Review of WIC Food Packages Improving Balance and Choice: Final Report (2017) / Chapter Skim
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11 Recommendations for Implementation and Research
11 Recommendations for Implementation and Research
Pages 443-464
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From page 443... ...
RECOMMENDATIONS FOR IMPLEMENTATION OF THE REVISED FOOD PACKAGES The Complexities of Implementation As noted in Chapter 2, administration of the WIC food packages involves stakeholders at many levels: federal, state, local, participant, clinic, vendor, and food manufacturer. At each level, a series of factors ease or pose barriers to redemption of WIC foods by program participants.
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From page 444... ...
into a quantity of vegetables and fruits; keeping track of the CVV balance • Checking out with ease • Understanding the electronic benefit transfer (EBT) system and maintaining a list of nonredeemed foods Clinic level • Assisting WIC participants in identifying local WIC vendors, particularly when authorized vendors change • Adapting to the EBT system • Training staff • Vendor level • dapting to the EBT system A • Keeping required WIC products in stock • Updating UPC coding of WIC-approved products • Training staff • Providing refrigeration at small stores • Maintaining inventory of WIC-approved foods while maintaining a viable business Manufacturer level • Meeting WIC food specifications for composition and sizes SOURCES: Evidence derived from the literature review (see the phase I report, NASEM, 2016)
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From page 445... ...
Content that demonstrates the expanded options for vegetables and fruits, fish, dairy, and whole grains may enhance the shopping experience for WIC participants. Given that the revised packages may require vendors to offer more options, collaboration with vendors and food manufacturers to address challenges with stocking of WIC foods is essential to enhance participants' ability to locate and redeem these foods.
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From page 446... ...
Several aspects of this guidance were considered particularly important to retain and/or enhance as part of the food package revisions. These are: • Continue to encourage state agencies to authorize as many food options as feasible within the limits of cost-containment, stocking requirements, and the redemption patterns of WIC participants.
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From page 447... ...
a A priority or emerging health issue as indicated in the phase I Review of WIC Food Packages report (NASEM, 2016) , or based on other evidence collected by USDA-FNS specific to the WIC-eligible population.
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From page 448... ...
. RESEARCH AND DATA COLLECTION RECOMMENDATIONS FOR EVALUATION OF THE WIC FOOD PACKAGES Consistent with its task, the committee developed a prioritized list of recommendations for research and data collection.
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From page 449... ...
. Rationale: Although results from regional and state studies provided the committee with important evidence about the effects of the 2009 food package changes, no nationally representative study evaluated how the new food packages affected participant satisfaction, participation in the program, and use of the new WIC foods.2,3 In addition, only limited information was 2 To understand the effect of policy changes on participant purchasing patterns and/or nutrition and health outcomes, a study that applies the difference-in-difference approach, which is common in economics and health information research, to the timing of the policy changes is needed.
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From page 450... ...
Such data would inform how the WIC food packages can be designed to optimize the overall diet and complement other food resources. The recently released Food Acquisition and Purchase Survey (FoodAPS)
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From page 451... ...
Continued improvements in the coverage and quality of breastfeeding counseling available to WIC participants are necessary to achieve national breastfeeding goals. Adequate support by state and local agencies is important to determine the level of breastfeeding support provided through nutrition services administration funds as well as through peer-counseling funding and other sources.
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From page 452... ...
USDA-FNS should fund research to assess how inclusion of the cash value voucher as a component of WIC food packages affects: food package redemption rates; participant choice of 7 In alignment with 7 C.F.R. § 246.26, all participant or applicant information would remain confidential.
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From page 453... ...
Future evaluations of the WIC food packages would also benefit from information on vendor stocking practices for vegetables and fruits as an outcome of increasing the CVV. It would be valuable to understand the feasibility of stocking the new WIC food options as well as the effects of vendor stocking practices on participant purchasing patterns.
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From page 454... ...
PRIORITIES FOR FUNDING OUTSIDE COST-NEUTRALITY USDA-FNS asked that the committee identify changes to the food packages that should be made if funding for the WIC food packages is either 10 percent higher or 10 percent lower than cost neutrality. The committee's priority in case of additional funding is enhancement of food package IV (for children)
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Retention of children in the WIC program is a concern. Inasmuch as this food package represents approximately 53 percent of all food packages issued, changes to food package IV have a significant effect on overall program costs for food.
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From page 456... ...
MULTILEVEL APPROACHES TO IMPROVING CONSUMPTION OF WIC FOODS Nutrition Education WIC is the only federal nutrition assistance program that requires nutrition education as part of its core services. There is some evidence to suggest that the WIC program is a key resource for nutrition education within the WIC-participating population (Hromi-Fiedler et al., 2016; USDA/FNS, 2016a)
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From page 457... ...
Optimizing Redemption and Consumption of WIC Foods To increase the availability of vegetables and fruits to WIC participants, the committee increased the value of the CVV in the revised food packages by $4 to $24. This decision was prompted by evidence that vegetable intakes were particularly low across participant subgroups (see Chapter 4)
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From page 458... ...
Infant Nutrition Needs in the First 6 Months of Life In contrast to other components of the WIC food packages that were reduced to conform to the committee's definition of "supplemental," the provision of infant formula was retained at its current level of approximately 100 percent of infant needs from birth to 6 months. The committee was concerned that reducing the amount of infant formula currently provided would impose a cost burden on families served by the program.
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From page 459... ...
However, given the barriers to breastfeeding faced by low-income women in the United States, it is possible that WIC may be reaching nearly all those who are willing and able to breastfeed exclusively. To promote and encourage any breastfeeding, the committee also chose to enhance the food package for partially breastfeeding women and allow issuance of this package in the first month postpartum.
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From page 460... ...
Participants who receive the largest increase in the CVV in the revised food packages should be able to satisfy their preference for fruits and begin to purchase more vegetables. However, to increase vegetable redemption, the CVV may have to be substantially increased for all participants and accompanied by appropriate nutrition education and perhaps further incentives as well.
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From page 461... ...
2016a. If you build it they will come: Satisfaction of WIC participants with online and traditional in-person nutrition education.
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From page 462... ...
2006. WIC food packages: Time for a change.
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From page 463... ...
2015. WIC policy memorandum #2015-7 to WIC state agency directors: Medic aid primary payer for exempt infant formulas and medical foods.
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