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Spence EH, Niles MT, Bertmann F, Belarmino EH. Experiences participating in federal nutrition assistance programs during the early months of the COVID-19 pandemic: an investigation in Vermont. Nutr J 2024; 23:74. [PMID: 39004722 PMCID: PMC11247766 DOI: 10.1186/s12937-024-00963-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 05/28/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND Federal nutrition assistance programs serve as safety nets for many American households, and participation has been linked to increased food security and, in some instances, improved diet quality and mental health outcomes. The COVID-19 pandemic brought new and increased economic, social, and psychological challenges, necessitating inquiry into how nutrition assistance programs are functioning and associated with public health outcomes. METHODS Using data from a representative statewide survey administered in Vermont (n = 600) between July and September 2020, we examined participant experiences with major federal nutrition assistance programs: the Supplemental Nutrition Assistance Program (SNAP), the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and school meal programs. We explored quantitative and qualitative responses regarding perceptions of program utility, and used nearest neighbors matching analyses in combination with bivariate statistical tests to assess associations between program participation and food insecurity, perceived stress, and fruit and vegetable intake as indicators of dietary quality. RESULTS One in four respondents (27.3%) used at least one federal nutrition assistance program. As compared to non-participants, we found higher rates of food insecurity among program participants (57.5% vs. 18.1%; p < 0.001), an association that persisted even when we compared similar households using matching techniques (p ≤ 0.001). From matched analyses, we found that, compared to low-income non-participants, low-income program participants were less likely to meet fruit intake recommendations (p = 0.048) and that low-income SNAP and WIC participants were less likely to meet vegetable intake recommendations (p = 0.035). We also found lower rates of perceived stress among low-income school meal participant households compared to low-income non-participants (p = 0.039). Despite these mixed outcomes, participants broadly valued federal nutrition assistance programs, characterizing them as helpful or easy to use. CONCLUSIONS We found that federal nutrition assistance programs as a group were not sufficient to address food insecurity and stress or increase fruit and vegetable intake in the state of Vermont during the early months of the COVID-19 pandemic. Nonetheless, participants perceived benefits from participation in these programs. Optimizing the utility of nutrition assistance programs depends on critical examination of their functioning under conditions of great stress.
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Affiliation(s)
- Emma H Spence
- Food Systems Program, University of Vermont, 109 Carrigan Drive, Burlington, VT, 05405, USA
| | - Meredith T Niles
- Food Systems Program, University of Vermont, 109 Carrigan Drive, Burlington, VT, 05405, USA
- Department of Nutrition and Food Sciences, University of Vermont, 109 Carrigan Drive, Burlington, VT, 05405, USA
- Gund Institute for Environment, University of Vermont, 210 Colchester Ave, Burlington, VT, 05405, USA
| | - Farryl Bertmann
- Food Systems Program, University of Vermont, 109 Carrigan Drive, Burlington, VT, 05405, USA
- Department of Nutrition and Food Sciences, University of Vermont, 109 Carrigan Drive, Burlington, VT, 05405, USA
| | - Emily H Belarmino
- Food Systems Program, University of Vermont, 109 Carrigan Drive, Burlington, VT, 05405, USA.
- Department of Nutrition and Food Sciences, University of Vermont, 109 Carrigan Drive, Burlington, VT, 05405, USA.
- Gund Institute for Environment, University of Vermont, 210 Colchester Ave, Burlington, VT, 05405, USA.
