Individual and Household-Level Factors Associated With Caregivers' Intention to Keep Their Child Enrolled in WIC.

OBJECTIVE: Identify factors associated with caregivers' intention to keep their child enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program until age 5 years. METHODS: Baseline data from a longitudinal questionnaire aiming to assess the impact of a statewide intervention to increase WIC retention in Illinois were analyzed in 2018. Data on sociodemographics and household characteristics were collected in 2015 from 174 caregiver/child dyads. Logistic regression was used to identify factors associated with caregivers' intention to keep their child enrolled in WIC until age 5 years (ie, intention). RESULTS: A total of 66% of caregivers stated they were very likely to keep their child enrolled in the WIC program. Breastfeeding and homeownership status were associated with 58% (P =.03) and 72% (P =.02) lower odds of intention among caregivers, respectively. CONCLUSIONS AND IMPLICATIONS: Significant inverse associations among breastfeeding, homeownership, and intention support the need for tailoring state-level WIC retention efforts to specific population characteristics and health behaviors.

Understanding the factors influencing low-income caregivers' perceived value of a federal nutrition programme, the Special Supplemental Nutrition Program for Women, Infants and Children (WIC).

OBJECTIVE: Retention of participants has been an issue in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). It has been suggested that the perceived value of WIC may affect whether participants remain in the programme. The present study aimed to explore this phenomenon. DESIGN: Using a constructivist approach, thirty-one individual in-depth interviews were conducted. Transcripts were analysed using constant comparative analysis. Social, cultural and environmental factors that contribute to the value of WIC were explored as the phenomenon of interest. SETTING: Eight WIC clinics across the State of Illinois, USA.ParticipantsThirty-one caregivers of children enrolled in WIC for at least 6 months. RESULTS: Several factors influenced perceived value of WIC at the interpersonal (level of social support), clinic (value of WIC services v. programme administration issues), vendor (shopping difficulties), community and systems levels (other programme use, stigma and restrictions on food choice). Other themes existed along continua, which overlapped several levels (continuum of perceived need and perceived value of infant formula). CONCLUSIONS: Many caregivers value WIC, especially before their child turns 1 year old. Improvements are needed at the clinic, during shopping and within the food packages themselves in order to increase perceived value of WIC.

Preferences and Perceived Value of WIC Foods Among WIC Caregivers

OBJECTIVE: To evaluate preferences for and values of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) foods and packages and understand what factors may influence these preferences and values. DESIGN: Using a mixed-methods approach, surveys and individual in-depth interviews were conducted to measure and understand preferences for specific WIC foods and how much WIC food packages are worth to participants. SETTING: Eight WIC clinics across Illinois. PARTICIPANTS: Caregivers of infants enrolled in WIC for at least 3-6 months. PHENOMENON OF INTEREST: Preferences for WIC foods, WIC food package values, and factors that influence these categories. ANALYSIS: Frequencies were gathered to analyze survey data and interview transcripts were analyzed using constant comparative analysis to identify emergent themes. RESULTS: Survey (n = 150) and interview (n = 31) participants valued the food packages in WIC but they valued the infant packages more. The cash value fruit and vegetable voucher increased the perceived value of the program for many participants. Restrictions on food choice preferences (eg, type of milk) detracted value from the program. CONCLUSIONS AND IMPLICATIONS: This study shows that providing more choice in the program could improve satisfaction with WIC overall. More research is warranted with a more representative sample to assess whether expanded food choice would improve value of and preference for WIC foods.

The 18-month impact of special supplemental nutrition program for women, infants, and children food package revisions on diets of recipient families.

BACKGROUND: Beginning in 2009, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) revised its food packages and provided more whole grains, fruits, and vegetables and fewer foods with high saturated fat content. However, knowledge of the impact of this policy shift on the diets of WIC participants remains limited. PURPOSE: To examine the longer-term impact of the 2009 WIC food package change on nutrient and food group intake and overall diet quality among African American and Hispanic WIC child participants and their mothers/caregivers. METHODS: In this natural experiment, 24-hour dietary recalls were collected in the summer of 2009, immediately before WIC food package revisions occurred in Chicago IL and at 18 months following the food package change (winter/spring 2011). Generalized estimating equation models were used to compare dietary intake at these two time points. Data were analyzed in July 2013. RESULTS: Eighteen months following the WIC food package revisions, significant decreases in total fat (p=0.002) and saturated fat (p=0.0004) and increases in dietary fiber (p=0.03) and overall diet quality (p=0.02) were observed among Hispanic children only. No significant changes in nutrient intake or diet quality were observed for any other group. The prevalence of reduced-fat milk intake significantly increased for African American and Hispanic children, whereas the prevalence of whole milk intake significantly decreased for all groups. CONCLUSIONS: Positive dietary changes were observed at 18 months post policy implementation, with the effects most pronounced among Hispanic children.

Evaluating the initial impact of the revised Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food packages on dietary intake and home food availability in African-American and Hispanic families.

OBJECTIVE: The present study assessed the impact of the 2009 food packages mandated by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) on dietary intake and home food availability in low-income African-American and Hispanic parent/child dyads. DESIGN: A natural experiment was conducted to assess if the revised WIC food package altered dietary intake, home food availability, weight and various lifestyle measures immediately (6 months) following policy implementation. SETTING: Twelve WIC clinics in Chicago, IL, USA. SUBJECTS: Two hundred and seventy-three Hispanic and African-American children aged 2-3 years, enrolled in WIC, and their mothers. RESULTS: Six months after the WIC food package revisions were implemented, we observed modest changes in dietary intake. Fruit consumption increased among Hispanic mothers (mean = 0·33 servings/d, P = 0·04) and low-fat dairy intake increased among Hispanic mothers (0·21 servings/d, P = 0·02), Hispanic children (0·34 servings/d, P < 0·001) and African-American children (0·24 servings/d, P = 0·02). Home food availability of low-fat dairy and whole grains also increased. Dietary changes, however, varied by racial/ethnic group. Changes in home food availability were not significantly correlated with changes in diet. CONCLUSIONS: The WIC food package revisions are one of the first efforts to modify the nutrition guidelines that govern foods provided in a federal food and nutrition assistance programme. It will be important to examine the longer-term impact of these changes on dietary intake and weight status.