scholarly journals Association Between Usage of an App to Redeem Prescribed Food Benefits and Redemption Behaviors Among the Special Supplemental Nutrition Program for Women, Infants, and Children Participants: Cross-Sectional Study (Preprint)

2020 ◽  
Author(s):  
Qi Zhang ◽  
Junzhou Zhang ◽  
Kayoung Park ◽  
Chuanyi Tang

BACKGROUND The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is one of the most important food assistance programs in the United States, serving 6.4 million low-income, eligible women, infants, and children under 5 years of age in 2019. In the program, participants are prescribed a list of food benefits, which can be redeemed in WIC-authorized stores. However, there are multiple behavioral barriers in the program and the stores that prevent participants from redeeming the benefits fully. OBJECTIVE This study aims to examine the relationship between the use of a widely used mobile phone app, WICShopper, and the redemption of the prescribed food packages. METHODS WIC administrative data were obtained from West Virginia for the period January 2019 to January 2020 and included 30,440 WIC households that had received food benefits in that period. The redemption rates of 18 WIC food benefits were compared between app users and nonapp users, that is, those who never used the app in the study period. The use behaviors were defined for the app users, including the number of active use benefit cycles, active benefit cycle rates, number of active use days in the cycle, and proportion rates of daytime use. Panel linear regressions were applied to examine how the redemption rates were related to these behaviors over time. RESULTS App users consistently had higher average redemption rates than nonapp users; the difference ranged from 3.6% (4.8% relative) for infant formula to 14.3% (40.7% relative) for fish. After controlling for sociodemographics, the coefficients of app use were significantly positive for all benefit categories except for WIC-eligible nutritionals. More active cycles and active days in the cycle were significantly related to redemption rates for all categories, except for frozen juice (coefficient=−0.002, <i>P</i>=.09). Daytime app access was positively associated with redemption rates for most food benefits except only a few, such as infant formula (coefficient=−0.03, <i>P</i>&lt;.001). CONCLUSIONS Use of the WIC app was significantly related to higher redemption rates across food benefits, although the association varied across benefit categories. More active days were positively related to benefit redemptions across food categories, and the app’s daytime use was positively associated with the redemption of most benefit categories. These findings suggest that the WIC app can be an important tool for the promotion of benefit redemption among WIC participants.

10.2196/20720 ◽  
2020 ◽  
Vol 8 (10) ◽  
pp. e20720 ◽  
Author(s):  
Qi Zhang ◽  
Junzhou Zhang ◽  
Kayoung Park ◽  
Chuanyi Tang

Background The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is one of the most important food assistance programs in the United States, serving 6.4 million low-income, eligible women, infants, and children under 5 years of age in 2019. In the program, participants are prescribed a list of food benefits, which can be redeemed in WIC-authorized stores. However, there are multiple behavioral barriers in the program and the stores that prevent participants from redeeming the benefits fully. Objective This study aims to examine the relationship between the use of a widely used mobile phone app, WICShopper, and the redemption of the prescribed food packages. Methods WIC administrative data were obtained from West Virginia for the period January 2019 to January 2020 and included 30,440 WIC households that had received food benefits in that period. The redemption rates of 18 WIC food benefits were compared between app users and nonapp users, that is, those who never used the app in the study period. The use behaviors were defined for the app users, including the number of active use benefit cycles, active benefit cycle rates, number of active use days in the cycle, and proportion rates of daytime use. Panel linear regressions were applied to examine how the redemption rates were related to these behaviors over time. Results App users consistently had higher average redemption rates than nonapp users; the difference ranged from 3.6% (4.8% relative) for infant formula to 14.3% (40.7% relative) for fish. After controlling for sociodemographics, the coefficients of app use were significantly positive for all benefit categories except for WIC-eligible nutritionals. More active cycles and active days in the cycle were significantly related to redemption rates for all categories, except for frozen juice (coefficient=−0.002, P=.09). Daytime app access was positively associated with redemption rates for most food benefits except only a few, such as infant formula (coefficient=−0.03, P<.001). Conclusions Use of the WIC app was significantly related to higher redemption rates across food benefits, although the association varied across benefit categories. More active days were positively related to benefit redemptions across food categories, and the app’s daytime use was positively associated with the redemption of most benefit categories. These findings suggest that the WIC app can be an important tool for the promotion of benefit redemption among WIC participants.