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Hammad NM, Kay MC. Perspectives on healthy eating practices and acceptance of WIC-approved foods among parents of young children enrolled in WIC. PLoS One 2023; 18:e0295902. [PMID: 38127887 PMCID: PMC10734995 DOI: 10.1371/journal.pone.0295902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 12/01/2023] [Indexed: 12/23/2023] Open
Abstract
INTRODUCTION The prevalence of childhood obesity remains high in the United States, particularly among children living in low-income households. Diet quality plays an important role in obesity prevention, particularly among mothers as they serve as role models. Those served by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) receive nutrient-rich foods aimed at increasing diet quality, yet redemption is low. Digital interventions targeting WIC parents show potential for behavior change and could be used for childhood obesity prevention. METHODS This study describes the formative research conducted to understand perspectives on healthy eating practices, acceptance of WIC-approved foods, and preferences for the use of digital tools to improve the purchasing and consumption of WIC-approved foods to improve diet quality. In-depth interviews were conducted with 13 WIC parents and caregivers. RESULTS A variety of definitions for and misconceptions about healthy eating exist among WIC caregivers. Most purchased foods were fruits, vegetables, milk, cheese, and eggs and the least purchased foods were yogurt and peanut butter. The biggest facilitator for purchasing WIC-approved foods was the preference of children and caregivers, whereas the biggest barrier was children's picky eating behaviors. Most caregivers reported using their phone to get nutrition information. Most caregivers reported their interest in receiving weekly text messages and indicated preferences about receiving recipes. CONCLUSION A text messaging program that includes sending weekly messages, recipes, and nutrition tips is hypothesized to improve diet quality and increase redemption of WIC-approved foods.
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Affiliation(s)
- Nour M. Hammad
- Department of Nutrition, Harvard University, Boston, Massachusetts, United States of America
| | - Melissa C. Kay
- Department of Pediatrics, Duke University, Durham, North Carolina, United States of America
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Whaley SE, Anderson CE, Tsai MM, Yepez CE, Ritchie LD, Au LE. Increased WIC Benefits for Fruits and Vegetables Increases Food Security and Satisfaction Among California Households with Young Children. J Acad Nutr Diet 2023; 123:1440-1448.e1. [PMID: 37209964 DOI: 10.1016/j.jand.2023.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 05/09/2023] [Accepted: 05/15/2023] [Indexed: 05/22/2023]
Abstract
BACKGROUND The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a critical source of nutrition support for young children in low-income families, providing access to healthy foods and a cash value benefit (CVB) for the purchase of fruits and vegetables (FV). In 2021, the WIC CVB increased substantially for women and children aged 1 to 5 years. OBJECTIVE To investigate whether or not the increased WIC CVB for purchasing FV was associated with greater redemption of the FV benefit, satisfaction, household food security, and child FV intake. DESIGN Longitudinal study of WIC participants receiving WIC benefits from May 2021 through May 2022. Through May 2021, the WIC CVB for children aged 1 to 4 years was $9/month. The value increased to $35/month from June through September 2021, and changed to $24/month starting October 2021. PARTICIPANTS AND SETTING WIC participants from seven WIC sites in California with one or more child aged 1 to 4 years during May 2021 and one or more follow-up surveys during September 2021 or May 2022 (N = 1,770). MAIN OUTCOMES AND MEASURES CVB redemption (in US dollars), satisfaction with the amount (prevalence), household food security (prevalence), and child FV intake (cups per day). STATISTICAL ANALYSES Associations of increased CVB issuance following the June 2021 CVB augmentation with child FV intake and CVB redemption were assessed using mixed effects regression, and associations with satisfaction and household food security were assessed using modified Poisson regression. RESULTS The increased CVB was associated with significantly greater redemption and satisfaction. At the second follow-up (May 2022), household food security increased by 10% (95% CI 7% to 12%); total FV intake decreased by 0.03 c/day (95% CI -0.06 to -0.01) in the overall sample, but increased by 0.23 c/day (95% CI 0.17 to 0.29) among children with the lowest baseline FV intake. CONCLUSIONS This study documented benefits of augmentation to the CVB for children. WIC policy augmenting the value of WIC food packages to increase access to FV had the intended effects, lending support to making the increased FV benefit permanent.
