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
Objectives This study assesses the relationship between household food insecurity and adiposity, measured as BMI-for-age z-score (BMI-z), overweight/obesity, and waist circumference, as well as dietary intake and diet-related behaviors in US children. Methods A total of 5138 US schoolchildren ages 4–15 years from 130 communities in the cross-sectional Healthy Communities Study were included in this analysis. Household food insecurity was self-reported using a validated 2-item screener. Dietary intake was assessed using National Cancer Institute's (NCI) Dietary Screener Questionnaire (DSQ), a 26-item food frequency questionnaire, and dietary behaviors were assessed during a household survey. Data were analyzed using multilevel statistical models, including interaction tests for age, sex, and race/ethnicity. Results Food insecure children had a BMI z-score of 0.14 higher (95% CI: 0.06, 0.21) and a waist circumference of 0.91 cm higher (95% CI: 0.18, 1.63) than food secure children. Food insecure children have 1.17 times the odds of being overweight/obesity compared with food secure children (95% CI: 1.02, 1.34). There was no significant interaction by sex or race/ethnicity. Food insecure children consumed more sugar from sugar sweetened beverages (0.36 tsp/day; 95% CI: 0.09, 0.63), and ate breakfast (−0.28 days/week; 95% CI: −0.39, −0.17) and together with family (−0.22 days/week; 95% CI: −0.37, −0.06) less frequently compared to food secure children. Conclusions The present study found a significant, positive association between household food insecurity and child adiposity for children ages 10–15 years, as well as for several dietary intake and diet-related behaviors. This research helps disentangle the complex picture of food insecurity as a contributor to childhood obesity and poorer dietary outcomes in diverse populations. Funding Sources Research was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health under award number K01HL131630. The authors would also like to acknowledge the Global Food Initiative at the University of California Office of the President for their support of this project.
Objectives While it has been recommended that schools be the hub of efforts to improve child nutrition, research describing dimensions of U.S. school nutrition environments is limited. This study used exploratory factor analysis to estimate dimensions of school nutrition environments and examined their association with child anthropometric and dietary measures. Methods Cross-sectional analyses of 386 U.S. elementary and middle schools and 4635 children from the national Healthy Communities Study (2013–2015) was conducted. Three complementary instruments to assess the school nutrition environment were used to create 34 variables. Data were collected by observation and surveys. Factor analysis was done with orthogonal rotation. Mixed-effects regression models examined the multivariate-adjusted associations of dimensions of school nutrition environments with child anthropometric and dietary measures accounting for community and school variation. Results Six dimensions of school nutrition environments were derived: 1) nutrition education; 2) fruit and vegetable availability; 3) dining environment, including size and crowding; 4) school meal quality, including compliance with competitive food standards, amount of whole grains, and high fat foods; 5) school participation in state and federal nutrition programs; and 6) self-reported implementation of school wellness policies. Higher school meal quality was associated with lower added sugars intake (ß = –0.94, P < 0.01), better dining environment was associated with higher body mass index z scores (ß = 0.04, P = 0.03), and higher implementation of school wellness policies was associated with higher waist circumference (ß = 0.54, P < 0.01). Conclusions Schools serving meals of higher nutritional quality had children with lower added sugars intake. Associations between dining environment and BMI-z; and implementation of school wellness policies and waist circumference were counterintuitive and may be due to school selection or the inability of cross-sectional data to capture relationships with longer-term health outcomes. More efforts are needed to identify school nutrition environments that have the greatest impact on child diet and adiposity outcomes. Funding Sources National Heart, Lung, and Blood Institute #K01HL131630.
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.
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.
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.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.