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- All Subjects: WIC
- Creators: Ohri-Vachaspati, Punam
- Creators: Bertmann, Farryl M. W
- Resource Type: Text
Description
In October, 2009, participants of the Arizona Special Supplemental Nutrition Program for Women, Infants and Children (WIC) began receiving monthly Cash Value Vouchers (CVV) worth between six and 10 dollars towards the purchase of fresh fruits and vegetables. Data from the Arizona Department of Health Services (ADHS) showed CVV redemption rates in the first two years of the program were lower than the national average of 77% redemption. In response, the ADHS WIC Food List was expanded to also include canned and frozen fruits and vegetables. More recent data from ADHS suggest that redemption rates are improving, but variably exist among different WIC sub-populations. The purpose of this project was to identify themes related to the ease or difficulty of WIC CVV use amongst different categories of low-redeeming WIC participants. A total of 8 focus groups were conducted, four at a clinic in each of two Valley cities: Surprise and Mesa. Each of the four focus groups comprised one of four targeted WIC participant categories: pregnant, postpartum, breastfeeding, and children with participation ranging from 3-9 participants per group. Using the general inductive approach, recordings of the focus groups were transcribed, hand-coded and uploaded into qualitative analysis software resulting in four emergent themes including: interactions and shopping strategies, maximizing WIC value, redemption issues, and effect of rule change. Researchers identified twelve different subthemes related to the emergent theme of interactions and strategies to improve their experience, including economic considerations during redemption. Barriers related to interactions existed that made their purchase difficult, most notably anger from the cashier and other shoppers. However, participants made use of a number of strategies to facilitate WIC purchases or extract more value out of WIC benefits, such as pooling their CVV. Finally, it appears that the fruit and vegetable rule change was well received by those who were aware of the change. These data suggest a number of important avenues for future research, including verifying these themes are important within a larger, representative sample of Arizona WIC participants, and exploring strategies to minimize barriers identified by participants, such as use of electronic benefits transfer-style cards (EBT).
ContributorsBertmann, Farryl M. W (Author) / Wharton, Christopher (Christopher Mack), 1977- (Thesis advisor) / Ohri-Vachaspati, Punam (Committee member) / Johnston, Carol (Committee member) / Hampl, Jeffrey (Committee member) / Dixit-Joshi, Sujata (Committee member) / Barroso, Cristina (Committee member) / Arizona State University (Publisher)
Created2013
Description
Objective: The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is a federally-funded program that provides supplemental food packages, nutrition education, and healthcare referrals to low-income women, infants, and children under 5, who are at the highest nutritional risk. This study explores if household WIC participation is associated with healthier dietary behaviors among age-ineligible children (5-18-years-old) in WIC households. Consumption frequency of fruits, vegetables, 100% juice, sugar-sweetened beverages (SSBs), and energy-dense snacks (sweet and salty snacks) among children from WIC and income-qualifying non-WIC households were compared.
Methods: Data were obtained from two cross-sectional panels (2009-10 and 2014) of the New Jersey Child Health Study conducted in four low-income New Jersey cities. Questions from previously validated surveys assessed consumption frequency of fruits, vegetables, SSBs, and sweet and salty snacks. Analyses were confined to 570 children between 5-18 yrs; of which 365 (5-11 yrs: 237, 12-18 yrs: 128) resided in WIC participating households and 205 (5-11 yrs: 138, 12-18 yrs: 67) in income-qualifying non-WIC households. Over half of the sample was African American and 43% were Hispanic. Multivariable analyses were conducted to compute incidence rate ratios (IRRs) using negative binomial regression to compare the differences in eating behaviors of children in WIC vs. Non-WIC households
Results: Household WIC participation was associated with a slightly higher frequency of vegetable consumption among 12-18-year-old children (IRR= 1.25, p=.05); differences were significant among older males (12-18-years-old) (p=.006), and not in females.
Frequency of 100% juice consumption was significantly higher among younger females (5-11-years-old) in WIC households who consumed juice about 44% more frequently (p=.02) compared to similar age girls in non-WIC households. Hispanic children in WIC households reported a lower frequency of SSBs consumption (p=.01); this association was only true among males (p=.02).
Conclusions: Household WIC participation is associated with healthier dietary behaviors among age-ineligible children living in the households, suggesting a positive spillover effect of the program. Proposed changes to WIC packages are likely to have dietary implications not only for WIC participants but also for non-participating children residing in WIC households,
Methods: Data were obtained from two cross-sectional panels (2009-10 and 2014) of the New Jersey Child Health Study conducted in four low-income New Jersey cities. Questions from previously validated surveys assessed consumption frequency of fruits, vegetables, SSBs, and sweet and salty snacks. Analyses were confined to 570 children between 5-18 yrs; of which 365 (5-11 yrs: 237, 12-18 yrs: 128) resided in WIC participating households and 205 (5-11 yrs: 138, 12-18 yrs: 67) in income-qualifying non-WIC households. Over half of the sample was African American and 43% were Hispanic. Multivariable analyses were conducted to compute incidence rate ratios (IRRs) using negative binomial regression to compare the differences in eating behaviors of children in WIC vs. Non-WIC households
Results: Household WIC participation was associated with a slightly higher frequency of vegetable consumption among 12-18-year-old children (IRR= 1.25, p=.05); differences were significant among older males (12-18-years-old) (p=.006), and not in females.
