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Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report (2016)

Chapter: Appendix N: Committee Perceptions of the WIC Experience

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Suggested Citation: "Appendix N: Committee Perceptions of the WIC Experience." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.

Appendix N

Committee Perceptions of the WIC Experience

As noted in Chapter 3, committee members were required to visit one or more Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) sites. The plan was designed to ensure national coverage both geographically and with respect to racial and ethnic diversity. Committee members prepared and shared reports in a closed session.¹ The most outstanding comment from committee members was the variability across WIC sites in several programmatic aspects, as summarized in Box N-1. Previously in this report, the difficulties finding a 1-pound loaf of whole wheat bread were described. Similarly, in states where whole wheat pasta is permitted for purchase, finding a product meeting the 1-pound specification was difficult. Other whole grain products in a 1-pound size but not currently permitted for purchase included whole grain corn pasta and whole grain brown rice pasta. These two versions may also be suitable for gluten-free diets, although the cost is significantly greater. Checkout efficiency although not quantifiable appeared to be qualitatively improved with the electronic benefit transfer instrument.

Similarly, some WIC personnel with whom the committee met on site visits expressed concern about the 18-ounce container of peanut butter, because not all peanut butter vendors offer this size. They and also public commenters expressed concern that manufacturers frequently change package sizes. These changes can affect availability to participants when WIC state agencies define the allowable package sizes to contain costs, which

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¹ A summary of the committee reports is accessible through the National Academies Public Access File. Email: paro@nas.edu.

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may not align with package size revisions. WIC participants are an important customer base, and it benefits manufacturers to be cognizant of WIC rules, particularly considering potential variation across states.

BOX N-1

Committee Site Visits: Key Perceptions

A key take-away for committee members was that states vary widely in their structure and program implementation. The U.S. Department of Agriculture’s Food and Nutrition Service offers states a variety of implementation options. A summary of the points of variability is provided here with examples.

Program Component	Variation
Services offered in conjunction with WIC	Medical, dental, sexually transmitted disease testing, immunization check, voter registration; other sites offer exclusively WIC-based services
Clinic flow	Depends on the size of the staff; the process may be handled largely by one or a different staff person for each stage.
Breastfeeding support	Breastfeeding support offered via peer counseling or colocated breastfeeding clinic paid for by WIC funds. Some sites have International Board-Certified Lactation Consultants (IBCLCs) on staff. Time spent talking to prenatal participants about breastfeeding plans varies. Provision of materials and supplies (including pumps, educational pamphlets, and incentives to breastfeed) varies
Education	Group classes, one-on-one instruction, and/or online instruction. Detail of food guides vary (with or without photos, multiple languages)
Vendors	WIC-only vendors, WIC-authorized grocery and corner stores, home delivery (Vermont only)
State food options	Forms of produce permitted for purchase with the cash value voucher vary widely, with some states offering fresh only. States vary in the number of options and brands as well as in the availability of state-approved foods at each vendor. Choices may sometimes be made at the store or, alternatively, must be made before the food package is issued.

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Cost-containment practices	These include “Least Expensive Brand” policies and offering of regular-sodium, or regular-fat only options
In-store labeling	All WIC foods labeled, specific foods labeled, or no WIC foods labeled
Checkout process	The elecronic benefit transfer process is faster and less noticeable to other shoppers than the paper voucher process; the ease of the transaction depends on staffing and staff knowledge, food labeling, consumer knowledge, accuracy of store databases, and other factors

Other notes:

Participant racial and ethnic diversity is wide overall, but varies by state. The staff is typically attuned to the needs of participants in their region, providing education accordingly. Mechanisms were usually in place to deal with language differences. There was positive feedback from users of mobile-based applications when available in the state.

WIC foods that were difficult to find on more than one occasion include the 16-oz loaf of bread or whole wheat pasta and yogurt with the required sugar limits.