National WIC Association

Spring 2018 WIC Research to Practice

Welcome

It’s been a busy few months in the world of WIC research! In this edition of WIC Research to Practice, we are excited to share the 2018 Research Needs Assessment – this important resource highlights areas of WIC where additional research is needed. We are also pleased to share the United States Department of Agriculture, Food and Nutrition Service’s 2016 WIC Program and Participant Characteristics Report and the WIC Infant Toddler Feeding Practices Study, Second Year Report. Michigan WIC shares how their use of a Pregnancy and Pediatric Nutrition Surveillance System helps with program management and evaluation, and NWA’s Quinney Harris shares insights on the impact WIC can make on Community Health. In addition, this edition of R2P provides some high-level details of new NWA projects coming your way! And, as always, we provide links to upcoming conferences and new research.

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 Georgia Machell, [email protected].

WIC Research Priorities: 2018 Research Needs Assessment

We are excited to announce that the 2018 Research Needs Assessment has been completed and is available here.

The goal of the biennial Research Needs Assessment is to identify research areas that support NWA and WIC programs nationwide to (1) be responsive to emerging issues and (2) continue to explore, demonstrate and integrate evidence-based practices that improve the health and well-being of low-income families. The Committee has prioritized six research areas, including long-standing questions related to the health outcomes associated with WIC participation as well as those related to better understanding, and subsequently addressing, the shifting patterns of WIC participation. Newly identified areas of research include an expanded view of the economic impact of WIC, the impact of potential changes to the WIC food packages, aligning policies and procedures for systems-level innovation, and understanding how WIC participants use technology. Click on the links below to learn more about why these were identified as research areas of need.

  1. Health Outcomes Associated with WIC Participation
  2. Economic Value of WIC Participation
  3. Impact of Potential Changes to WIC Food Packages
  4. Aligning Policies and Procedures for Systems-Level Innovations
  5. Understanding How WIC Participants Use Technology and Considering Barriers to Technology Access
  6. Understanding Changes in WIC Caseload to Target WIC Services to the Most At-Risk Families

Please share this document widely with your research colleagues. NWA strongly encourages collaboration between researchers and WIC practitioners to conduct high quality research to support the program and identify innovative approaches to program improvement. If you have any questions, please contact Georgia Machell, Research and Evaluation Manager [email protected].

2017 Michigan Pregnancy & Pediatric Nutrition Surveillance Annual Report with 2010-2015 Trends

The 2017 Michigan Pregnancy (PNSS) and Pediatric Nutrition (PedNSS) Annual Report is comprised of data collected via the MI-WIC system utilized by local WIC agency staff members. Previously, the PNSS and PedNSS report was nationally generated by the Center for Disease Control and Prevention (CDC), but was last generated by the CDC in 2011. Since 2012, Michigan PNSS and PedNSS has been generated by the Michigan Department of Health and Human Services’ (MDHHS) WIC Program and is implemented using the CDC model. The 2017 report explores the demographic composition and health status of Michigan WIC participants in 2015 and highlights trends from 2010-2015. The data is analyzed using SAS 9.4, and both descriptive and analytical statistics are used to comprehend the data outcomes and identify important trends. The Michigan PNSS and PedNSS reports monitor the nutritional status and health outcomes of all WIC participants, and are therefore excellent administrative tools for evidence based decision-making.

The release of this annual report is important because it keeps Michigan WIC state and local agency staff aware of how the program is progressing toward its goals. The report is used in strategic planning and program evaluation by allowing Michigan WIC to focus on specific areas that require improvement, and tailoring interventions toward them. Additionally, the report displays strongpoints of the Michigan WIC program, which aids local legislators in making decisions about the program’s funding. Finally, this report gives all of Michigan WIC the opportunity to celebrate the achievements of local agencies. The consistent and improved outcomes serve as encouraging reminders to Michigan WIC staff to continually strive for excellence in their daily work of serving Michigan families.

FNS Update: WIC Participant and Program Characteristics 2016

On May 27th, the USDA Food and Nutrition Service (FNS) released the WIC Participant and Program Characteristics 2016 (PC 2016) Report. PC 2016 summarizes the demographic characteristics of participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) nationwide in April, 2016. It includes information on participant income and nutrition risk characteristics, estimates breastfeeding initiation rates for WIC infants, and describes WIC members of migrant farm-worker families. PC 2016 is the most recent in a series of reports generated from WIC State management information systems data biennially since 1992.

