National WIC Association

Fall 2016 WIC Research To Practice

Welcome

Welcome to the Fall 2016 edition of WIC Research to Practice! We are excited to announce that the USDA Food and Nutrition Service (FNS) will now be regular contributors to WIC Research to Practice. In this edition, FNS shares some good news on how WIC positively impacts obesity rates in 2-4 year olds. We also have an update on the CDC funded project at NWA that has recently been evaluated. In addition, we have an interview with Professor Tatiana Andreyeva who provides some advice on conducting research within WIC and tells us about her work evaluating the impact of the last food package changes. As always, we have calls for abstracts, upcoming conferences, and recent publications.

Greater With WIC! Supporting policy, systems and environmental change in local communities 

Through a grant from the Centers for Disease Control and Prevention, NWA funded seventeen local WIC agencies to implement policy, systems, and environmental (PSE) change in their local communities. Agencies implemented several interventions to promote chronic disease prevention or improve the local food environment. Agencies had a wide menu of interventions with which they could implement.

Altarum Institute conducted an evaluation of this project, collecting data through telephone interviews with local staff, web surveys, and site visits. The evaluation focused on three key areas: coalition building in local communities, implementation of key outcome objectives, and sustainability of local interventions. Some of the key findings from this study include:

  1. While some agencies found it difficult to find appropriate partners and create local coalitions, all were eventually successful in creating meaningful working coalitions. Coalition partners included such organizations as SNAP Ed, YMCAs, local hospitals and community clinics, restaurants, corner stores, and Head Start Programs. Three-quarters of the local agencies were confident that they had found the right partners for implementing their interventions.
  2. Most local WIC agency staff had little or some experience with implementing PSE, but felt that after the grant period, they had gained significant experience in PSE implementation.
  3. Forty-seven percent of project directors felt that they were extremely successful in implementing their objectives, while another 40% felt they were somewhat successful. Some of the factors that contributed to their success was the cooperation from coalition partners, strong leadership, cooperation from target organizations allowing programs to implement their interventions, and building on existing relationships.
  4. Some of the challenges of implementing interventions identified by Project Directors included lack of interest on the part of target organizations (such as corner stores, restaurants, public health clinics, etc.), difficulty in keeping partners engaged or partners not living up to their commitments, lack of time for implementing the intervention, selection of too many objectives, staff turnover among partner agencies, and delays in getting projects started.
  5. Sustainability of project coalitions was a significant program success. All of the Project Directors noted that their community coalitions will continue even after funding ends.

To learn more about this project, please visit www.greaterwithwic.org.

FNS Update: Obesity rates decline among young children enrolled in WIC

The Centers for Disease Control and Prevention (CDC) and the United States Department of Agriculture (USDA) jointly released a report on the decrease in obesity among young children enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). The study, published in CDC’s Morbidity and Mortality Weekly Report (MMWR), found that obesity among 2 to 4 year old children enrolled in WIC decreased from 15.9 percent in 2010 to 14.5 percent in 2014. The prevalence of obesity decreased among all racial and ethnic groups and among 34 of the 56 WIC State Agencies included in the report. The data for this study were based on the weight and height measurements taken during WIC certification visits and submitted by State Agencies to USDA for the WIC Participant and Program Characteristics biennial reports.

Obesity during childhood negatively affects a child’s health and increases his or her risk of obesity and its related health consequences during adulthood. Preventing obesity during early life is an important public health priority. The modest decreases in obesity noted in this study are most likely due to a combination of prevention efforts at the national, state, community and family levels. Federal efforts include USDA’s revision of the WIC food package to align with the updated U.S. Dietary Guidelines for Americans and to establish successful long-term breastfeeding, CDC’s Early Care and Education Childhood Obesity program, and State Public Health Actions.

For more information on CDC’s childhood obesity prevention efforts, visit www.cdc.gov/obesity/childhood.

Reported by the Office of Policy Support, Food and Nutrition Service, USDA.

Extended Grant Application Deadline: USDA FNS Participant Research Innovation Laboratory to Enhance WIC Services

This is an announcement of the availability of funds for one new cooperative agreement for FY 2017-2019 with a public or private Academic or Research Institution. In this funding cycle, the USDA anticipates awarding up to $1,000,000 in grant funding to support the creation of a Participant Research Innovation Laboratory for administering and awarding sub-grants for researcher-initiated projects that develop and test strategies to encourage retention of children in WIC. Developed strategies should focus on WIC service delivery sites or retail environments. Further, strategies must acknowledge the social and cultural diversity of WIC participants and those eligible for the Program. For more information please visit the FNS and Grants.gov website.

