how to achieve better utilization of the wic food package · 2019. 4. 18. · how to achieve better...
TRANSCRIPT
How to Achieve Better Utilization of the WIC Food Package
NWA Leadership Academy September 25, 2013: 3:00 – 4:00 p.m. EST PRESENTERS: Barbara Longo, MS, RD, Deputy Division Chief, Nutrition and Local Program Services, California WIC Program Jackie Charnley, MS, RD, WIC Nutrition Coordinator, Vermont WIC Program Sanya Peck, MPH, Program Research Specialist II, Division of Nutrition, New York State Department of Health Diane Phillips, MBA, RD, Senior Associate, Altarum Institute, Center for Food Assistance and Nutrition
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National WIC Association Introduction
Barbara Longo, MS, RD, Deputy Division Chief, Nutrition and Local Program Services, California WIC Program
Jackie Charnley, MS, RD, WIC Nutrition Coordinator, Vermont WIC Program
Sanya Peck, MPH, Program Research Specialist II, Division of Nutrition, New York State Department of Health
Diane Phillips, MBA, RD, Senior Associate, Altarum Institute, Center for Food Assistance and Nutrition
National WIC Association Q&A
Agenda
• Learn from California’s and Vermont’s experience to keep WIC local;
• Understand the 3 strategies that help overcome NY WIC participants’ food package-related issues;
• Identify potential implications for impacting redemption of WIC foods.
Objectives
Barbara Longo, MS, RD Deputy Division Chief, Nutrition and Local Program Services Women, Infants and Children (WIC) Program California Department of Public Health
September 25, 2013
California Dried Fruit Coalition
California Dried Fruit Coalition…easy as 1,2,3
1. Patience and persistence 2. Economic and health facts 3. Food preference survey
Not allowed for children
Working with Industry Partners: How Vermont Kept it Local Jackie Charnley, MS, RD Vermont WIC Program
WIC: Still home delivered in Vermont.
WIC Fruit and Veggie Card
La Panciata Bakery, Northfield, VT
NY WIC Retention Promotion Study: Keep, Reconnect, Thrive
Sanya Peck, M.P.H - Project Coordinator
Evaluation, Research, and Surveillance Unit, Division of Nutrition,
NYS Department of Health
Acknowledgements USDA, Food & Nutrition Service
Evaluation, Research, and Surveillance Unit
- DON, NYS DOH
• Dr. Jackson Sekhobo, Principal Investigator
• Dr. Lynn Edmunds, Co-Principal Investigator
• Mark Giddings
• Dr. Chengxuan Yu
• Youjung Byun
• Mary Ellen Murphy
WIC Program Staff --- DON, NYS DOH
• Heidi Militana, Public Health Nutritionist
• Connie Stephano
Partnering Institutions
• Mailman School of Public Health, Columbia
University: Dr. Sally Findley and staff.
• Public Health Solutions: Dr. Mary Ann
Chiasson and staff.
Health Research, Inc.
NYS WIC Association
WIC Retention Advisory Board
WIC Local Agencies
PRECURSORY RESULTS
IMPLEMENTATION
INTERVENTION
BACKGROUND Problem Statement
Documentation
OUTLINE
Study Goals Identification of Barriers
Strategies Planning
Eligible > Enrolled > Caseload
155,848 143,639
498,550
141,902 137,465
297,531
125,786 121,843
263,736
0
100,000
200,000
300,000
400,000
500,000
600,000
Women Infants Children
Estimated Eligible
Avg Mthly Enrollment
Avg Mthly Caseload
Source: NYS Estimated 2010 WIC Eligible NYS DOH DON EAU
OVERVIEW Problem
OVERVIEW Goals
WIC RPS Goal
RETENTION
SUSTAINABLE
TRANSFERABLE
Strategies Identify
Implement
Evaluate
WIC Retention Advisory Board (RAB)
OVEVIEW Collaboration
COORDINATORS & STAFF
PROGRAM STAFF RESEARCHER
CURRENT WIC PARTICIPANT BREASTFEEDING
PEER COUNSELOR
PROGRAM STAFF CONSULTANT
CONSULTANT
VMA Director
EVALUATION RESEARCH &
SURVEILLANCE UNIT
Barriers, Strategies, & Suggestions
Coordinators n=104
Staff n=48
Vendors n=132
T:
Q:
OVERVIEW Barriers
21 FOCUS GROUPS
9 7
5
Consensus on Barriers
COORDINATORS
VENDORS STAFF
Negative Shopping Experience
Low Perceived Value of WIC
OVERVIEW Barriers
2. ENGAGED RAB
3. NYS WIC ASSOCIATION CONFERENCE
1. FOCUS GROUP STRATEGIES 4. PHONE INTERVIEWS
WITH OTHER STATES
INTERVENTION PLANNING
Process for Selecting Potential Strategies
INTERVENTION Strategies
Final 3 Strategies
SHOPPING ORIENTATION
GUIDED SHOPPING
TOURS
PICTORIAL FOODS CARD
Shopping Orientation
Improve the shopping journey!
Empower participants to properly identify WIC foods!
Check-out with confidence!
