legal adulthood interviews were conducted with 46 parents plus 13 autistic teens enrolled in the Simons Foundation Powering Autism Research for Knowledge (SPARK) study. Qualitative analysis focused on family sensitivities regarding guardianship decisions, transition concerns, and the re-consenting process. Questions regarding guardianship were difficult for parents unsure of a teen's future status. Mothers were key facilitators of re-consenting for soon-to-be-independent teens. As legal adulthood approached, parents were willing to assist teens with re-consenting but needed support, asking for multiple contacts, transition resources, and explanatory materials from the research team. Most teens were not cognizant of SPARK but willing to continue participation once made aware.