ABSTRACT
BACKGROUND: The US Department of Agriculture granted waivers to allow flexibility in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) operations during the coronavirus disease 2019 (COVID-19) pandemic; however, research examining the associations between waiver introduction and changes in perceptions, practices, and challenges of WIC participants' and agency directors' experiences is limited. OBJECTIVE: The objective of this study was to assess California WIC participants' and agency directors' perceptions and practices of remote WIC services during the COVID-19 pandemic. A secondary aim was to understand other COVID-19 challenges related to maintaining access to healthy foods by WIC participants. DESIGN: A qualitative study that included semistructured interviews was conducted between June 2020 and March 2021. PARTICIPANTS AND SETTING: One hundred eighty-two WIC participants with a child aged 0 to 5 years from three regions of California (Southern, Central, and Northern) and 22 local WIC agency directors across the state were interviewed. MAIN OUTCOME MEASURES: WIC participants' and agency directors' perceptions, practices, and other challenges during COVID-19. STATISTICAL ANALYSES PERFORMED: Interviews were recorded, transcribed, and analyzed using a grounded theory approach. RESULTS: Participants shared that they valued the information received from WIC and were very satisfied with remote WIC services. Participants reported that enrolling in WIC remotely was easier than coming in person. All waivers and changes to WIC operations, namely the physical presence, remote benefit issuance, and separation of duties waivers, and remote work and remote delivery of nutrition education, were largely viewed by WIC agency directors as options that should be continued postpandemic. Further, a majority (63%) of households reported experiencing food insecurity, and half of respondents received food from a food bank or pantry during the pandemic. CONCLUSIONS: Findings suggest WIC will attract and retain the most families by offering a hybrid model of services, incorporating both onsite services and remote options to work more efficiently and effectively.
Subject(s)
COVID-19 , Food Assistance , Infant , Child , Humans , Female , Pandemics , Health Education , Family CharacteristicsABSTRACT
Objectives Economic impacts of COVID-19 have intensified the burden of food insecurity amongst low-income minority populations, especially women and children. This study aimed to understand the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participant and local agency director experiences with the adoption of USDA federal waivers, designed to overcome operational barriers during the COVID-19 pandemic in 3 regions in California. Methods A qualitative cross-sectional study included structured phone interviews (June 2020-March 2021) in Spanish or English of 182 California WIC participants’ experience and satisfaction with remote interactions, enrollment or recertification in WIC, and shopping for WIC foods. Twenty-two local agency directors were interviewed on how operational challenges were overcome, and preferences on the continuation of specific waivers post-pandemic. The study utilized integrated approach comprised of deductive framework and inductive identification to organize interview responses and identify themes for statistical analysis. Results Most WIC participant respondents (69%) were on WIC prior to the pandemic;39% enrolled in WIC in March 2020 or later. Most participants were moderately (41%) or very (40%) concerned about the pandemic with more than a quarter (29%) experiencing less income due to COVID-19 challenges. A third (30%) reported challenges shopping for WIC foods at the start of the pandemic with the most common being milk (64%), eggs (33%), and fresh fruit (33%). Despite most participants (63%) reporting household food insecurity, 70% reported how easy and quick it was enrolling in WIC services. Most WIC agency directors (59%) reported offering only virtual services. Nearly all (95%) of agency directors wanted to continue the option to certify participants remotely, and all directors desired to continue issuing food benefits remotely, both practices enabled by federal waivers. Directors reported that WIC clinics were successfully able to pivot to remote operations because of the USDA federal waivers. Conclusions WIC may attract and retain most families by incorporating a hybrid approach including both on-site services and remote options. Funding Sources The David and Lucile Packard Foundation.