National WIC Association

Spring 2017 WIC Research to Practice


Welcome to the Spring edition of WIC Research to Practice! There has been a lot happening in the WIC research world and we are excited to share some of the latest items with you. In this edition of WIC Research to Practice, we focus on the Review of the WIC Food Packages and the recommendations for research that were made, FNS share their new 2017 Research and Evaluation Plan, we highlight the importance of research communications through a new infographic on the Feeding My Baby Study, and our Researcher Spotlight is Marie Latulippe, Study Director of the Review of the WIC Food Package. As always, we include information on upcoming conferences and links to abstracts for new WIC research publications.

Thanks for reading WIC Research to Practice! If there are studies or reports you would like us to highlight in our summer edition, please contact Hannah Shultz,

Hot Topic: The Review of the WIC Food Package Final Report Recommendations for Research and Data Collection

After an almost three-year review process, on January 5th, 2017, the National Academy of Sciences, Engineering and Medicine (NASEM) published their final report Reviewing the WIC Food Package: Improving Balance and Choice. The report, written by an Expert Committee charged with reviewing the current WIC food package and making recommendations for changes, is over 900 pages long and provides an exceptionally detailed account of how the WIC food package could be improved to better support the mission of WIC while maintaining cost neutrality. A summary of the recommendations can be found here.

Attendees of the recent NWA Annual Networking and Education Conference in Philadelphia were honored to have a general session presentation by the Chair and Vice Chair of the Committee to Review WIC Food Packages, Dr. Kathleen Rasmussen and Dr. Shannon Whaley. There were cheers from the crowd as the presenters talked through many of the proposed changes to the food package, such as increasing the value of the CVV for vegetables and fruits, and the option of replacing both juice and infant foods with additional CVV for vegetables and fruits. A copy of the PowerPoint presentation can be found here.

In addition to the recommendations for changes to the WIC food package, the Committee took the opportunity to make recommendations for research. The process of collecting and reviewing the available data to make recommendations illuminated a few areas where additional research would be valuable. NWA commends the committee for taking the opportunity to highlight how crucial WIC research and data are across many aspects of WIC. Key research recommendations include:

  • Fund research to evaluate the effects of the recommended revisions to the WIC food packages on participant satisfaction, participation in the program, redemption of WIC foods, and participants’ diets and health.
  • Collect WIC state agency policies on an annual basis and establish a national database of EBT expenditures by program participants.

In the Q&A portion of the general session presentation on the food package recommendations, an audience member raised a question about if there are plans to pilot any of the recommendations in the near future. Dr. Whaley suggested that some of the recommendations may not require a policy change and some pilots could potentially be undertaken within the parameters of current regulations or through a waiver. If you, your state, or local agency are interested in piloting any of the recommendations, please contact Darlena Birch,

It is important to note that the recommendations made by the Committee are just that – recommendations. The recommendations will now be considered by USDA. How long this process will take is unknown.

NWA provided recommendations throughout the review process, many of which were incorporated into the Committee’s final recommendations. A side by side of NWA’s recommendations and the final recommendations can be found here.

USDA Food and Nutrition Service releases annual Research and Evaluation Plan

On March 13, 2017, the Food and Nutrition Service (FNS) released its 2017 Research and Evaluation Plan. The annual plan is developed by FNS program and research staff and leadership to meet the information needs of FNS programs, including WIC. The plan is a forecast of the studies FNS expects to initiate in fiscal year 2017, but it is subject to modification based on the Agency’s budget and emerging program and policy priorities.

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

Great News from Phase Two of the “Feeding My Baby Study”

The second report from the FNS funded WIC Infant and Toddler Feeding Practices Study 2 (WIC ITFPS-2), also known as the “Feeding My Baby” study, was published earlier this year. The longitudinal study describes the feeding practices used by infant caregivers and measures the nutrition outcomes of children who participate in WIC. This is an exciting study as it will track children from a nationally representative sample until their fifth birthday. It is a rare opportunity to collect 24 hour dietary recall data in parallel to frequent weight and height measurements. The study will develop deeper understanding of the impacts of WIC. In addition, the study will continue to track families if they exit the WIC program, this will provide important new insight and understanding on participant retention.

The new report provides findings from the prenatal survey. In general, the second phase of this study highlights the positive impact that WIC participation has on breastfeeding acceptance, beliefs and education. Key findings are listed below.

  • WIC mothers are breastfeeding at much higher rates than they were 20+ years ago, with 83 percent now initiating breastfeeding as compared to 56 percent 20+ years ago, 62 percent breastfeeding at 1-month postpartum as compared to 33 percent 20+ years ago, and 18 percent still breastfeeding at 12 months as compared to 7 percent 20+ years ago.
  • Study mothers report receiving extensive support from WIC for breastfeeding. This includes education from WIC, individual support calls, and guidance when encountering breastfeeding problems.
  • Introduction of complementary foods prior to 4 months, which was a substantial problem 20+ years ago, is no longer a major issue among WIC mothers. Few mothers (20 percent) are introducing complementary foods before 4 months, as compared to at least 62 percent of mothers 20+ years ago.
  • Mothers report having made positive changes in how they feed themselves and their families due to WIC. The most commonly reported changes include knowing how to choose more healthy foods, and eating more fruits and vegetables.