2021 ◽  
pp. 089033442199377
Author(s):  
Kirstie Ducharme-Smith ◽  
Susan M. Gross ◽  
Amy Resnik ◽  
Nadine Rosenblum ◽  
Chloe Dillaway ◽  
...  

Background The Baby-Friendly Hospital Initiative is an effective intervention to support maternal practices around breastfeeding. However, adherence of hospitals to the Baby-Friendly 10 Steps, as determined from the perspective of women participating in the United States Special Supplemental Nutrition Program for Women, Infants, and Children, has not been assessed. Research Aims (1) To compare maternal perceptions about maternity practices in Baby-Friendly Hospitals and non-Baby-Friendly Hospitals; (2) to evaluate the associations between degree of exposure to the Baby-Friendly 10 Steps and breastfeeding practices through the first 6 months; and (3) to evaluate whether the receipt of specific Steps was associated with breastfeeding practices through 6 months. Methods This study was a cross-sectional 2 group comparison, using prospective data collected through a self-report telephone survey and retrospective data gathered from participants’ records. Women ( N = 182) participating in four Maryland Special Supplemental Nutrition Program for Women, Infants and Children agencies were recruited. One hundred and eight (59%) participants delivered at designated Baby-Friendly Hospitals; 74 (41%) delivered in non-Baby-Friendly designated hospitals. Logistic regression models were utilized to determine the influence of perceived Step adherence on exclusive breastfeeding. Results Reported adherence to 10-Steps policies ranged from 10%–85% (lowest for Step 9, highest for Step 10) and only Step 9 (give no pacifiers or artificial nipples to breastfeeding infants) differed according to Baby-Friendly Hospital status. Greater exposure to the 10 Steps was positively associated with exclusive breastfeeding during hospitalization. The lack of perceived adherence to Step 6 (no food or drink other than human milk), Step 9, and the International Code of Marketing of Breast-milk Substitutes (no formula, bottles, or artificial nipples) significantly decreased the likelihood of exclusive breastfeeding through 6 months. Conclusion Maternal perception of Baby-Friendly Step adherence was associated with exclusive breastfeeding.


2020 ◽  
Vol 111 (6) ◽  
pp. 1278-1285
Author(s):  
Katelin M Hudak ◽  
Rajib Paul ◽  
Shafie Gholizadeh ◽  
Wlodek Zadrozny ◽  
Elizabeth F Racine

Abstract Background Many lower-income communities in the United States lack a full-line grocery store. There is evidence that the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) increases the availability of healthy foods in stores. One national discount variety store chain (DVS) that is often located in low-income neighborhoods became an authorized WIC vendor in 8 pilot stores. Objectives The objective of this study was to evaluate how implementing WIC in DVS pilot stores affected sales of healthy, WIC-eligible foods. Methods We used DVS sales data and difference-in-differences regression to evaluate how WIC authorization affected sales of WIC-eligible foods in 8 DVS pilot stores, compared with 8 matched comparison stores. Results DVS added 18 new WIC-approved foods to become an authorized vendor. Results indicate that becoming a WIC vendor significantly increased sales of healthy, WIC-eligible foods that DVS carried before authorization. WIC implementation in DVS led to a 31-unit increase in sales of the original WIC foods per week on average (P &lt; 0.01). Lower socioeconomic status, assessed using a summary measure, is associated with increased sales of WIC foods. Yet sales of non-WIC eligible foods (e.g., salty snack foods, candy bars, soda, and processed meats) were not affected by WIC authorization. Conclusions Encouraging DVS stores to become WIC-authorized vendors has the potential to modestly increase DVS sales and the availability of healthy foods in low-income neighborhoods. If WIC authorization is financially viable for small-format variety stores, encouraging similar small-format variety stores to become WIC-authorized has the potential to improve food access.