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Affiliation(s)
- Shannon E Whaley
- Division of Research and Evaluation, Public Health Foundation Enterprises WIC Program, a Program of Heluna Health, Irwindale, California.
| | - Christopher E Anderson
- Division of Research and Evaluation, Public Health Foundation Enterprises WIC Program, a Program of Heluna Health, Irwindale, California
| | - Marisa M Tsai
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, California
| | - Catherine E Yepez
- Division of Research and Evaluation, Public Health Foundation Enterprises WIC Program, a Program of Heluna Health, Irwindale, California
| | - Lorrene D Ritchie
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, California
| | - Lauren E Au
- Department of Nutrition, University of California, Davis, Davis, California
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Kay MC, Hammad NM, Truong T, Herring SJ, Bennett GG. Feasibility, Acceptability, and Initial Efficacy of a Digital Intervention to Improve Consumption of Foods Received within a National Nutrition Assistance Program. Nutrients 2023; 15:nu15020438. [PMID: 36678309 PMCID: PMC9861113 DOI: 10.3390/nu15020438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 12/31/2022] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
Many mothers are vulnerable to poor diet quality, particularly those living in low-income households. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides nutrient-rich foods through its benefits packages, but many WIC participants are not redeeming them. We assessed the feasibility and acceptability of a digital intervention to support redemption and consumption of WIC-approved foods to ultimately improve diet quality. We enrolled 54 maternal-child dyads receiving WIC benefits to receive three to four weekly text messages for 12 weeks focused on behavioral goals to improve consumption of WIC-approved foods. We assessed engagement with weekly tracking messages and satisfaction and collected 24 h dietary recalls to assess preliminary efficacy on dietary intake. Participants were mostly non-Hispanic white (63%) and working (63%), and responded to 7.4 (standard deviation: 4.6) of the 12 weekly messages. Half (n = 27) were high engagers (responded to 80% or more of weekly messages), with 28% (n = 15) responding to all messages. Most felt the feedback (94%) and tips (87%) were helpful and would recommend the program (91%). More were consuming leafy green vegetables compared to baseline (p = 0.01). Mothers of children enrolled in WIC found a text messaging intervention focused on consumption of WIC-approved foods enjoyable and helpful.
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Affiliation(s)
- Melissa C. Kay
- Department of Pediatrics, Duke University, Durham, NC 27708, USA
- Correspondence:
| | - Nour M. Hammad
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Tracy Truong
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC 27708, USA
| | - Sharon J. Herring
- Program for Maternal Health Equity, Center for Urban Bioethics, Temple University, Philadelphia, PA 19140, USA
| | - Gary G. Bennett
- Department of Psychology and Neuroscience, Duke University, Durham, NC 27708, USA
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Caregivers' Perceived Impact of WIC's Temporary Cash-Value Benefit (CVB) Increases on Fruit and Vegetable Purchasing, Consumption, and Access in Massachusetts. Nutrients 2022; 14:nu14234947. [PMID: 36500976 PMCID: PMC9739164 DOI: 10.3390/nu14234947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 11/17/2022] [Accepted: 11/20/2022] [Indexed: 11/23/2022] Open
Abstract
Responding to the COVID-19 pandemic, the American Rescue Plan (2021) allowed state agencies of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) the option of temporarily increasing the Cash-Value Benefit (CVB) for fruit and vegetable (FV) purchases. To examine the impact of this enhancement on WIC caregiver experience, the MA WIC State Office invited 4600 randomly selected MA WIC caregivers to complete an online survey (February-March 2022). Eligible adults had at least one child, had been enrolled at least a year, and were aware of the increase. Of those who opened the screener (n = 545), 58.9% completed it (n = 321). We calculated the frequencies of reporting increased FV outcomes and tested whether responses differed by race/ethnicity, market access, and food security. Most caregivers perceived the CVB increase to benefit FV purchasing (amount and quality, 71.0% and 55.5%), FV consumption (offered to children and personally consumed, 70.1% and 63.2%), and satisfaction with the WIC food package (37.1% reported improved satisfaction, pre- vs. post-increase). Probability of reporting improved outcomes was not found to differ by race/ethnicity, market access, or food security. CVB increases may pose important implications for dietary behaviors and satisfaction with WIC. Policymakers should consider making this increase permanent.