  • Similar to 2014, just over 76 percent of participants were infants and children under 5 years of age.
  • The proportion of breastfeeding women exceeded that of non-breastfeeding postpartum women, continuing the trend first seen in 2012.
  • Breastfeeding initiation and duration continues to increase. Among the 83 WIC State agencies that reported breastfeeding data for 2016, 71.0 percent of all 6- to 13-month-old infants and children participating in WIC were breastfed or still breastfeeding compared with 69.8 percent in 2014.
  • The racial and ethnic characteristics of the WIC population in 2016 were similar to 2014.
  • Nearly all (98 percent) of WIC participants reporting income had an income at or below 185 percent of poverty.
  • In 2016, over 53 percent of pregnant WIC participants enrolled in WIC during their first trimester, a slightly lower percentage than in 2014.
  • Dietary (57.0 percent) and anthropometric (51.8 percent) risks were the most common broad categories of nutritional risk assigned at program enrollment.

A summary of the report can be found here. For questions about this report, please contact [email protected].

WIC Infant Toddler Feeding Practices Study 2: Second Year Report

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

On May 20th, the USDA Food and Nutrition Service (FNS) released the WIC Infant and Toddler Feeding Practices Study-2 (WIC ITFPS-2), also known as the “Feeding My Baby” Study. This study captures data on caregivers and their children over the first 5 years of the child’s life after WIC enrollment to address a series of research questions regarding feeding practices, associations between WIC services and those practices, and the health and nutrition outcomes of children receiving WIC. The study previously produced two reports, the Intentions to Breastfeed Report and the Infant Year Report. The current report focuses on caregivers’ employment, school, and childcare circumstances, as well as the feeding progressions, dietary intake, and weight status of children from birth through around 24 months.

  • Mothers receiving WIC are returning to work and school, and many are continuing to breastfeed while working.
  • Most breastfed children who attend child care regularly continue to receive breastmilk.
  • Most children receiving WIC eat regular meals and consume foods provided by the WIC food package.
  • Most children receiving WIC meet their recommended nutrient intakes, with the exception of vitamins D and E.
  • While most children have a healthy weight-for length, about one in four toddlers have a high weight-for-length

A summary of the report can be found here. Authors of this report recently presented findings at the NWA Annual Conference in Chicago, the presentation slides will soon be available on www.nwica.org. For questions about this report, please contact [email protected].

Integrating Community Health into WIC Practice: Lessons from the Community Partnerships for Healthy Mothers and Children Project

Food deserts stemming from limited community infrastructure, gaps in healthcare services, and social norms discouraging breastfeeding are a few challenges that put healthy living out of reach for many families served by the WIC program. The National WIC Association’s (NWA) Community Partnerships for Healthy Mothers and Children (CPHMC) project aimed to address this challenge by bolstering WIC’s direct service model with policy, systems, and environmental changes to make the healthy choice the easy or default option. In October 2017, NWA published the Partnering4Health white paper in conjunction with four other national organizations funded through the Centers for Disease Control and Prevention’s National Implementation and Dissemination for Chronic Disease Prevention FOA.

As detailed in the white paper, there were local impacts in each geographic region as the local coalitions strategically built and enhanced their partnerships with food retailers, food pantries, restaurants, legislators, WIC clients, healthcare providers, community service providers, and breastfeeding advocates to promote a culture of health in their local communities. In three states, local practices were adopted at the state level:

1) The Breastfeeding Friendly Pharmacy Toolkit developed by the Wood County, WI coalition was adopted by the Pharmacy Society of Wisconsin. 

2) The WIC vendor open house developed by the coalition in Richmond, VA was adopted by the Virginia WIC statewide vending team to provide technical assistance to retailers interested in applying to be a WIC authorized vendor.

3.) The Healthy Food Pantry Toolkit developed by the Thornton, CO coalition was adopted by Hunger Free Colorado and will be a resource for the entire state of Colorado. The coalition’s non-pharmaceutical prescription pads were also shared with all Colorado WIC agencies.

 

Heads-up! New projects from NWA are coming your way!

  • Focus on Caseload: NWA staff, Elisabet Eppes, has taken-on a new role at the Association and will be focusing on the issue of WIC caseload decreases – be on the lookout for opportunities from Elisabet to share your experiences of caseload decreases, best practices, and current trends.

