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D’Angelo Campos A, Ng SW. Nutritional quality of food purchases during the COVID-19 public health crisis: An analysis of geographic disparities in North Carolina. Prev Med Rep 2024; 44:102812. [PMID: 39091570 PMCID: PMC11292539 DOI: 10.1016/j.pmedr.2024.102812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 06/28/2024] [Accepted: 06/30/2024] [Indexed: 08/04/2024] Open
Abstract
Objective To examine geographic disparities in the nutritional quality of food purchases during the COVID-19 public health crisis in North Carolina (NC). Methods Using shopper-level longitudinal transaction records between October 2019- and December 2020 from NC's largest grocery retailer, we fit mixed-effect models to examine disparities in the nutritional quality of food purchases among shoppers in counties with different levels of socioeconomic development and how such disparities changed after March 2020, accounting for other observed and contextual factors. Results Shoppers in counties with lower development levels purchased a larger share of calories from least healthy foods and a smaller share from healthier foods compared to shoppers in counties with higher development levels. These disparities were slightly attenuated for the least healthy foods and did not change for healthier foods after the onset of the COVID crisis. Conclusion Despite existing nutritional disparities among shoppers in counties with different levels of socioeconomic development, we did not observe a large-scale accentuation of inequities in dietary quality during the COVID-19 crisis. This pattern may have resulted from programmatic responses to mitigate the adverse effects of the COVID crisis on vulnerable populations. Future work should further explore the role of such responses.
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Affiliation(s)
- Aline D’Angelo Campos
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Shu Wen Ng
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Richardson TN, Ventura AK, Brewer A, Shirwani A, de la Barrera B, Kay MC. Awareness and Support of Responsive Bottle Feeding Among WIC Counselors and Caregivers: A Formative Qualitative Study. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:342-350. [PMID: 38466247 PMCID: PMC11081858 DOI: 10.1016/j.jneb.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 03/12/2024]
Abstract
OBJECTIVE To understand the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) counselor experiences discussing responsive bottle feeding during counseling and WIC participants' knowledge, understanding, and use of responsive bottle feeding. METHODS Qualitative descriptive, semistructured interviews with 23 participants (8 WIC counselors and 15 WIC participants) were conducted online via Zoom. The WIC counselors and mothers of WIC-enrolled bottle-fed infants were recruited through a network of WIC clinics in North Carolina. Interviews were recorded, transcribed, and collaboratively analyzed using content analysis. RESULTS The WIC participants received responsive infant feeding support from WIC counselors but often in the context of breastfeeding. WIC counselors provided valuable support for families but were challenged by limited training on responsive bottle feeding, balancing promoting breastfeeding with supporting mothers' feeding decisions, and time constraints. CONCLUSIONS AND IMPLICATIONS Findings provide preliminary support for the need to develop and pilot an intervention focused on promoting responsive feeding for parents of bottle-fed infants.
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Affiliation(s)
- Taylor N Richardson
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC.
| | - Alison K Ventura
- Department of Kinesiology and Public Health and Center for Health Research, California Polytechnic State University, San Luis Obispo, CA
| | | | - Avan Shirwani
- School of Osteopathic Medicine, Campbell University, Lillington, NC
| | | | - Melissa C Kay
- Department of Pediatrics, Duke University, Durham, NC
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Halpern-Meekin S, Gennetian LA, Hoiting J, Stilwell L, Meyer L. Monthly unconditional income supplements starting at birth: Experiences among mothers of young children with low incomes in the U.S. JOURNAL OF POLICY ANALYSIS AND MANAGEMENT : [THE JOURNAL OF THE ASSOCIATION FOR PUBLIC POLICY ANALYSIS AND MANAGEMENT] 2024; 43:871-898. [PMID: 39035030 PMCID: PMC11257019 DOI: 10.1002/pam.22571] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/23/2024]
Abstract
Recently, U.S. advocates and funders have supported direct cash transfers for individuals and families as an efficient, immediate, and non-paternalistic path to poverty alleviation. Open questions remain, however, about their implementation. We address these using data from debit card transactions, customer service call-line logs, and in-depth interviews from a randomized control study of a monthly unconditional cash gift delivered via debit card to mothers of young children living near the federal poverty line. Because much of the impact of the intervention occurs through mothers' decisions about how to allocate the Baby's First Years (BFY) money, we argue that implementation science must recognize the role of policy targets in implementing policy, not just in terms of policy outcomes but also policy implementation processes. Further, our analysis shows that mothers experience key aspects of the cash intervention's design as intended: they viewed the cash gift as unconditional and knew the money was reliable and would continue monthly, receiving the correct amount with few incidents. Delivering funds via debit card worked well, offering mothers flexibility in purchasing. We also illuminate how design features shaped mothers' experiences. First, although they knew it was unconditional, the social meaning of the BFY money to mothers-seen as "the baby's money"-shaped their engagement with and allocation of it. Second, low public visibility of mothers' receipt of this money limited the financial demands or requests from others, potentially facilitating more agency over and a greater ability to use the money as they chose, without claims from kin.