As well as a full report, Westat, the contractor undertaking this work have produced an infographic that provides a fun, easy to understand method of communicating the research findings. We love this infographic and hope more research projects will use this creative technique to communicate important WIC research.

Upcoming WIC Research Webinar: What will you do with WIC EBT data?

June 29, 3:00 PM Eastern.

The NWA Evaluation Committee is planning to host their first webinar in June. The objective is to learn from our community about the different ways in which WIC data is being used and discuss expanding the use of WIC data. The webinar will include short presentations from three states about the different ways they are using and sharing their WIC EBT data. This will be followed by an interactive discussion. Please encourage those who work closely with WIC data, evaluation or research to attend.

We invite you to register here.

Are you from the Southeast or Southwest region? Love research and evaluation? Apply to be a consultant on the NWA Evaluation Committee.

This Committee meets by phone the fourth Tuesday of each month and produces a biennial Research Needs Assessment, stays abreast of current issues and needs across the WIC research community. If you would like to learn more, please contact Darlena Birch,

Researcher Spotlight: Marie Latulippe, NASEM Study Director, Review of the WIC Food Package

Marie Latulippe was the Study Director for the NASEM review of the WIC food packages and is now one of the nation’s experts on the Committee’s recommendations. Marie spoke to us about her role as Study Director, reading the 900+ page final report multiple times and keeping the Committee on task.

With a background in committee work and nutrition science, the role of NASEM Study Director for the review of the WIC Food Package appealed to Marie as it was an opportunity to influence policy with science:

I had been working with committees for a long time, doing more nutrition science as opposed to policy. I thought that using science to inform policy within a committee would be really interesting. WIC is such a huge program and in the nutrition world is so significant, it has been an honor to work on it.

The review itself was conducted by a Committee of 15 volunteers (a full list of committee members can be found here). NASEM staff, led by Marie, ensured that the objectives of the review were met by the committee and that the committee had the necessary information in order to make decisions. It is important to note that all of the decisions were made by full consensus i.e. everyone had to agree on all the recommendations made. Marie’s task began by forming a Committee of experts.

The sponsor (USDA) required specific expertise on the committee. The first objective is to ensure that the required expertise is covered. Recommendations for committee members are solicited from the public noting the required expertise. We collect all of the input and conduct a rigorous review of the suggested individuals and their respective backgrounds and put together a proposed committee slate. This slate is reviewed by an independent division of NASEM, to make sure that there are no conflicts of interest.

Once the committee was formed, Marie then had to keep the group of 15 (who all had full-time day jobs as well) on task for the 3-year review period.

When committee members are selected, it is important to keep in mind the amount of work involved and their interest in and ability to be dedicated to the task. This sets up the project for success from the outset. Then, it is a matter of distributing the work. This is facilitated by understanding the specific expertise of each committee member. As the study goes along, there are a lot of reminders because the committee members are trying to fit the volunteer work into an already full schedule.

What is not included in the final report is the amount of time dedicated to coordinating and participating in the Committee. Marie estimates that as well as the multiple in-person meetings on both the east and west coast, site visits and WIC shopping experiences across the country that committee members participated in, there were hundreds of phone calls to keep the process on track.

The Chair spent 4-6 hours a week on the project for around 3 years. At critical times, the weekly hours were much higher.

When asked about challenges throughout the report, Marie mentioned that cost containment presented challenges to committee:

A huge challenge was the cost neutral requirement. First the committee made their decisions about what should ideally change based on the science. To reach the final set of changes, the committee needed to make decisions about which of these ideal changes to retain or drop to produce a final set of packages that was cost-neutral but as optimal as possible.

This is to say, that the task of reviewing the WIC food package came with many tough decisions. NWA is grateful for Marie’s leadership and strongly supports the recommendations this process produced.

Overview - NWA 2017 Annual Education and Networking Conference and Exhibits, Philadelphia, PA, April 2nd – 5th

NWA was delighted by the number of research focused abstract for presentations submitted to the NWA 2017 Annual Conference in Philadelphia, PA. There were a number of sessions that highlight some of the most important aspects of WIC research from the last year, these include:

  • Reviewing the WIC Food Package: Improving Balance and Choice
  • Improving the retail experience using behavioral economics and EBT/Redemption Data - ERS
  • Feeding My Baby Study – FNS
  • FITS Data
  • Using data to help triage caseload retention efforts
  • Modeling program participation and increases in the CVV on WIC Participant Health Outcomes

Presentations are available here.

Missed this conference? Join us September 25th – 28th in Memphis, TN for our 2017 Biennial NWA WIC Technology, Program Integrity and Vendor Management Education and Networking Conference and Exhibits.


Below is a selection of recently published article abstracts.


