National WIC Association

Summer 2017 WIC Research to Practice



Welcome to the Summer 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 highlight the importance of research in determining how to enhance the WIC shopping experience, learn more about Anthony Panzera, public health researcher, and his research involving WIC mothers, and give you a chance to submit an abstract for our 2018 Annual Conference. 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 Fall edition, please contact Georgia Machell, .

New York State Report

Through a 2010 WIC Special Projects Grant from the Food and Nutrition Service (FNS) of the U.S. Department of Agriculture (USDA), the NY State WIC Program pilot-tested three strategies aimed at improving the shopping experience of WIC participants and the retention of eligible participants. Agencies implemented one or a combination of the following three strategies: a standardized Shopping Orientation (SO) curriculum, Guided Shopping Tours (GST), and/or a Pictorial Foods Card (PFC). The evaluation team used a mixed-method approach consisting of WIC administrative data, focus group and semi-structured interview data to determine how WIC local agencies implemented the strategies and whether improvements in shopping or retention rates were subsequently observed. Several sites implemented the SO and PFC programs as intended (fidelity) and covered the relevant SO topics depending on participants’ needs and experience with the WIC program. Sites that were assigned to the GST strategy struggled to attract participants to attend shopping tours at participating grocery stores. However, in preparing for the GST strategy, staff conducted test-runs of the intervention at grocery stores and thought the shopping tours could serve as a useful training tool for new WIC staff. Additionally, use of the standardized SO allowed staff to use a “consistent list of shopping tips” to educate participants about the proper use of checks. Use of the PFC helped participants gain a better awareness of the variety of WIC-allowable foods. During follow-up telephone calls, 91 percent of participants reported that the shopping tips were helpful.

Perceived Impact Among Staff and Participants:

  • During and after the implementation phase, WIC staff reported an enhanced knowledge of shopping strategies that can be used to educate participants on how to shop for their WIC foods.
  • Participants who were contacted after the intervention expressed an appreciation of the intervention materials, particularly the pictorial foods card, which led to improved knowledge of the variety of allowable WIC foods; and an appreciation for the follow-up telephone calls that staff made to inquire about their shopping experience.

Policy Implications:

  • Measures that enable participants to gain a better understanding of WIC-allowable foods are important for promoting a positive shopping experience. This can be achieved through the use of tools such as the pictorial foods card, web-based and mobile device-supported pictorial foods card.
  • While the arrival of EBT cards in the WIC program will undoubtedly make the redemption of benefits much smoother, WIC staff will still need to educate participants on how to select WIC-approved foods in stores. As such, a standard shopping orientation for WIC participants will still be essential, and may require the training of WIC staff using a shopping orientation curriculum or guided shopping tours similar to those pilot-tested in this study.

For a summary report that highlights the intervention results click here . For the peer-reviewed manuscript that provides a detailed description of the strategies and the implementation evaluation methodology click 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: Anthony Panzera, PhD, MPH

Anthony “Tony” Panzera is a public health researcher with a background in epidemiology, social marketing, community health, and policy. He is a New York native and has been living in Washington, D.C. with his husband for more than ten years.

These responses were written by Anthony Panzera in his personal capacity. The opinions expressed herein are his own and do not reflect the view of the United States Department of Agriculture, the Food, Nutrition, & Consumer Services Agency, or the United States Government.


What drew you to study WIC?

I had a specific interest in WIC since I began a public health career. WIC is the nexus of public health, nutrition, and service to low-income and vulnerable populations – it is an incredibly important part of maternal and child health in this country.

The dissertation is a unique experience where you get to devote a considerable amount of time on a very particular subject. However, I am very practical, and I wanted my dissertation to respond to real questions that were important to state agencies. This study, in addition to two other efforts, was a culmination of these factors.

What was the goal of your study?

The goal of this study was to describe the experiences of those WIC mothers who had missed scheduled appointments and were subsequently dropped from the program, with the hope of informing efforts to prevent such nonparticipation.

What were the main methods used?

For this study, we employed direct observation, an abbreviated participant observation, and focus group techniques, to build a description of participant journeys.

What is the relationship between social marketing and public health, why did you choose to integrate the two?

Broadly, social marketing is an approach to a behavioural objective; it is one of many approaches and frameworks public health practitioners can use to directly address health outcomes that are dependent on people taking action. In social marketing, the solution is driven by deep formative research on the target audience, from objectives to positioning and messaging, and involves assessment and evaluation, which is a function of public health.

What is Journey Mapping?