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Federal Food Assistance Program Participation during the COVID-19 Pandemic: Participant Perspectives and Reasons for Discontinuing. Nutrients 2022; 14:nu14214524. [PMID: 36364785 PMCID: PMC9654117 DOI: 10.3390/nu14214524] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/19/2022] [Accepted: 10/24/2022] [Indexed: 11/24/2022] Open
Abstract
This study aims to describe reasons for discontinuing participation and experiences participating in the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC) during the COVID-19 pandemic. We analyzed data from a cross-sectional online survey distributed to a national sample, restricted to (1) households that discontinued participating in SNAP (n = 146) or WIC (n = 149) during the pandemic and (2) households that participated in SNAP (n = 501) or WIC (n = 141) during spring 2021—approximately one year into the pandemic. We conducted thematic analyses of open-ended survey questions and descriptive statistics for Likert-scale items. Themes raised by respondents who discontinued participating in SNAP or WIC included difficulty recertifying and virus exposure concerns. Former WIC participants reported the program was not worth the effort and former SNAP participants reported failing to requalify. Respondents participating in WIC or SNAP during the pandemic mentioned transportation barriers and insufficient benefit value. WIC participants had trouble redeeming benefits in stores and SNAP participants desired improved online grocery purchasing experiences. These results suggest that enhancements to WIC and SNAP, such as expanded online purchasing options, program flexibilities, and benefit increases, can improve program participation to ensure access to critical nutrition supports, especially during emergencies.
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Halverson MM, Karpyn A. WIC Participants’ Perceptions of the Cash-Value Benefit Increase during the COVID-19 Pandemic. Nutrients 2022; 14:nu14173509. [PMID: 36079766 PMCID: PMC9460143 DOI: 10.3390/nu14173509] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/22/2022] [Accepted: 08/24/2022] [Indexed: 11/16/2022] Open
Abstract
Recent changes to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Cash-Value Benefit (CVB), which provides participants with money to spend on fruits and vegetables, have the potential to reduce disparities in healthy food access and food insecurity that were exacerbated by the COVID-19 pandemic. However, few studies have examined how the changes to the CVB allotment that occurred during the pandemic influenced WIC participants’ perceptions of the benefit or their fruit and vegetable purchasing and consumption. To address this gap, we conducted semi-structured interviews with 51 WIC participants in Wilmington, Delaware. Survey measures included demographic questions, the Hunger Vital Sign food insecurity screener, and open-ended questions regarding perceptions of the CVB increase and its influence on participants’ fruit and vegetable purchasing and consumption. Data were analyzed using a hybrid inductive and deductive coding approach. The results demonstrate that higher CVB allotments increased WIC participants’ purchasing and consumption of fruits and vegetables, increased the frequency of their shopping occasions, and enhanced their dietary variety. Our findings also suggest that WIC participants highly value the increased CVB. Consequently, maintaining the increased CVB allotment could improve the nutritional outcomes of low-income mothers, infants, and children participating in WIC.
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Gago CM, Wynne JO, Moore MJ, Cantu-Aldana A, Vercammen K, Zatz LY, May K, Andrade T, Mendoza T, Stone SL, Mattei J, Davison KK, Rimm EB, Colchamiro R, Kenney EL. Caregiver Perspectives on Underutilization of WIC: A Qualitative Study. Pediatrics 2022; 149:184490. [PMID: 35039867 PMCID: PMC8934047 DOI: 10.1542/peds.2021-053889] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/28/2021] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a federal program that improves the health of low-income women (pregnant and postpartum) and children up to 5 years of age in the United States. However, participation is suboptimal. We explored reasons for incomplete redemption of benefits and early dropout from WIC. METHODS In 2020-2021, we conducted semistructured interviews to explore factors that influenced WIC program utilization among current WIC caregivers (n = 20) and caregivers choosing to leave while still eligible (n = 17) in Massachusetts. By using a deductive analytic approach, we developed a codebook grounded in the Consolidated Framework for Implementation Research. RESULTS Themes across both current and early-leaving participants included positive feelings about social support from the WIC clinic staff and savings offered through the food package. Participants described reduced satisfaction related to insufficient funds for fruits and vegetables, food benefits inflexibility, concerns about in-clinic health tests, and in-store item mislabeling. Participants described how electronic benefit transfer cards and smartphone apps eased the use of benefits and reduced stigma during shopping. Some participants attributed leaving early to a belief that they were taking benefits from others. CONCLUSIONS Current and early-leaving participants shared positive WIC experiences, but barriers to full participation exist. Food package modification may lead to improved redemption and retention, including increasing the cash value benefit for fruits and vegetables and diversifying food options. Research is needed regarding the misperception that participation means "taking" benefits away from someone else in need.