Both Prenatal and Postnatal Interventions Are Needed to Improve Breastfeeding Outcomes in a Low-Income Population
PK Schreck, K Solem, T Wright, C Schulte, KJ Ronnisch, Szpunar - Breastfeeding Medicine, 2017

Association Between WIC Enrollment and Exclusive Breastfeeding at 3 Months Postpartum Among Low-Income Mothers.
J Francescon, ZT Haile, D Kling, I Chertok - The Journal of the American Osteopathic Association, 2016

Utilizing Group Model Building to Develop a Culturally Grounded Model of Breastfeeding for Low‐Income African American Women in the USA
R Reno - Journal of Clinical Nursing, 2017

Employer-Based Programs to Support Breastfeeding Among Working Mothers: A Systematic Review
LM Dinour, JM Szaro - Breastfeeding Medicine, 2017

The Effect of a Breastfeeding Motivation Program Maintained During Pregnancy on Supporting Breastfeeding: Randomized Controlled Trial
E Cangöl, N Hotun Şahin - Breastfeeding Medicine, 2017

The Effect of Breast Pump Use on Exclusive Breastfeeding at 2 Months Postpartum in an Inner-City Population
E Bream, H Li, L Furman - Breastfeeding Medicine, 2017

Knowledge of Breastfeeding Recommendations and Breastfeeding Duration: A Survival Analysis on Infant Feeding Practices II
JT Wallenborn, T Ihongbe, S Rozario, SW Masho - Breastfeeding Medicine, 2017

Should We Pay Mothers Who Receive WIC to Breastfeed?
L Furman - Pediatrics, 2017

Long-Term Breastfeeding in African American Mothers: A Positive Deviance Inquiry of WIC Participants
TT Gross, M Davis, AK Anderson, J Hall, K Hilyard - Journal of Human Lactation, 2017

Incentive-based intervention to maintain breastfeeding among low-income Puerto Rican mothers
Y Washio, M Humphreys, E Colchado, M Sierra-Ortiz, Z Zhang, B Collins, L Kilby, D Chapman, S Higgins, K Kirby - Pediatrics, 2017

Breastfeeding Supports and Services in Rural Hawaii: Perspectives of Community Healthcare Workers
JL Flood - Nursing Research and Practice, 2017

Recruitment and Retention

Use of a Mixed-Method Approach to Evaluate the Implementation of Retention Promotion Strategies in the New York State WIC Program
JP Sekhobo, SR Peck, Y Byun, MAK Allsopp, MK Holbrook, L Edmunds, C Yu - Evaluation and Program Planning, 2017

Improving California Children's Participation in Nutrition Programs
C Danielson, S Bohn – Public Policy Institute of California, 2016

Mapping a WIC Mother's Journey: A Preliminary Analysis
AD Panzera, CA Bryant, F Hawkins, R Goff, A Napier, T Schneider, R Kirby, M Coulter, W Sappenfield, J Baldwin, K O’Rourke - Social Marketing Quarterly, 2017

Food Retail and Consumption

The prospective impact of food pricing on improving dietary consumption: A systematic review and meta-analysis
A Afshin, JL Peñalvo, L Del Gobbo, J Silva, M Michaelson, M O’Flaherty, S Capewell, D Spiegelman, D Goodarz, D Mozaffarin - PloS one, 2017

Personal characteristics, cooking at home and shopping frequency influence consumption
J Gustat, YS Lee, K O'Malley, B Luckett, L Myers, L Terrell, L Amoss, E Fitzgerald, P Stevenson, C Johnson - Preventive Medicine Reports, 2017

Choice architecture to promote fruit and vegetable purchases by families participating in the Special Supplemental Program for Women, Infants, and Children (WIC): randomized corner store …
AN Thorndike, OM Bright, MA Dimond, R Fishman, LE Levy - Public Health Nutrition, 2016

Water, juice, or soda? Mothers and grandmothers of preschoolers discuss the acceptability and accessibility of beverages
K Eli, A Hörnell, ME Malek, P Nowicka - Appetite, 2017

Establishing Partnerships with Food Retailers to Conduct Local and Healthy Food Choice Research
M De Marco, L Chapman, N Siddique – 2016

Overweight and Obesity

Results and lessons learned from a prevention of weight gain program for low-income overweight and obese young mothers: Mothers In Motion
MW Chang, R Brown, S Nitzke - BMC Public Health, 2017

Longitudinal associations between maternal feeding and overweight in low-income toddlers
JC Lumeng, N Kaciroti, L Retzloff, K Rosenblum, A Miller - Appetite, 2017

What is the effectiveness of obesity related interventions at retail grocery stores and supermarkets?—a systematic review
A Adam, JD Jensen - BMC Public Health, 2016

Leveraging Opportunities for Postpartum Weight Interventions
A Berger, WK Nicholson - Obstetrics and Gynecology Clinics of North America, 2017

WIC Summer EBT

Delivering Summer Electronic Benefit Transfers for Children through the Supplemental Nutrition Assistance Program or the Special Supplemental Nutrition Program for Women, Infants and Children: Benefits Use and Impact on Food Security and Foods Consumed
AR Gordon, RR Briefel, AM Collins, GM Rowe, JA Klerman - Journal of the Academy of Nutrition and Dietetics, 2016

Infant Formula

Marketing Claims for Infant Formula: The Need for Evidence
HK Hughes, MM Landa, JM Sharfstein - JAMA Pediatrics

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