Journey mapping is the wonderful tool that helps us come closer to understanding service use from the eyes of participants. The article provides a fuller description of journey mapping, but briefly it encompasses a variety of techniques to systematically document the participant, patient, or target user narrative, often resulting in a visual “journey map” or “process map.” But the role of maps goes beyond description – it highlights where in the process of service program staff can make real changes to enhance participant experiences.

From your work, what are the main barriers to WIC participation?

As we looked at nonparticipation specifically, the barriers echoed what others have found over the years: scheduling appointments can be difficult; transportation and childcare are not always assured and can be prohibitive; different forms of stigma play a role in eligible women’s decisions to participate; confusion regarding eligibility persists; and satisfaction with the quality of provided service (both at sites of WIC services and at vendor environments) has some impact on decisions to continue participating.

What about the WIC experience did participants value most?

Mothers in Kentucky valued screenings, the “financial assistance” in the form of the prescribed food packages, and the counselling WIC staff provided. Moms were really happy to have access to healthy food options for their children. A finding that bears repeating is that WIC staff members play such a crucial role in the value of the program to moms; the positive experiences mothers noted were those moments when a WIC staff member was a source of personalized nutritional and health-related advice. Appointments that are “quick and easy” were regarded as a benefit by moms in the study.

How can state and local WIC agencies use journey mapping to better understand and document the WIC participant experience?

The flexibilities in journey mapping make it very useful for state and local agencies. In our work, we started by developing a depiction of the journey map of what participants were “supposed to experience” based on procedures manuals and regulations regarding nonparticipation – starting there helps begin discussions. While this is step is important, this will only get you half the story.

If I could do this work over again with more resources than we had, I would recruit many mothers to develop their own journey maps. Identifying where agency and participant journey maps diverge tells you two key insights: where program operations move away from what’s intended or expected by participants, and the location of “touchpoints” along participant-defined journeys. Touchpoints on participant maps are where creative solutions are needed.

Also, including local agency, clinic, and mobile site staff in the development of journey maps would also bring stronger insight. These staff are the face of the program and know the daily struggles that they and participants encounter. Both mothers (and caregivers) and local staff should be included in the development of practical creative solutions to overcome local barriers to high-value WIC experiences.

How did you build rapport with the local WIC clinic you were conducting research within?

It was essential to emphasize with WIC staff that they were the ones with knowledge and I was there to learn from them. I made sure to thank each and every person that helped with coordinating activities (like focus groups) or taught me something during my time at local agencies. Every staff member can teach you something important about the program; it is important to honour their hard work with listening. Congeniality and being accommodating while minimizing the burden of the research is absolutely key – research on WIC is practice-based.

What advice do you have for other researchers hoping to work with local WIC agencies and vice-versa?

For researchers, abandon “research jargon” when discussing the work with staff; speaking in terms that only you understand will end discussions before they really begin. Consider yourself the outsider eagerly wanting to be an insider, but do your due diligence with learning about the program and how it operates before starting any conversation (read regulations and procedures manuals). Explain in simpler terms how local WIC agency participation in research will indirectly or, if possible, directly benefit them. Understand the struggles of the local agency with which you are partnering. If possible, involve staff members in the development of research.

For local WIC agencies, use researchers to your advantage. Outline the pressing needs of your office that staff members just do not have the time to address. Partnerships with researchers can lead to great collaborative solutions that are informed of data, program policy, and operations.

Supplemental Issue to the Journal of Nutrition and Education Focuses on WIC and Breastfeeding

The Society for Nutrition Education and Behavior published a supplemental issue on WIC in the Journal of Nutrition Education and Behavior. Featuring 15 articles, the special issue presents exciting new research on breastfeeding and WIC, and provides important historical context on the role of breastfeeding promotion and support activities in the WIC program. In addition, it also discusses USDA’s breastfeeding priorities. We are thrilled to see this collection of peer reviewed articles that demonstrate the impact that WIC can make on breastfeeding.

Call for Abstracts

The National WIC Association invites members and partners to submit presentation and poster proposals for the NWA 2018 Annual Education and Training Conference and Exhibits being held April 22-25, 2018, in Chicago, IL. The 2018 conference theme is: Lifting WIC Voices to Engage & Inspire . What are you doing to lift up WIC in your community? How are you engaging your clients? How are you inspiring those around you in WIC? Share your strategies and successes with us!