Frequency of 100% juice consumption was significantly higher among younger females (5-11-years-old) in WIC households who consumed juice about 44% more frequently (p=.02) compared to similar age girls in non-WIC households. Hispanic children in WIC households reported a lower frequency of SSBs consumption (p=.01); this association was only true among males (p=.02).
Conclusions: Household WIC participation is associated with healthier dietary behaviors among age-ineligible children living in the households, suggesting a positive spillover effect of the program. Proposed changes to WIC packages are likely to have dietary implications not only for WIC participants but also for non-participating children residing in WIC households,
ContributorsSteeves, Stephanie N (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Tasevska, Natasha (Committee member) / DeWeese, Robin (Committee member) / Arizona State University (Publisher)
Created2019
Description
Individual behavior change is a goal of many public policies directed at people of low socioeconomic status. Without evidence of behavioral change, these policies cannot be considered a success: a process of co-production where some level of cooperation between the client and program administrators is required to successfully meet program objectives. The Special Supplemental Nutrition Program for Women, Infants and Children (WIC), is one example of a co-production design. WIC encourages women to engage in healthy behaviors by providing healthy food along with nutrition education to improve the health status of low-income families. However, while WIC is one of the most studied nutrition programs, little attention has been paid to the nutrition education portion or to interactions between staff members and participants. This research draws on the public policy and administration literature about street-level bureaucrats and co-production, which provides a framework for understanding the purposeful, inter-dependent relationships between front-line service providers and clients. However, neither literature explicates the process of interactions that is expected to lead to client behavior change and co-production. The primary contribution of this research is the creation of a grounded theory that identifies and explains the WIC interaction process as one of "negotiating healthy self-government". Based on analysis of three months of observations of WIC encounters in two clinics, this research finds that participants and staff members enter into tacit and explicit negotiations concerning the degree to which participants should govern their family's nutrition-related behavior. Clients actively shape the interactions by demonstrating their discipline and efforts to feed their families, while staff members refine and reinforce self-governing behaviors through assessing action, and providing advice to ensure behaviors meet recommendations. Finally, participants and staff members distinctly link self-governing behavior to identity: "good mothers" feed their children healthy food and govern their behaviors to meet nutritional recommendations. This research has implications for the study of behavior change promotion in public programs by introducing the concept of identity as a mechanism for governance and explicating the interaction process between front-line service providers and clients
ContributorsHand, Laura Catherine (Author) / Catlaw, Thomas J. (Thesis advisor) / Ohri-Vachaspati, Punam (Committee member) / Lucio, Joanna (Committee member) / Arizona State University (Publisher)
Created2014
Description
Background: Stores authorized by the Supplemental Nutrition Program for Women, Infants, and Children (WIC) have been shown to improve the community food environments of lower-income areas by stocking healthy food items in accordance with the program’s food package guidelines. Whether greater access to WIC-authorized stores is associated with improvements in diet among children from WIC and non-WIC households is not well understood. Methods: Secondary analysis of cross-sectional data collected in 2009-2010 and 2014 for the New Jersey Child Health Study (NJCHS). Surveys from 2,211 urban households with 3-18-year-old children. Counts of WIC stores near children’s homes determined through geo-coding of store and household addresses using roadway network distances of 0.5 and 1.0 mile. Children’s consumption was categorized in age-specific deciles of quantities consumed for each food category examined: fruits, vegetables, sugar from sugar-sweetened beverages, total added sugars. Associations between counts of WIC stores and children’s consumption were examined, first for the full sample, then by household WIC participation.
Results: No significant associations between WIC store counts near children’s homes and consumption were observed in the overall sample at any distance. A small, but significant inverse relationship was seen in total added sugar consumption among children residing in WIC households only, with each additional WIC store within a 0.5 mile roadway network associated with a 0.24-decile lower consumption (p = .047). In age-stratified exploratory analysis, higher vegetable (p = .024) and combined fruits and vegetables (p = .006) consumption were seen in the under 5 age group only.
Conclusions: Living close to more WIC-authorized stores was associated with healthier consumption, but only for a subset of children and only for a few food categories examined. Lack of a consistent pattern of healthier consumption among children suggests that access to WIC stores may have a positive, albeit limited impact on children’s diets.
Results: No significant associations between WIC store counts near children’s homes and consumption were observed in the overall sample at any distance. A small, but significant inverse relationship was seen in total added sugar consumption among children residing in WIC households only, with each additional WIC store within a 0.5 mile roadway network associated with a 0.24-decile lower consumption (p = .047). In age-stratified exploratory analysis, higher vegetable (p = .024) and combined fruits and vegetables (p = .006) consumption were seen in the under 5 age group only.
Conclusions: Living close to more WIC-authorized stores was associated with healthier consumption, but only for a subset of children and only for a few food categories examined. Lack of a consistent pattern of healthier consumption among children suggests that access to WIC stores may have a positive, albeit limited impact on children’s diets.
ContributorsStevens, Clinton (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Gosliner, Wendi (Committee member) / Martinelli, Sarah (Committee member) / Arizona State University (Publisher)
Created2021