Objectives In response to the COVID-19 pandemic, the USDA announced a temporary augmentation of the cash value benefit (CVB) for vegetables and fruits across all Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) agencies nationally, increasing the child CVB from $9 to $35/month for 4 months in the summer of 2021. The augmentation has continued since October 2021, with children ages 1 to 4 years receiving a CVB of $24/month. This study aimed to understand if augmenting the value of the WIC CVB for vegetables and fruits is associated with access to fruits and vegetables, fruit and vegetable intake (FVI), household food insecurity, and WIC program satisfaction among WIC participants from Los Angeles County, California. Methods This longitudinal, observational study of the 2021 CVB augmentation involved data collection using surveys at three time points: baseline (May 2021), midpoint (September 2021, before the CVB reduced from $35 to $24/month) and endpoint (May 2022, to be conducted). Detailed data on child FVI (using the NHANES Dietary Screener Questionnaire), household food security (using the USDA 6-item food security screener), and parental perception of the CVB changes were collected. Descriptive statistics and changes in study outcomes for respondents from baseline to midpoint were calculated in the full sample and stratified by race and ethnicity. Results 1,673 families completed both baseline and midpoint surveys. Following the increased CVB amount ($9 to $35), the proportion of families reporting the benefit was ‘not enough’ decreased (89% to 23%) and the proportion saying the benefit was ‘just right’ increased (7% to 73%) (p < 0.0001). Household food insecurity decreased following the increase in CVB (55% to 44%, p < 0.0001). Child FVI decreased between baseline and midpoint surveys (2.43 vs 2.37 cups/day, p < 0.01). Baseline to midpoint change in FVI did not differ significantly by race and ethnicity (p = 0.19). Conclusions A short-term increase in WIC CVB was associated with improved participant experience and higher food security in California WIC participants. Longer-term increases in CVB may be needed to improve child fruit and vegetable intake. Funding Sources Robert Wood Johnson Foundation Healthy Eating Research Program and The David and Lucile Packard Foundation.

Objectives The COVID-19 pandemic has changed the way that the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) delivers services. The USDA granted multiple waivers to allow flexibility in WIC operations during the pandemic. The objective of this study was to hear from WIC participants about the impact of changes due to COVID-19. Methods In the summer of 2020, 60 semi-structured interviews were completed, half with English-speaking and half with Spanish-speaking WIC participants in the Los Angeles area. Interviews were recorded, transcribed, and analyzed using a deductive content analysis approach to describe responses and identify themes. Results Four themes emerged: 1) The pandemic has exacerbated the ckhallenges facing low-income families; 2) WIC continues to be a valued resource especially under the challenging circumstances; 3) WIC's transition to remote service delivery has ensured that families continue to receive not only critical WIC food benefits, but also nutrition education and support; 4) Lessons learned during COVID-19 can inform needed WIC modernizations to maximize WIC's proven benefits post-pandemic. Nearly 75% of WIC participants faced reductions in income due to job loss or reduced work hours. Nearly 60% of households reported experiencing food insecurity. Early in the pandemic, many reported challenges accessing WIC-eligible foods, resulting in lost food benefits. Approximately 43% reported getting food from a food pantry or church, with most (77%) reporting first time usage. Participants shared that even with the change to only remote education, they valued the information and were very satisfied with WIC services. The majority (83%) found the California WIC App helpful in informing what WIC foods they could purchase. Participants also reported that enrolling in WIC remotely was easier than coming in-person and they were comfortable providing documents related to income and eligibility determination remotely. Conclusions WIC has been essential in helping families cope with COVID. WIC's transition to remote service delivery has ensured seamless and safe delivery of services, helping families with young children during an unprecedented time of need. Funding Sources The David and Lucile Packard Foundation

The purpose of this randomized‐controlled trial was to compare the impact of online to in‐person group nutrition education on changes in knowledge, beliefs, and behaviors related to breakfast eating. The content of the lesson focused on ways to reduce breakfast skipping and promoted healthy options at breakfast for parents and their 1‐5 year‐old children on WIC. Questionnaires were administered before and after‐education, and at a 2‐4‐month follow‐up to 604 California WIC participants. T‐tests and x2 tests were used to compare changes within and between in‐person versus online groups. ANOVA and GEE analysis were used to assess differences in change between groups over time. Increases in the frequency of eating breakfast were greater for both parents (P=0.001) and children (P=0.003) in the online group compared to the in‐person group. Both groups reported reductions in barriers to eating breakfast due to time constraints, not having enough foods, and hunger. Positive changes in knowledge were similar, but decreasing 100% fruit juice consumption was only seen in the in‐person compared to the online group for both parents (P=0.005) and children (P=0.01). Satisfaction with the class was high in both groups, but significantly higher in the online group (P=0.0001). Overall, this study supports online nutrition education as a viable supplement to traditional education to promote healthy breakfast behaviors; however in‐person education may be better for sustained behavior change in WIC participants.

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