2018 ◽  
Vol 35 (1) ◽  
pp. 37-41 ◽  
Author(s):  
Shari Salzhauer Berkowitz

Background: Breastfeeding is known to be the most beneficial way of feeding infants, but 68% of the infants enrolled in the U.S. Department of Agriculture’s Special Supplemental Nutrition Program for Women, Infants, and Children are fully formula fed. Mandated annual reports about breastfeeding aggregate data from the states into regions, which obscures important information. Research Aim: The aim of this study is to reexamine the data supplied by the Special Supplemental Nutrition Program for Women, Infants, and Children to identify which areas of the United States have the lowest incidence of breastfeeding infants. Methods: A retrospective cross-sectional observational study was conducted. Data from the Breastfeeding Data Local Agency Report were extracted, graphed, and analyzed. Results: Data provided from the Special Supplemental Nutrition Program for Women, Infants, and Children for fiscal year 2016 show that the range of fully formula fed infants at the regional level is 60% to 78%, while at the state level the range is wider, at 51% to 89%. The states with the largest numbers of fully formula fed infants were Mississippi (89%), Louisiana (88%), Alabama (88%), and Arkansas (87%). When examining data from all 90 reporting agencies, the range of fully formula fed infants was 38% to 95%. Conclusions: Aggregating state, Native American nation, and territorial data at the regional level resulted in a loss of important information. WIC’s current breastfeeding interventions may be more effective in some areas than others. Future research can examine successful and unsuccessful interventions on a state or local level.


2020 ◽  
Vol 150 (11) ◽  
pp. 2985-2993
Author(s):  
Joanne F Guthrie ◽  
Andrea S Anater ◽  
Joel C Hampton ◽  
Diane J Catellier ◽  
Alison L Eldridge ◽  
...  

ABSTRACT Background In 2009 the USDA's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) updated the food packages provided to participants. Objectives This study investigates associations between WIC participation and nutrients and food groups consumed using data from the Feeding Infants and Toddlers Study's 2008 and 2016 nationwide, cross-sectional surveys of children &lt;4 y, weighted to be representative of the US population. Methods The study data included 2892 children aged 6–47.9 mo in 2008 and 2635 in 2016. Differences were analyzed by WIC participation, survey year, and child age (infants 6–11.9 mo old, toddlers 12–23.9 mo old, preschoolers 24–47.9 mo old). Usual nutrient intake distributions were estimated using National Cancer Institute methodology. Daily food group consumption differences were tested via multivariate regression. All analyses controlled for income. Results In 2016 18.6% of infants had iron intakes below the estimated average requirement (EAR), compared to 7.6% in 2008; 87% of WIC infants met the EAR, compared with 69% of non-WIC infants. In 2016 37% of WIC preschoolers met saturated fat guidelines, compared with 25% in 2008; in both years, fewer than one-third of non-WIC preschoolers met the guidelines. More WIC infants than non-WIC infants consumed infant cereals in 2016 (58% compared with 45%, respectively). More WIC infants ate vegetables daily in 2016 than in 2008 (74% compared with 59%, respectively).  In 2016, as compared with 2008, more WIC infants consumed baby-food vegetables (55% compared with 29%, respectively) and fruits (56% compared with 41%, respectively). In 2016 47% of WIC preschoolers drank low-fat milk, compared with 19% of non-WIC preschoolers. Conclusions Infant iron intakes are concerning, although more WIC infants meet the EAR. WIC infants’ vegetable intakes have improved; baby-food vegetables have become important contributors to their intakes. In 2016 WIC children were more likely than non-WIC children to shift to lower-fat milks at 2 y of age, likely contributing to lower saturated fat intakes.


Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3888
Author(s):  
Morium B. Bably ◽  
Rajib Paul ◽  
Sarah B. Laditka ◽  
Elizabeth F. Racine

Added sugar intake at a young age is associated with chronic diseases including cardiovascular diseases, asthma, elevated blood pressure, and overweight. The Dietary Guidelines for Americans 2020–2025 and the American Heart Association recommend delaying the introduction of added sugar until age 2. The aims of this study were to identify the timing of added sugar initiation; factors associated with added sugar initiation; and the top five added sugar foods and beverages consumed by infants and children at three age ranges (< 7 months, 8–13 months, and 14–24 months). Data were from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Infant and Toddler Feeding Practices Study-2, a longitudinal, national population of WIC participants enrolled in WIC eligible clinics (n = 3835). The Cox proportional hazards model was used to examine the factors associated with introducing added sugar. About 25% of children were given added sugar at or before 7 months. Contributing factors were caregivers’ race/ethnicity, education, employment, weight status, parity, child sex, and premature birth (all p < 0.05). The top added sugar foods consumed between 1–24 months were cereal, crackers, apple sauce, dessert, yogurt, sweetened beverages, syrup and preserves, and cookies. Further research to examine the impact of early initiation of added sugar on health outcomes and taste preferences is warranted.


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