In the true spirit of this conference, below are the suggested educational tracks for oral and poster submissions:

  • Advocacy
  • Breastfeeding & Nutrition
  • Communication (Recruitment & Retention)
  • Community Engagement
  • Leadership
  • Program Integrity
  • Research & Evaluation
  • Technology
  • Vendor Management

The conference tracks may align with your content but is not required. All topics within a track’s purview are welcome. 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 Friday, October 13, 2017 , and will be reviewed by the Annual Conference Program Planning Committee.

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

Proposal Guidelines
Authors will be prompted to provide the following information into the submission platform.


  • Suggested topical track and presentation title
  • Abstract (The recommended proposal length is 300 words)
  • Presenter information: name, institution, city, state, email address
  • Co-Author(s) Information: name/s, institution/s, email address/es

A maximum of four presenters may be listed on each proposal. The submitting author will receive an email message confirming the receipt of the abstract proposal submission and are responsible for keeping co-authors up to date on the status of the submission. All presenting authors are responsible for registration, travel, and hotel costs.

Contact Information
If you have any questions regarding this process or the conference in general, please contact Shameka Jennings at or 202-232-5492.

The Annual Conference is an excellent opportunity to expand your professional skills and knowledgebase to equip you to face coming WIC challenges and to take advantage of current and future WIC opportunities.

On behalf of the 2018 Conference Planning Committee, we look forward to receiving your abstract submission. Thank you in advance for your commitment to the excellence of next year’s meeting.

Upcoming NWA Conferences

September 25-28, 2017: Memphis, TN, Biennial Technology and Program Integrity Education & Networking Conference and Exhibits .

March 4-7, 2018: Washington, DC, Washington Leadership Conference .

April 22-25, 2018: Chicago, IL, NWA Annual Education and Training Conference and Exhibits .

September 24-27, 2018: New Orleans, LA, Nutrition Education and Breastfeeding Promotion Conference and Exhibits .


Below is a selection of recently published article abstracts.


Breastfeeding Initiation in Mothers with Repeat Cesarean Section: The Impact of Marital Status
Wallenborn J, Graves W, Masho S - Breastfeeding Medicine: The Official Journal Of The Academy Of Breastfeeding Medicine , 2017

Low rate of initiation and short duration of breastfeeding in a maternal and infant home visiting project targeting rural, Southern, African American women
Thomson J, Tussing-Humphreys L, Goodman M, Landry A, Olender S - International Breastfeeding Journal , 2017

An assessment of the social cognitive predictors of exclusive breastfeeding behavior using the Health Action Process Approach
Martinez-Brockman J, Shebl F, Harari N, Pérez-Escamilla R - Social Science and Medicine , 2017

Relationship of feeding practices with sleep duration on infant weight at 12 months
Wyst K, Whisner C, Petrov G, Gallagher M, Reifsnider E - The Official Journal of the Federation of American Societies for Experimental Biology , 2017

The impact of WIC on breastfeeding initiation and gestational weight gain: Case study of South Carolina Medicaid mothers
Sonchak L - Children and Youth Service Review , 2017

New Opportunities for Breastfeeding Promotion and Support in WIC: Review of WIC Food Packages, Improving Balance and Choice
Rasmussen K, Whaley S, Escamilla R, Ross A, Baker S, Hatfield T, Latulippe M - Journal of Nutrition Education and Behavior , 2017

The Impact of Federal Policy Changes and Initiatives on Breastfeeding Initiation Rates and Attitudes Toward Breastfeeding Among WIC Participants
Panzera A, Brown K, Paolicelli C, Morgan R, Potter A, Berman D - Journal of Nutrition Education and Behavior , 2017

Maternal Distraction During Breast- and Bottle Feeding Among WIC and non-WIC Mothers
Ventura A, Teitelbaum S - Journal of Nutrition Education and Behavior , 2017

Associations Between Peer Counseling and Breastfeeding Initiation and Duration: An Analysis of Minnesota Participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)
McCoy M, Geppert J, Dech L, Richardson M - Maternal and Child Health Journal , 2017

Feasibility and acceptability of a text message intervention used as an adjunct tool by WIC breastfeeding peer counsellors: The LATCH pilot
Harari N, Rosenthal M, Bozzi V, Goeschel L, J Ayewickreme T, Onyebeke C, Griswold M, Perez-Escamila R - Maternal and Child Health Journal , 2017

A Community Partnership to Support Breastfeeding Mothers of Late Preterm Infants
Bennett C, Grassley J - Nursing for Women's Health , 2017

WIC Food Package

WIC Works! Positive Influence of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) on Diet Quality in Low Income Children
Zimmer M, Vernarelli J - The Official Journal of the Federation of American Societies for Experimental Biology , 2017