Application deadline: December 2nd, 2016
Expected award date: January 12th, 2017

Researcher Spotlight: Tatiana Andreyeva - Helping Us Understand the Impact of the WIC Food Package Revisions

Tatiana Andreyeva is Associate Professor in the Department of Agricultural and Resource Economics at the University Connecticut, and the Director of Economic Initiatives at the Rudd Center for Food Policy and Obesity, also at the University of Connecticut. In recent years, Tatiana Andreyeva has become a prominent name in WIC research. Tatiana and her colleagues have conducted multiple studies in recent years that have considered the impact of the revisions to the WIC food package based on the recommendations from an Institute of Medicine Expert Committee in 2006. Much of Tatiana’s research has been used in the recent review of the WIC food package. Recommendations from this review are due to be published in January 2017.

Last month, Tatiana published a paper in Preventive Medicine that considered how the WIC food package impacts the overall healthfulness of food purchases by WIC participants. You may have recently seen an article about this in the New York Times. Tatiana and her co-author Amanda Tripp found that the changes to the WIC food package have resulted in families purchasing healthier foods. Their study concluded that “Efforts to encourage healthy eating by people receiving federal food assistance are paying off.”

We had the opportunity to speak with Tatiana to learn why as an economist she is interested in studying WIC and what her advice is for conducting research within WIC. Tatiana told us:

I’ve always been interested in policies that could improve the diet quality, particularly for low income populations.

The IOM Committee published their recommendations in 2006 and in 2007, interim revisions to the WIC food package were announced, but not implemented until 2009. The three-year period between recommendations being made and the new rules being implemented enabled baseline data to be collected. Tatiana told us how this process enabled researchers to carefully plan evaluations of the changes.

Good research design with good baseline data, the recommendations were made in 2007 and implemented in 2009. So it was a no brainer – a big policy change coming up (the changes to the WIC food package), we had secured funding to be able to evaluate it.

Tatiana has worked primarily in the North East region of the US and spent many years building relationships with State programs. When asked what advice she has for other researchers interested in working with WIC, she told us:

If someone is interested in working on WIC, they have to focus on building relationships with their local communities, state agencies, and also understand the ins and outs of the program.

Researchers from academic institutions and state agencies can have mutual benefits:

There are a lot of avenues that the State Agency might want to pursue, but they don’t have resources and they may need a researcher from a university to help them, or it could be the opposite.

Tatiana also spoke candidly about some of the challenges of conducting research within WIC. Like challenges to many aspects of the program, funding can be a problem as can access to data.

The first problem is research funding, the second problem is researchers don’t have access to a lot of data that states have. For example, children’s BMI height/weight data could be made available.

Access to data can be a thorny issue and one where a good relationship of trust between researchers and state WIC program is necessary. In response to the challenge of funding, Tatiana told us that creativity goes a long way and assessing relationships that already exist is a good place to start.

It’s a lot about relationships. For example, I had a relationship with a grocery chain so we worked with them.

Also on the theme of relationship building, Tatiana pointed out that:

Building relationships and trust among different parties takes time.

Therefore, Tatiana encourages researchers to take the time to consider relationship building. For more information on how researchers and state and local WIC programs can work together, please see this guidance on Planning, Conducting and Communicating a WIC Research Project, which NWA produced last year.

On the issue of access to data, Tatiana spoke specifically about how researchers will be able to use EBT data to support program development and evaluation, but only if they can access it. This is an issue that Tatiana urged the WIC community to think about. In their 2016 Study and Evaluation Plan, the USDA Food and Nutrition Service notes that they will be exploring options to consider a national EBT database.

When asked how Tatiana hoped her research would be used, she responded:

Hopefully to make a difference, we at the Rudd Center pay a lot attention to communications, not just getting things published… Our key goal is to communicate our research findings as widely as possible and reach all stakeholders.

Tatiana’s work is making a difference as it has been included in the current review of the WIC food package. We thank Tatiana for building relationships with the WIC community and helping us understand the impact of food package policy decisions in WIC.

Conference Calendar

2017 NWA Washington Leadership Conference, Washington, DC: February 26th – 28th.

2017 NWA Annual Education and Training Conference and Exhibits, Philadelphia, PA: April 2nd – 5th.

2017 Communities Joined in Action, San Antonio, TX: February 15th – 17th.

National Conference of Association for Community Health Improvement, Denver, CO: March 9th – 11th.

Association of Maternal and Child Health Programs, Kansas City, MO: March 4th – 7th.

Call for Abstracts

There is so much happening in WIC! What have you been up to? Have you been involved with a great WIC project that you’d like to share with the WIC community? Please consider submitting an abstract for an oral or poster presentation at the NWA 2017 Annual Education and Training Conference and Exhibits in Philadelphia, PA, April 2nd – 5th 2017. The Annual Conference is an important forum for sharing new ideas and learning from each other.

Below are some suggested topics and issues we’d love to hear about. If your project does not fall within one of these topic areas, don’t worry – please submit an abstract anyway! All abstracts are due by January 9th, 2017 and will be reviewed by the Annual Conference Program Planning Committee.

