Understanding satisfaction of nutrition education and other services provided in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is needed to ensure the program is responsive to the needs of diverse populations. This study examined the variation of WIC participants’ perceptions and satisfaction with WIC nutrition education and services by race, ethnicity, and language preference. Phone surveys were conducted in 2019 with California WIC families with children aged 1–4 years. While most participants (86%) preferred one-on-one nutrition education, online/mobile apps were also favored (69%). The majority (89%) found nutrition education equally important to receiving the WIC food package. Racial/ethnic groups differed in which WIC service they primarily valued as 20% of non-Hispanic White people rated the food package as more important than nutrition education compared to 5% of Spanish- and 6% of English-speaking Hispanic people, respectively. More Spanish (91%) and English-speaking Hispanic people (87%) than non-Hispanic white (79%) or Black people (74%) changed a behavior because of something they learned at WIC (p < 0.001). Spanish-speaking Hispanic people (90%) had the highest satisfaction with WIC nutrition education. Preferential differences among participants suggest that providing flexible options may improve program satisfaction and emphasizes the need for future studies to examine WIC services by race and ethnicity.
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.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.