CAREGIVER RISK FACTORS AND REASONS FOR NONPARTICIPATION IN THE WIC PROGRAM

ABSTRACT

Purpose of Study Children's WIC coverage rates nationally and in Connecticut (CT) have gradually decreased over the decades and substantially trail behind Infants' and Pregnant/Postpartum Women's coverage rates. The COVID-19 pandemic compounded this issue;SNAP and Medicaid enrollments increased while WIC enrollments continued to lag. Under these conditions, childhood food insecurity and nutritionrelated health disparities persist. More information is needed to identify risk factors and reasons for caregiver nonparticipation in WIC to inform potential family-centered interventions to decrease attrition. Methods Used This is a single-center cross-sectional survey study. Inclusion criteria were caregivers of WIC-eligible children who are recipients of Medicaid and present to an urban pediatric emergency department in Hartford, CT. Questions focused on caregivers' sociodemographic characteristics and attitudes, knowledge and experiences related to the WIC program. Data were analyzed using exploratory methods and logistic regression, p-values <0.05 considered significant. Summary of Results 288 caregivers met inclusion criteria. Many sociodemographic factors were similar between participants and nonparticipants (table 1). However, an association existed between nonparticipation (NP) and gender, number of adults in a household and presence of healthcare provider- dispensed education on health benefits of WIC. The risk of NP for male compared to female caregivers was 1.6, 95% CI (1.1, 2.0), p=0.02. For caregivers in two-adult households compared to one-adult households the risk of NP was 1.5, 95% CI (1.1, 2.0), p=0.02. The risk of NP for caregivers lacking compared to possessing healthcare provider- sourced education on health benefits of WIC was 1.7, 95% CI (1.3, 2.0), p<<0.01. Nonparticipating caregivers reported not needing WIC services, not knowing how to apply and being ineligible. Caregivers also disclosed barriers related to WIC appointment/clinic availability and accessibility (table 2). Conclusions Risk factors for WIC nonparticipation by caregivers of WIC-eligible children include identifying as male, living in a two-adult household and lacking healthcare providersourced education on health benefits of WIC. This suggests that clinical interventions during primary care visits, with attention to two-adult households and males with WIC-eligible children, may be a key step to decreasing WIC attrition. Further qualitative research is needed to fully grasp nonparticipating caregivers' attitudes towards WIC. (Table Presented).