  • WIC Research, Policy and Practice Hub: NWA is in the process of developing an online Research, Policy and Practice Hub. The goal of the hub is to become a one-stop-shop for WIC research, data, best practices, messaging and more. The Hub will also be a venue for sharing YOUR work. If you would like to learn more or join the Hub Review Group, please contact Georgia Machell, Research and Evaluation Manager – [email protected].
  • Pre-Conference on Maternal Mortality: NWA will be hosting a pre-conference before our 2018 Nutrition Education and Breastfeeding Promotion Conference. The pre-conference will involve panels on the issue of rising maternal mortality rates in the US, racial disparities in maternal mortality, the role of implicit bias, and how WIC can help highlight the risk factors associated with maternal mortality. Note: There are limited spaces available. Information on registration will be forthcoming.
  • Call for Abstracts: Virtual Conference- Using Technology to Improve the WIC Participant Experience: By 2020, all State WIC Agencies are required to implement EBT, replacing the old system of paper food vouchers. With the transition to EBT, there is an opportunity for WIC state agencies to use data to inform program management decisions and improve the experience of participation in WIC. To support this transition, the National WIC Association is offering a virtual conference in early December. We invite you to submit presentation proposals for this virtual conference here. All abstracts are due by Sunday, June 17.

Upcoming Conferences

Publications

The last few months have seen a number of new publications on the topic of WIC. To view an abstract, click on the links below.

Food Purchasing and Consumption

Lovelace A, Schetzina K & Jaishankar G. 2018 'Juice Consumption Among Children Aged 9 to 24 Months Participating in Women, Infants, and Children (WIC) Program', Pediatrics, 141, 1.

Cakir M, Beatty T, Boland M, Park T, Snyder S, & Wang Y, 2018 'Spatial and Temporal Variation in the Value of the Women, Infants, and Children Program’s Fruit and Vegetable Voucher' American Journal of Agricultural Economics, 100: 3.

Ng S, Hollingsworth B, Busey E, Wandell J, Miles D & Poti J. 2018, 'Federal Nutrition Program Revisions Impact Low-income Households' Food Purchases', American Journal Of Preventive Medicine, 54, 3, pp. 403-412.

Maternal Health

Gross S, Augustyn M, Henderson J, Baig K, Williams C, Ajao B, Bell-Waddy P, & Paige D 2018, 'Integrating obstetrical care and WIC nutritional services to address maternal obesity and postpartum weight retention', Maternal And Child Health Journal, 22, 6, pp. 794-802.

Thompson, S, Jiang, L, Hammen, C, & Whaley, S 2018, 'Association of maternal depressive symptoms and offspring physical health in low-income families', Maternal And Child Health Journal, 22, 6, pp. 774-882.

Childhood Obesity

Morris G, Bailey-Davis L, Cochran W, Hess L, Marini M, Mowery J, Lutcher S, Savage J & Hosterman J., 2018 'Perceptions About Care Coordination Between Pediatricians and Women, Infants and Children (WIC) for Early Childhood Obesity Prevention' Pediatrics, 141, 1.

Baby Friendly

Patterson J, Keuler S & Olson B (2018) "The effect of Baby-friendly status on exclusive breastfeeding in U.S. hospitals", Maternal & Child Nutrition, ,pp. e12589-n/a.

Client-Facing Technology

Martinez-Brockman J, Harari N, Segura-Pérez S, Goeschel L, Bozzi V & Pérez-Escamilla, R 2018, 'Impact of the Lactation Advice Through Texting Can Help (LATCH) Trial on Time to First Contact and Exclusive Breastfeeding among WIC Participants', Journal Of Nutrition Education And Behavior, 50, 1, p. 33-42.e1.

Marijuana Use in Pregnancy

Ko J, Tong V, Bombard J, Hayes D, Davy J, & Perham-Hester K 2018, 'Marijuana use during and after pregnancy and association of prenatal use on birth outcomes: A population-based study, Drug And Alcohol Dependence, 187, pp. 72-78.

WIC Caseload Issues

Harding, A., Ragan, A., & Khan, A, 2018 'Systematic underutilization of WIC in Athens-Clarke County' The University of Georgia.

Smock L, Nguyen T, Metallinos-Katsaras E, Magge H, Cochran J, & Geltman P 2018, 'Refugee Children's Participation in the Women, Infants, and Children Supplemental Nutrition (WIC) Program in Massachusetts, 1998-2010', Journal Of Public Health Management And Practice: Published online ahead of print.

Disaster Preparedness

Wemette, M, Shipp Hilts, A, Mack, S, Li, Y, Eidson, M, Santilli, L, Nguyen, T, & Birkhead, G 2018, 'Superstorm Sandy's impact on the provision of WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) services in New York State', Public Health Nutrition, 21, 7, pp. 1388-1398.

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 [email protected].