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Affiliation(s)
| | | | | | | | | | - Laura Y. Zatz
- Departments of Nutrition,Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Kelley May
- Massachusetts Department of Public Health, Boston, Massachusetts
| | - Tina Andrade
- Massachusetts Department of Public Health, Boston, Massachusetts
| | - Terri Mendoza
- Massachusetts Department of Public Health, Boston, Massachusetts
| | - Sarah L. Stone
- Massachusetts Department of Public Health, Boston, Massachusetts
| | | | | | - Eric B. Rimm
- Departments of Nutrition,Epidemiology,Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Erica L. Kenney
- Departments of Nutrition,Address correspondence to Erica L. Kenney, ScD, Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115. E-mail:
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Zhang Q, Zhang J, Park K, Tang C. App Usage Associated With Full Redemption of WIC Food Benefits: A Propensity Score Approach. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:779-786. [PMID: 34175218 DOI: 10.1016/j.jneb.2021.03.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 03/04/2021] [Accepted: 03/07/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To examine the relationship between WICShopper application (app) usage and full redemption of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food benefits. DESIGN A cross-sectional study. SETTING West Virginia WIC program. PARTICIPANTS A total of 23,050 West Virginia WIC households in 2019. MAIN OUTCOME MEASURES Full redemptions were defined as the redemption rate of ≥ 90% for a given food benefit. ANALYSIS App/non-app users were defined as households with someone using/not using the WICShopper app. Multivariate logistic regressions were applied. To address the potential self-selection bias in app usage, the propensity score (PS) of app usage was estimated. The regressions were rerun with the balanced sample by matching the PS. RESULTS With PS matching, the prevalence of full redemption at the household level was 7.2% for app users vs 4.7% for nonapp users (odds ratio, 1.64; 95% confidence interval, 1.40-1.92; P < 0.001). App users had a higher prevalence of full redemption in most food categories, even with PS matching. CONCLUSIONS AND IMPLICATIONS Use of the WICShopper app was associated with a higher prevalence of full redemptions in most food benefits after controlling the self-selection bias.
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Affiliation(s)
- Qi Zhang
- School of Community and Environmental Health, Old Dominion University, Norfolk, VA.
| | - Junzhou Zhang
- Department of Marketing, Feliciano School of Business, Montclair State University, Montclair, NJ
| | - Kayoung Park
- Department of Mathematics and Statistics, Old Dominion University, Norfolk, VA
| | - Chuanyi Tang
- Department of Marketing, Old Dominion University, Norfolk, VA
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Cabili C, Briefel R, Forrestal S, Gabor V, Chojnacki G. A Cluster Randomized Controlled Trial of a Home-Delivered Food Box on Children's Diet Quality in the Chickasaw Nation Packed Promise Project. J Acad Nutr Diet 2021; 121:S59-S69. [PMID: 33342526 DOI: 10.1016/j.jand.2020.08.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 08/02/2020] [Accepted: 08/12/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Poor diet quality among children can lead to poor health, development, and academic achievement. Child nutrition assistance programs aim to improve diet quality among children. OBJECTIVE This study tested the impact of the Packed Promise intervention on diet quality among low-income children in Chickasaw Nation territory. DESIGN This study was a cluster randomized controlled trial of 40 school districts and 4,750 eligible, consented households within treatment and control districts. PARTICIPANTS/SETTING Household data were collected at baseline (n = 2,859) and follow-up (n = 2,852) in 12 rural Oklahoma counties. INTERVENTION Packed Promise treatment households chose from 5 types of home-delivered food boxes that contained nutritious foods ($38 food value) and a $15 check for purchasing fruits and vegetables. MAIN OUTCOME MEASURES Key outcomes included children's daily consumed amounts of fruits and vegetables, whole grains, and added sugars collected by a dietary screener questionnaire. Other outcomes included food shopping frequency, type of grocery store used, distance traveled from home to grocery stores, and the number of weekly family dinners. All outcomes in this article are secondary to the study's primary outcome-food insecurity among children. STATISTICAL ANALYSES PERFORMED Differences between the treatment and control groups were estimated by a regression model controlling for baseline characteristics and population-based average portion sizes. RESULTS Children's mean daily consumption of fruits and vegetables combined was about 2.35-cup equivalents in the treatment group and 2.25-cup equivalents in the control group (P < 0.001). Mean consumption of whole grains was 0.73-ounce equivalents in the treatment group compared with 0.67-ounce equivalents in the control group (P < 0.001). Other outcomes were not statistically significant. CONCLUSION Packed Promise led to significant but small improvements in children's daily consumption of fruits and vegetables and whole grains. Several factors, including household participation levels in Packed Promise, may have moderated the size of impacts. FUNDING/SUPPORT This article is published as part of a supplement supported by the US Department of Agriculture, Food and Nutrition Service.