Nutrient Inadequacy Among Nutritionally Vulnerable Populations in the US
Conrad Z, Johnson L, WenyYen J, Roemmich J, Jahns L - The Official Journal of the Federation of American Societies for Experimental Biology , 2017

Healthful, Cultural Foods and Safety Net Use Among Cambodian and Brazilian Immigrant Communities in Massachusetts
Cordeiro L, Sibeko L, Nelson-Peterman J - Journal of Immigrant and Minority Health , 2017

Effect of an Internet-Based Program on Weight Loss for Low-Income Postpartum Women A Randomized Clinical Trial
Phelan S, Hagobian T, Brannen A - JAMA , 2017

Childhood obesity prevention in the Women, Infants, and Children Program: Outcomes of the MA-CORD study
Woo J, Nelson C, Perkins M, Colchamiro R, Leung-Strle P, Kwass J, Gortmaker S, Davison K, Taveras E - Obesity Society , 2017

The role of WIC in Obesity Prevention
Koleilat M, Whaley S, Esguerra K, Sekhobo J - Current Pediatrics Report , 2017

Rural and Urban

Household food insecurity and dietary patterns in rural and urban American Indian families with young children
Tomayko E, Mosso K, Cronin K, Carmichael L, Kim K, Parker T, Yaroch A, Adams A - BMC Public Health , 2017

Exploring the Potential for Technology-Based Nutrition Education Among WIC Recipients in Remote Alaska Native Communities
Power J, Braun K, Bersamin A - Journal of Nutrition Education and Behavior , 2017

WIC Participation

Do unconditional income supplements improve poor pregnant women’s birth outcomes?
Brownell M, Chartier M, Nickel N - Pediatrics , 2017

Juice and Sugar Sweetened Beverages

Time for an End to Juice in the Special Supplemental Nutrition Program for Women, Infants, and Children
Farris H, Isganaitis E, Brown F - JAMA Pediatrics , 2017

Choosy mothers choose ... fruit!
Mcnutly T - Contemporary Pediatrics , 2017

Cognitive Development

Decreasing Disparities in Child Development Assessment: Identifying and Discussing Possible Delays in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)
Zuckerman K, CHaves A, Reeders J - Journal of Developmental & Behavioral Pediatrics , 2017

Food Insecurity

The Association between Food Security and Store-Specific and Overall Food Shopping Behaviors
Ma X, Liese A, Hibbert J, Bell B, Wilcox S, Sharpe P - Journal of the Academy of Nutrition and Dietetics , 2017

Changes in household food insecurity are related to changes in BMI and diet quality among Michigan Head Start preschoolers in a sex-specific manner
Jansen E, Kasper N, Lumeng J, Brophy Herb H, Horodynski M, Miller A, Contreras D, Peterson K - Social Science and Medicine , 2017


Purchases Made with a Fruit and Vegetable Voucher in a Rural Mexican-Heritage Community
Hanbury MM, Gomez-Camacho R, Kaiser L, Sadeghi B, de la Torre A - Journal of Community Health , 2017

Tracking the Use of Free Produce Coupons Given to Families and the Impact on Children's Consumption
Chinchanachokchai S, Jamelske E, Owens D - Wisconsin Medical Journal , 2017

Outcomes of a randomized controlled trial of nutrition education to promote farmers' market fruit and vegetable purchases and consumption among women enrolled in the Special Supplemental Nutrition Program for Women Infants and Children (WIC)
Di Noia J, Monica D, Sikorskii A, Cullen K - BMC Nutrition , 2017

Effects of a 2014 statewide policy change on cash-value voucher redemptions for fruits/vegetables among participants in the Supplemental Nutrition Program for Women, Infants, and Children (WIC)
Okeke J, Ekanayake R, Santorelli L - Maternal and Child Health Journal , 2017

Perceived influences on Farmers' Market use among Urban, WIC-enrolled Women
Di Noia J, Monica D, Cullen K, Thompson D - American Journal of Health Behavior , 2017

Retain Experience

Minimum Stocking Requirements for Retailers in the Special Supplemental Nutrition Program for Women, Infants, and Children: Disparities Across US States
Pelletier J, Schreiber L, Laska M - American Journal of Public Health , 2017

A Smartphone App for Families With Preschool-Aged Children in a Public Nutrition Program: Prototype Development and Beta-Testing
Hull P, Emerson J, Quirk M, Canedo J, Jones J, Vylegzhanina V, Schmidt D, Mulvaney S, Beech B, Briley C, Harris C, Husaini B - Journal of Medical Internet Research , 2017

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 .