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Affiliation(s)
- Sarah Halpern-Meekin
- School of Human Ecology and La Follette School of Public Affairs, University of Wisconsin-Madison, 1300 Linden Dr., University of Wisconsin-Madison, Madison, WI 53711
| | - Lisa A Gennetian
- Public Policy & Pritzker Professor of Early Learning Policy Studies at Duke University, 212 Rubenstein Hall, Duke University, Durham, NC 27708
| | - Jill Hoiting
- Sandra Rosenbaum School of Social Work, University of Wisconsin-Madison, 1350 University Avenue, Madison, WI 53706
| | - Laura Stilwell
- Sanford School of Public Policy, Duke University and Duke University School of Medicine, 201 Science Drive, Durham, NC 27708
| | - Lauren Meyer
- Project Director of Baby's First Years, Teachers College, Columbia University, 525 West 120th Street, RH 21, New York, NY 10027
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DuMont K. Commentary for Special Issue on Advancing Health Equity Among Black Communities: Implications for Research Funders (and Researchers). PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:119-125. [PMID: 38190044 PMCID: PMC11196317 DOI: 10.1007/s11121-023-01636-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2023] [Indexed: 01/09/2024]
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Asada Y, Bleiweiss-Sande R, Barnes C, Lane H, Chriqui JF. In Pursuit of Equitable Access in Federal Food and Nutrition Assistance Programs. Am J Public Health 2023; 113:S175-S179. [PMID: 38118097 PMCID: PMC10733889 DOI: 10.2105/ajph.2023.307496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2023] [Indexed: 12/22/2023]
Affiliation(s)
- Yuka Asada
- Yuka Asada is with the School of Public Health, University of Illinois, Chicago. Rachel Bleiweiss-Sande is with Mathematica in Princeton, NJ. Carolyn Barnes is with the Crown Family School of Social Work, Policy, and Practice, The University of Chicago. Hannah Lane is with the Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC. Jamie F. Chriqui is with the Division of Health Policy Research, Institute for Health Research and Policy, and Department of Health Policy and Administration, School of Public Health, University of Illinois, Chicago. Yuka Asada and Rachel Bleiweiss-Sande are also Guest Editors for this supplement issue
| | - Rachel Bleiweiss-Sande
- Yuka Asada is with the School of Public Health, University of Illinois, Chicago. Rachel Bleiweiss-Sande is with Mathematica in Princeton, NJ. Carolyn Barnes is with the Crown Family School of Social Work, Policy, and Practice, The University of Chicago. Hannah Lane is with the Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC. Jamie F. Chriqui is with the Division of Health Policy Research, Institute for Health Research and Policy, and Department of Health Policy and Administration, School of Public Health, University of Illinois, Chicago. Yuka Asada and Rachel Bleiweiss-Sande are also Guest Editors for this supplement issue
| | - Carolyn Barnes
- Yuka Asada is with the School of Public Health, University of Illinois, Chicago. Rachel Bleiweiss-Sande is with Mathematica in Princeton, NJ. Carolyn Barnes is with the Crown Family School of Social Work, Policy, and Practice, The University of Chicago. Hannah Lane is with the Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC. Jamie F. Chriqui is with the Division of Health Policy Research, Institute for Health Research and Policy, and Department of Health Policy and Administration, School of Public Health, University of Illinois, Chicago. Yuka Asada and Rachel Bleiweiss-Sande are also Guest Editors for this supplement issue
| | - Hannah Lane
- Yuka Asada is with the School of Public Health, University of Illinois, Chicago. Rachel Bleiweiss-Sande is with Mathematica in Princeton, NJ. Carolyn Barnes is with the Crown Family School of Social Work, Policy, and Practice, The University of Chicago. Hannah Lane is with the Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC. Jamie F. Chriqui is with the Division of Health Policy Research, Institute for Health Research and Policy, and Department of Health Policy and Administration, School of Public Health, University of Illinois, Chicago. Yuka Asada and Rachel Bleiweiss-Sande are also Guest Editors for this supplement issue