To submit an abstract, click on this link. You will be asked to set-up a profile. You will then be given a ‘To-Do’ list – to submit your abstract, click on ‘Submit a Paper’ and follow the leads. For more information on how to submit an abstract see this guide.

Suggested topics:

Recruitment and Retention

WIC Research and Data

WIC Leadership Development

Innovations in Breastfeeding Promotion and Nutrition Education

Publications

Below is a selection of abstracts from WIC studies published in the last three months.

Breastfeeding:

Lactation and the Working Woman: Understanding the Role of Organizational Factors, Lactation Support, and Legal Policy in Promoting Breastfeeding Success
V Bruk-Lee, D Albert, KL Stone - Research Perspectives on Work and the Transition to Motherhood, 2016

Early Lactation and Infant Feeding Practices Differ by Maternal Gestational Diabetes History
R Oza-Frank, JJ Moreland, K McNamara, SR Geraghty, SA Keim - Journal of Human Lactation, 2016

Breastfeeding practices, timing of introduction of complementary beverages and foods and weight status in infants and toddlers participants of a WIC clinic in Puerto Rico
OE Sinigaglia, EM Ríos, M Campos, B Díaz, C Palacios - SpringerPlus, 2016

Breastfeeding Practices among Native Hawaiians and Pacific Islanders
IKR Adams, CTC Okoli, A Dulin Keita, AM Linares, K Tanaka, JR Polanin, and A Koempel - Journal of Obesity, 2016

Breastfeeding Initiation and Support: A literature review of what women value and the impact of early discharge
L James, L Sweet, R Donnellan-Fernandez - Women and Birth, 2016

Breast for Success: A Community–Academic Collaboration to Increase Breastfeeding Among High-Risk Mothers in Cleveland
L Furman, L Matthews, V Davis, S Killpack, M O'Riordan - Progress in Community Health Partnerships: Research, Education, and Action, 2016

Lactation Support Services and Breastfeeding Initiation: Evidence from the Affordable Care Act KA Kapinos, L Bullinger, T Gurley‐Calvez - Health Services Research, 2016

Consumption

Vegetable Consumption and Selected Nutrient Intakes of Women of Childbearing Age
ML Storey, PA Anderson - Journal of Nutrition Education and Behavior, 2016

Public Opinions About Infant Feeding in the United States
JM Nelson, R Li, CG Perrine, KS Scanlon - Birth, 2016

Social Desirability Trait Is Associated with Self-Reported Vegetable Intake among Women Enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children
J Di Noia, KW Cullen, D Monica - Journal of the Academy of Nutrition and Dietetics, 2016

Did Revisions to the WIC Program Affect Household Expenditures on Whole Grains?
M Oh, HH Jensen, I Rahkovsky - Applied Economic Perspectives and Policy, 2016

Food Security

Maternal Strategies to Access Food Differ by Food Security Status
KS Gorman, K McCurdy, T Kisler, E Metallinos-Katasras - Journal of the Academy of Nutrition and Dietetics, 2016

Nutrition Education

Fresh Start, a postpartum weight loss intervention for diverse low-income women: design and methods for a randomized clinical trial
MC Rosal, CF Haughton, BB Estabrook, ML Wang, G Chiriboga, OHT Nguyen, SD Pearson, SC Lemon - BMC Public Health, 2016

The Special Supplemental Nutrition Program for Women, Infants, and Children Fresh Start Randomized Controlled Trial: Baseline Participant Characteristics and Reliability of Measures
J Di Noia, D Monica, HL Gray, KW Cullen - Journal of the Academy of Nutrition and Dietetics, 2016

Integrating Behavioral Economics into Nutrition Education Research and Practice
JF Guthrie - Journal of Nutrition Education and Behavior, 2016

Data

The importance of matching the evaluation population to the intervention population: Using Medicaid data to reach hard-to-reach intervention populations
NM Askelson, EH Golembiewski, B Baquero, ET Momany, J Friberg, D Montgomary - Evaluation and Program Planning, 2016

WIC Retail

Perspectives of Urban Corner Store Owners and Managers on Community Health Problems and Solutions
VL Mayer - Preventing Chronic Disease, 2016

The Future of the Small Rural Grocery Store: A Qualitative Exploration
CA Pinard, HE Fricke, TM Smith, LR Carpenter, AL Yaroch - American Journal of Health Behavior 2016

States Differ in the Distribution of WIC Benefits Across Types of Retail Food Stores
A Rhone, L Tiehen - USDA Economic Research Service, 2016

Missed an edition of WIC Research to Practice?

You can now view past editions of WIC Research to Practice on the NWA website.

As always, if there are topics you would like to see covered in WIC Research to Practice or know someone who would be great to feature in our WIC Researcher Spotlight, please email Georgia Machell, Research and Evaluation Manager at gmachell@nwica.org.