TARGETED CURRICULUM
Strategy 1
INTERVENTION Strategies
Shopping Orientation
Parts
Checkout
Before Shopping
While Shopping
TARGETED CURRICULUM
BOOKMARK
Strategy 1
36” X 20” OVERSIZED CHECK on .25” foam board
Strategy’s Materials
INTERVENTION Strategies
Guided Shopping Tours HANDS-ON GUIDANCE
Strategy 2
GUIDED SHOPPING POSTER & PALM CARD Strategy’s Materials
INTERVENTION Strategies
Pictorial Foods Card
APPETIZING & IDENTIFIABLE PHOTOS OF WIC FOODS
EASY NAVIGATION - CATEGORY TABS - CONTENT ORGANIZED BY STORE
KEY ELEMENTS:
Strategy 3
Strategy’s Material
INTERVENTION Strategies
Pictorial Foods Card
• BUILT-IN SHOPPING ORIENTATION
• FRESH PRODUCE CHART
CONTENT
Strategy 3
INTERVENTION Strategies
Part 1 SHOPPING ORIENTATION FORM
Part 2 CLOSING THE LOOP FOLLOW-UP CALLS
PROBLEM SOLVE
2-WEEKS
Start Intervention…
WIC Staff Calls Participant
INTERVENTION Documentation Phone Calls &
Intervention Tracking
Target Population
New Participants
Infants adding solids at
6 months
Infants getting ready
to switch to the child food package at 9-12 months
1 2 3
INTERVENTION
INTERVENTION Usual Intensive 1 Intensive 2 Intensive 3
STRATEGY SO SO + GST SO + PFC SO + GST + PFC
# AGENCIES 4 2 3 1
Combination of Strategies
INTERVENTION
KEY SO – Shopping Orientation GST – Guided Shopping Tours
PFC – Pictorial Foods Card
MAT
ERIA
LS
• Enlarged Check
• Bookmarks
• Enlarged Check
• Bookmarks
• Palm Cards
• Posters
• Enlarged Check
• Pictorial Foods Card
• Enlarged Check
• Pictorial Foods Card
• Palm Cards
• Posters
Implementation
IMPLEMENTATION
At agencies
NOVEMBER 2012
JUNE 2013
STRATEGIES PRELIMINARY RESULTS
SO Mixed Response - Agencies said they were already doing some of these - Agencies found the checklist & tips insightful
GST Successful - Eye-opener for all staff who attended the tours - Useful for training NEW staff
PFC Successful - Easier for staff to education participants on the food packages
Phone Calls
Mixed Response - Some agencies felt it was time-consuming - Frustrated by the frequent change in contact information - Surprised by the positive responses from participants - Some staff enjoyed making the calls
RESULTS
from Staff
STRATEGIES PRELIMINARY RESULTS
SO Positive Response - Participant felt more prepared
GST
Not Successful - Participants liked idea, but wanted to try with friend/ family first - Participants tends to shop where there’s cultural, and language affinity
PFC
Highly Successful - Works very well for low-literacy, ESL, & non-English speakers - Participants excited about the variety of WIC foods - Some husbands now shop for WIC foods
Phone Calls Positive Response - Participants appreciated the follow-up calls - Used the calls to ask other questions
RESULTS
Participants from
Conclusion
CONCLUSION
3 STRATEGIES
ADDRESSED BARRIER of
Negative Shopping Experience
Which combination of strategies had the greatest impact on check utilization and retention ?
Highlights from a Redemption Study in 3 WIC EBT States
Diane Phillips, MBA, RD Center for Food Assistance and Nutrition
45
Study In 3 States: KY, MI, NV ▲ Issuance & redemption data from Jan-Mar 2012 ▲Obtained demographic characteristics of WIC families ▲Associated these two major data points – closer look at
characteristics of WIC families redeeming full benefit ▲Conducted participant focus groups in each state ▲Conducted vendor interviews in each state
46
Highlights
▲Greatest proportion live in urban areas
▲ In all 3 states combined:12% of WIC families redeemed all their WIC benefit
▲Of those WIC families fully redeeming, greatest proportion had 1 family member on WIC, and yet had 7 or more people in the household
▲For 3 states combined, of families fully redeeming, greatest proportion were Non-Hispanic Asians followed by Hispanic
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Family-Level ‘No Redemption’, By Food Type
▲What do you think is the WIC food item that has the lowest percentage of ‘no redemption’? Lowfat milk - only 9% of families did not redeem any
lowfat milk benefit
▲What’s the next food item closest to milk?
Whole milk – 9.5% of families did not redeem any whole milk benefit
48
Family-Level ‘Full Redemption’, By Food Type
▲Conversely, which WIC food item do you think has the highest percentage of full redemption? Eggs – 76% of WIC families fully redeem
▲Which food category is next? Cheese – 69% of WIC families fully redeem
49
Family-Level Redemption, By CVB
▲Fruit & Vegetable Cash Value Benefit – 3 states combined
36% fully redeemed
50% partially redeemed
14% did not redeem any
50
Family-Level Redemption: Cereal ▲What constitutes ‘full redemption’? If a participant couldn’t purchase any approved cereal with the
remaining benefit on their card
53% fully redeemed their cereal benefit 19% partially redeemed 27% did not redeem any of their cereal benefit
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Family-Level Redemption: Whole Grains
51% of families fully redeem their whole grain benefit
15% partially redeem
34% redeemed none of their whole grain benefit
52
Shopping Patterns During One Month
Mean Range
Number of Shopping Trips
3.2
1-25
Number of Vendors Visited
1.8
1-11
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Impressions? Application to Your Setting? ▲Only 12% families fully redeem – find out why?
– Confusion finding some WIC foods in stores
▲Fruits & veggies – 50% partially redeeming – Further education on paying ‘over the max amount’?
▲1/3 of families did not redeem whole grain benefit – Revisit approved items; variety allowed
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THANK YOU !!
Questions?
Barbara Longo, CA: [email protected]
Jackie Charnley, VT: [email protected]
Sanya Peck, NY: [email protected]
Diane Phillips, Altarum: [email protected]
*Please complete the survey after the webinar!*