| | - Jamie F Chriqui
- Yuka Asada is with the School of Public Health, University of Illinois, Chicago. Rachel Bleiweiss-Sande is with Mathematica in Princeton, NJ. Carolyn Barnes is with the Crown Family School of Social Work, Policy, and Practice, The University of Chicago. Hannah Lane is with the Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC. Jamie F. Chriqui is with the Division of Health Policy Research, Institute for Health Research and Policy, and Department of Health Policy and Administration, School of Public Health, University of Illinois, Chicago. Yuka Asada and Rachel Bleiweiss-Sande are also Guest Editors for this supplement issue
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Barnes C, Halpern-Meekin S, Hoiting J. "I Used to Get WIC… But Then I Stopped": How WIC Participants Perceive the Value and Burdens of Maintaining Benefits. THE RUSSELL SAGE FOUNDATION JOURNAL OF THE SOCIAL SCIENCES : RSF 2023; 9:32-55. [PMID: 38486832 PMCID: PMC10939995 DOI: 10.7758/rsf.2023.9.5.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
This study examines how individuals assess administrative burdens and how these views change over time within the context of the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC), which provides food to pregnant and breastfeeding women and children under age five. Using interview data from the Baby's First Years: Mothers' Voices study (n. = 80), we demonstrate how the circumstances of family life, shifiing food needs and preferences, and the receipt of other resources shape how mothers perceive the costs and benefits of program participation. We find that mothers' perceptions of WIC's costs and benefits vary over time and contribute to program participation trajectories, so many eligible people do not participate; need alone does not drive participation decisions.
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Affiliation(s)
- Carolyn Barnes
- Sanford School of Public Policy at Duke University, United States
| | - Sarah Halpern-Meekin
- School of Human Ecology and the La Follette School of Public Affairs at the University of Wisconsin-Madison, United States
| | - Jill Hoiting
- Sandra Rosenbaum School of Social Work at the University of Wisconsin-Madison, United States
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Frank TL, Jabbari J, Roll S, Ferris D, Terada T, Gilbert A, McDermott L. Connecting the Dots between Barriers to W.I.C. Access and Adult and Child Food Insecurity: A Survey of Missouri Residents. Nutrients 2023; 15:nu15112496. [PMID: 37299459 DOI: 10.3390/nu15112496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 05/20/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023] Open
Abstract
Background. Previous research has explored the impact of W.I.C. on recipients' health, but less is known about the connection between barriers to W.I.C. access and health outcomes. We fill in a gap in the literature by studying the relationship between barriers to Special Supplemental Nutrition Program for Women, Infants, and Children (W.I.C.) access and adult and child food insecurity. Methods. After survey administration, we analyzed a cross-sectional sample of 2244 residents in Missouri who have used W.I.C. or lived in a household with a W.I.C. recipient in the past three years. We ran logistic regression models to understand the relationships among barriers to W.I.C. utilization, adult food insecurity, and child food insecurity. Results. Having special dietary needs (for adults), lacking access to technology, encountering inconvenient clinic hours of operation, and experiencing difficulties taking off work were associated with increased adult food insecurity. Difficulties finding WIC-approved items in the store, technological barriers, inconvenient clinic hours, difficulties taking off work, and finding childcare were associated with increased child food insecurity. Conclusion. Barriers to accessing and utilizing W.I.C. are associated with adult and child food insecurity. However, current policies suggest promising approaches to curbing these barriers.
