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)

Abstract

ObjectiveRetention 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.DesignUsing 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.SettingEight WIC clinics across the State of Illinois, USA.ParticipantsThirty-one caregivers of children enrolled in WIC for at least 6 months.ResultsSeveral 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).ConclusionsMany 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.

Prioritization of Features for Mobile Apps for Families in a Federal Nutrition Program for Low-Income Women, Infants, and Children: User-Centered Design Approach

“…Bensley et al also demonstrated that WIC participants would find universal product code (UPC) scanning and verification of WIC items useful (5782/8144, 71%) [ 20 ]. Issues at checkout and conflicting information regarding WIC item eligibility remains a barrier to using WIC [ 13 ] and is one of the key factors that decrease participants’ perceived value of the program [ 14 ]. A barcode scanning feature to verify item eligibility and confirm whether or an item remains on the WIC balance could provide a solution to this common barrier to redeem WIC benefits.…”

“…A semistructured interview protocol was developed based on a multilevel model of factors influencing the perceived value of WIC [ 14 ], as well as formative research [ 28 ] and a review of existing WIC apps and features [ 27 ]. Using the semistructured interview protocol, participants were asked to speak about their experiences using WIC services, shopping for WIC foods, and using mobile phone technology.…”

“…At the shopping level, WIC state agencies were mandated to switch from a paper voucher system to an electronic benefits transfer (EBT) system for WIC by 2020, with some waivers of extension [ 23 ] in which participants make WIC purchases using an EBT card that resembles a debit card. Implementation of WIC EBT (or electronic WIC [eWIC]), as many state agencies refer to it) is a considerably large administrative undertaking that stands to benefit participants considerably owing to increased ease of use at checkout, elimination of the risk of theft or loss of paper vouchers, increased redemption of benefits, and decreased stigma associated with purchasing food using a discreet benefit card rather than cumbersome paper vouchers that can cause difficulties for customers and cashiers [ 14 , 24 - 26 ].…”

“…WIC has also been associated with improvements in household food security [10], childhood immunizations [11,12] and health care utilization [11]. Despite all the positive effects of WIC, barriers to the usage of the program and participation exist at the interpersonal (eg, family support), institutional (eg, prohibitive work schedules), clinical (eg, long wait times), shopping (eg, WIC items that are hard to find, not in stock, and inconsistent within and between vendors), and administrative/systems levels (eg, restrictive benefits and stigma surrounding government assistance) [13][14][15][16][17]. Addressing the issue of early exits from the WIC program has been identified as one of the key areas in a research needs assessment put forth by the National WIC Association (NWA) [18], and a national program retention campaign was rolled out in 2018 [19].…”

Prioritization of Features for Mobile Apps for Families in a Federal Nutrition Program for Low-Income Women, Infants, and Children: User-Centered Design Approach (Preprint)

“…At the shopping level, WIC state agencies were mandated to switch from a paper voucher system to an electronic benefits transfer (EBT) system for WIC by 2020, with some waivers of extension [23] in which participants make WIC purchases using an EBT card that resembles a debit card. Implementation of WIC EBT (or electronic WIC [eWIC]), as many state agencies refer to it) is a considerably large administrative undertaking that stands to benefit participants considerably owing to increased ease of use at checkout, elimination of the risk of theft or loss of paper vouchers, increased redemption of benefits, and decreased stigma associated with purchasing food using a discreet benefit card rather than cumbersome paper vouchers that can cause difficulties for customers and cashiers [14,[24][25][26].…”