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Lakshmanan A, Song AY, Flores-Fenlon N, Parti U, Vanderbilt DL, Friedlich PS, Williams R, Kipke M. Association of WIC Participation and Growth and Developmental Outcomes in High-Risk Infants. Clin Pediatr (Phila) 2020; 59:53-61. [PMID: 31672064 PMCID: PMC8345225 DOI: 10.1177/0009922819884583] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The objective of this study was to describe the association of enrollment in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), the Supplemental Nutrition Assistance Program (SNAP), and infant growth and neurodevelopmental outcomes. Z scores and Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III) and Vineland Adaptive/Behavior Scale-II (VABS-II) scores represented primary outcomes. We conducted bivariate analyses and linear regression. Children who were enrolled in WIC or WIC/SNAP had weight z scores U (95% confidence interval [CI]) that were 1.32 (0.42-2.21) or 1.19 (0.16-2.23) units higher. Enrollment in WIC or WIC/SNAP was associated with a higher score (95% CI) of 11.7 U (1.2-22.2 U) or 11.5 (0.1-22.9) for Bayley-III cognitive score and 10.1 U (1.9-19.1 U) or 10.3 (0.9-19.7) for the VABS-II composite score. These findings support increased advocacy for participation in WIC or WIC/SNAP for families with high-risk infants.
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Affiliation(s)
- Ashwini Lakshmanan
- Fetal and Neonatal Medicine, Division of Neonatology, Department of Pediatrics, Children’s Hospital Los Angeles; Keck School of Medicine, University of Southern California, Los Angeles, CA, United States,Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States,Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, United States
| | - Ashley Y. Song
- Fetal and Neonatal Medicine, Division of Neonatology, Department of Pediatrics, Children’s Hospital Los Angeles; Keck School of Medicine, University of Southern California, Los Angeles, CA, United States,Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Nicole Flores-Fenlon
- USC/LAC+USC Neonatal-Perinatal Medicine Fellowship Program, Division of Neonatology, LAC+USC Medical Center, Keck School of Medicine of USC, Los Angeles, CA, United States
| | - Urvashi Parti
- Fetal and Neonatal Medicine, Division of Neonatology, Department of Pediatrics, Children’s Hospital Los Angeles; Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Douglas L. Vanderbilt
- Fetal and Neonatal Medicine, Division of Neonatology, Department of Pediatrics, Children’s Hospital Los Angeles; Keck School of Medicine, University of Southern California, Los Angeles, CA, United States,Division of General Pediatrics, Children’s Hospital Los Angeles; Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Philippe S. Friedlich
- Fetal and Neonatal Medicine, Division of Neonatology, Department of Pediatrics, Children’s Hospital Los Angeles; Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Roberta Williams
- Division of Cardiology, Children’s Hospital Los Angeles; Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Michele Kipke
- Saban Research Institute, Children’s Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
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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). Public Health Nutr 2018; 22:1056-1065. [PMID: 30522548 DOI: 10.1017/s1368980018003336] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
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.
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