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Affiliation(s)
- Tyler L Frank
- Social Policy Institute, Brown School, Washington University in St. Louis, 1 Brookings Drive, St. Louis, MO 63130, USA
| | - Jason Jabbari
- Social Policy Institute, Brown School, Washington University in St. Louis, 1 Brookings Drive, St. Louis, MO 63130, USA
| | - Stephen Roll
- Social Policy Institute, Brown School, Washington University in St. Louis, 1 Brookings Drive, St. Louis, MO 63130, USA
| | - Dan Ferris
- Social Policy Institute, Brown School, Washington University in St. Louis, 1 Brookings Drive, St. Louis, MO 63130, USA
| | - Takeshi Terada
- Social Policy Institute, Brown School, Washington University in St. Louis, 1 Brookings Drive, St. Louis, MO 63130, USA
| | - Amanda Gilbert
- Social Policy Institute, Brown School, Washington University in St. Louis, 1 Brookings Drive, St. Louis, MO 63130, USA
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Pandemic-Era WIC Participation in Wilmington, Delaware: Participants' Experiences and Challenges. Nutrients 2023; 15:nu15030520. [PMID: 36771226 PMCID: PMC9921907 DOI: 10.3390/nu15030520] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/14/2023] [Accepted: 01/17/2023] [Indexed: 01/21/2023] Open
Abstract
Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participants faced unprecedented challenges during the coronavirus disease 2019 (COVID-19) pandemic including financial concerns, a national infant formula shortage, and rising food costs. To mitigate these challenges, the United States Department of Agriculture implemented WIC program waivers and flexibilities aiming to simplify program operations (e.g., remote appointments and food package substitutions). However, little is known about WIC participants' perceptions of these changes and their impact on in-store benefit redemption. As such, this study aimed to characterize how pandemic-related events impacted Delaware WIC participants' shopping experiences and program perceptions. The authors conducted semi-structured interviews with 51 WIC participants in Wilmington, Delaware. Survey measures included demographic questions, the Hunger Vital Sign, and open-ended questions regarding WIC program participation experiences during the pandemic. Data were analyzed using a hybrid inductive and deductive coding approach. The results demonstrate that WIC participants benefitted from the pandemic program's flexibilities. However, they continued to experience burdensome shopping trips as well as concerns about their ability to feed their families due to infant formula shortages and inflation. These findings indicate the importance of extending existing WIC flexibilities and providing continued support for both participants and WIC-authorized retailors.
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Blebu BE, Kuppermann M, Coleman-Phox K, Karasek D, Lessard L, Chambers BD. A qualitative exploration of experiences accessing community and social services among pregnant low-income people of color during the COVID-19 pandemic. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057231156792. [PMID: 36939097 PMCID: PMC9988620 DOI: 10.1177/17455057231156792] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 01/19/2023] [Accepted: 01/24/2023] [Indexed: 03/06/2023]
Abstract
BACKGROUND The COVID-19 pandemic has been associated with increased social and economic stressors among pregnant individuals. While community and social services have been available to mitigate stressors in pregnancy (e.g. food insecurity and financial hardship) and reduce the risk of adverse maternal outcomes, it is unclear how the pandemic impacted access to these resources, particularly in communities of color with lower incomes. OBJECTIVE To examine the experiences accessing community and social service resources during the COVID-19 pandemic among pregnant people of color with low incomes. DESIGN Participants for this COVID-related qualitative study were recruited from two sources-a prospective comparative effectiveness study of two models of enhanced prenatal care and the California Black Infant Health Program between August and November of 2020. METHODS We conducted 62 interviews with Medicaid-eligible participants in California's Central Valley. During their interviews, study participants were asked to share their pregnancy-related experiences, including how they felt the pandemic had affected those experiences. RESULTS We identified two broad themes: challenges with accessing community and social service resources during the pandemic and opportunities for improving access to these resources. Sub-themes related to challenges experienced included difficulty with remote access, convoluted enrollment processes for community and social services, and problems specific to accessing COVID-19 resources (e.g. testing). Sub-themes related to opportunities to improve access included leveraging instrumental support from perinatal staff and informational (e.g. practical) support from other community programs and pregnant peers. Participant recommendations included leveraging opportunities to improve client experiences through increased transparency and better patient-provider communication. CONCLUSION This study highlights some important trends that emerged with the rollout of remote service delivery for social services among a vulnerable population. Many participants were able to leverage support through other programs and perinatal staff. These individuals identified additional opportunities to improve client experiences that can inform the future implementation of support services for pregnant people.
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Affiliation(s)
- Bridgette E Blebu
- Department of Obstetrics and Gynecology, The Lundquist Institute at Harbor—UCLA Medical Center, Torrance, CA, USA
| | - Miriam Kuppermann
- California Preterm Birth Initiative, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
- Department of Obstetrics, Gynecology & Reproductive Sciences, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Kimberly Coleman-Phox
- California Preterm Birth Initiative, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
- Department of Obstetrics, Gynecology & Reproductive Sciences, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Deborah Karasek
- California Preterm Birth Initiative, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
- Department of Obstetrics, Gynecology & Reproductive Sciences, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Lauren Lessard
- Institute for Circumpolar Health Studies, University of Alaska, Anchorage, Anchorage, AK, USA
| | - Brittany D Chambers
- Department of Human Ecology, College of Agricultural and Environmental Sciences, University of California, Davis, Davis, CA, USA
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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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