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How to Strengthen and Enhance WIC Nutrition Education

2008; Elsevier BV; Volume: 40; Issue: 5 Linguagem: Inglês

10.1016/j.jneb.2007.08.002

1878-2620

Madeleine Sigman‐Grant, Alyssa Rye, Deborah A. Loesch-Griffin, Deborah Mitchell,

Urban Agriculture and Sustainability

For over 30 years, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) has provided specific food and nutrition education services to eligible low-income families. 1 Food Research and Action CenterWIC in the States: Thirty-one Years of Building a Healthier America. Food Research and Action Center, Washington, DC2005 Google Scholar Despite burgeoning caseloads, unfunded mandates, and continuous legislative reapplication for this discretionary program, WIC steadfastly addresses the needs of its participants. Individual counseling and/or group sessions accompanied by written materials are traditional WIC education approaches. Recently, questions have arisen regarding the impact of WIC's nutrition education component on participant behaviors. 2 Besharov D.J. Germanis P. Evaluating WIC. Eval Rev. 2000; 24: 123-190 Crossref PubMed Scopus (25) Google Scholar , 3 Dickin K. Dollahite J. Habicht J.P. Nutrition behavior change among EFNEP participants is higher at sites that are well managed and whose front-line nutrition educators value the program. J Nutr. 2005; 135: 2199-2205 PubMed Scopus (30) Google Scholar , 4 US General Accounting OfficeFood Assistance: Research Provides Limited Information on the Effectiveness of Specific WIC Nutrition Services. General Accounting Office, Washington, DC2001 Google Scholar , 5 US General Accounting OfficeFood Assistance: WIC Faces Challenges in Providing Nutrition Services. General Accounting Office, Washington, DC2004 Google Scholar , 6 US General Accounting OfficeNutrition Education: USDA Provides Services through Multiple Programs, but Stronger Linkages among Efforts are Needed. General Accounting Office, Washington, DC2004 Google Scholar , 7 United States Department of Agriculture Economic Research ServiceThe WIC Program: Background, Trends and Issues. United States Department of Agriculture Economic Research Service. Food Assistance and Nutrition Research, Washington, DC2002 Google Scholar , 8 Sigman-Grant M. Loesch-Griffin D. Rye A. Mitchell D. Evaluation Executive Summary: WIC Nutrition Education on the Road to Excellence. University of Nevada–Reno, Reno, Nev2002http://www.nal.usda.gov/wicworks/Sharing_Center/Road_to_Excellence/Executive_Summary.pdf Google Scholar , 9 US Food and Nutrition ServiceNutrition Education in FNS: A Coordinated Approach for Promoting Healthy Behaviors A Report to Congress. Office of Analysis, Nutrition and Evaluation, Alexandria, Va2002 Google Scholar Reviews of WIC nutrition education outcomes are mixed, generally owing to methodological weaknesses (eg, selection bias, simultaneity bias, and lack of generalizability). 2 Besharov D.J. Germanis P. Evaluating WIC. Eval Rev. 2000; 24: 123-190 Crossref PubMed Scopus (25) Google Scholar , 5 US General Accounting OfficeFood Assistance: WIC Faces Challenges in Providing Nutrition Services. General Accounting Office, Washington, DC2004 Google Scholar Relevant factors impacting healthy nutrition behavior outcomes include but are not limited to: (1) insufficient time for staff to spend on education (average time 4 to 17 minutes); (2) infrequent contacts with participants (basic requirement is 2 nutrition contacts within a 6-month period); (3) demographic changes in WIC populations (eg, language needs); (4) substitution of messages about basic nutrition with messages addressing chronic health issues (eg, obesity); (5) recruitment and retention of skilled staff; and (6) meeting increased requirements (eg, voter registration) without concomitant funding increases. 5 US General Accounting OfficeFood Assistance: WIC Faces Challenges in Providing Nutrition Services. General Accounting Office, Washington, DC2004 Google Scholar Administrative issues associated with program size and complexity, food packet composition, cost containment practices, program accessibility, eligibility standards, and reduction of fraud and abuse 7 United States Department of Agriculture Economic Research ServiceThe WIC Program: Background, Trends and Issues. United States Department of Agriculture Economic Research Service. Food Assistance and Nutrition Research, Washington, DC2002 Google Scholar are further challenges to WIC. Moreover, the funding formula for food is tied to administrative dollars that must be spent to qualify for nutrition education funds. Food dollars cannot be spent on nutrition education activities. Any press for increasing caseloads will more than likely have negative repercussions for nutrition education, as recruitment will divert local agency staff time away from education.