Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report (2016)
Chapter: Appendix R: Summary of National Dataset Characteristics Applied in the Evaluation of Health Risks
TABLE R-1 Summary of National Dataset Characteristics Applied in the Evaluation of Health Risks
| Database | Summary | Data Collection | Relevant Outcomes |
|---|---|---|---|
| NHANES: National Health and Nutrition Examination Survey (USDA/ARS, 2005–2008, 2011–2012) |
Nationwide data collected annually from 1999–2014 20,000–50,000 individuals of all ages each cycle Sample sizes and design differ across cycles of NHANES NHANES 1999–2006 oversampled Hispanics, pregnant women, and adolescents |
Household screener, an interview, and an examination Interview: person-level demographic, health, and nutrition information, information about the household Examination: physical measurements such as blood pressure, dental examination, plus blood and urine specimens for laboratory testing Dietary survey: 24-hour recalls with the USDA Automated Multiple-Pass Method |
Women: Prevalence of diabetes, visual impairment, iron deficiency anemia, low serum, and RBC folate Children: Prevalence of child obesity and overweight, underweight, and iron deficiency anemia in children Dietary intake for women and children |
|
WIC ITFPS-2 Infant Report: Intention to Breastfeed (May et al., 2015) |
Longitudinal study from 1994–2013 measuring feeding practices employed by caregivers and the nutrition outcomes of children who participate in WIC Captures data on caregivers and children over the first 3 years of the child’s life |
Screening and enrollment interviews with WIC enrollees, telephone follow-up interviews, WIC administrative records, site visits and key informants interviews, and WIC site staff survey |
Prenatal views on breastfeeding Pre-pregnancy weight status |
| Database | Summary | Data Collection | Relevant Outcomes |
|---|---|---|---|
| NIS: National Immunization Survey (CDC, 2015a) | Retrospective national breastfeeding data collected annually from 2001 to 2013 on children 19 to 35 months of age | List-assisted random-digit-dialing telephone survey followed by a mailed survey to children’s immunization providers. Breastfeeding questions posed to mothers are retrospective | Breastfeeding initiation, duration, and exclusivity |
|
PC 2008 and 2012: WIC Participant and Program Characteristics 2008 and 2012 (USDA/FNS, 2010, 2013) |
National WIC participant data collected by FNS and published in reports every 2 years starting in 1984 Anthropometric data from NCHS Cutoff values are according to FNS-issued nutrition risk criteria |
The Minimum Data Set provided by states to FNS consists of 20 items |
Maternal weight status by pregnancy and breastfeeding status, prevalence of anemia, prevalence of overweight in children 2 years and older, growth outcomes, underweight in children, low birth weight, or premature birth |
|
PNSS: Pregnancy Nutrition Surveillance System (CDC, 2011a) |
WIC program data from 29 states, the District of Columbia, 3 ITOs, and 1 U.S. territory Discontinued after 2011 Data collected at the clinic level, aggregated at the state level, then submitted to CDC for analysis |
Demographic data: maternal age, race and ethnicity, education level, household income, migrant status, and participation in food and medical assistance programs Women: height/ weight before, during, and after pregnancy; hemoglobin and hematocrit levels; parity; medical care during pregnancy; and enrollment in WIC |
Prevalence of prepregnancy overweight and obesity, maternal weight gain greater than ideal, gestational diabetes, 3rd trimester anemia, and postpartum anemia |
| Database | Summary | Data Collection | Relevant Outcomes |
|---|---|---|---|
| PedNSS: Pediatric Nutrition Surveillance System (CDC, 2011b) | WIC program (87.5 percent) and other programs (12.5 percent) data from 46 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and 6 ITOs | Children: birthweight, anemia, breastfeeding, short stature, underweight, overweight, and obesity |
Prevalence of obesity and overweight for children < 5 years and ≥ 2 years Prevalence of underweight and short stature for children < 5 years |
| Discontinued after 2011 | Prevalence of anemia for children 5 years | ||
| Data collected at the clinic level, aggregated at the state level, then submitted to CDC for analysis | Prevalence of very low birth weight, low birth weight, normal birth weight, high birth weight, preterm birth, full-term low birth weight, and multiple births | ||
| NATFAN: National Food and Nutrition Questionnaire—WIC Food Package Revisions (Texas A&M, 2013) | National multiyear, multilevel study to examine participant food and nutrition behavior before and after implementation of the revisions in the WIC food package (FY 2009, FY 2010, and early 2011) | Food choice questionnaires and frequency instruments developed specifically for WIC participants. Involved state, territorial, tribal, and local WIC programs | Data not used in this review due to convenience sampling |
| Database | Summary | Data Collection | Relevant Outcomes |
|---|---|---|---|
| PRAMS: Pregnancy Risk Assessment Monitoring System (CDC, 2015b) | Data from state birth certificates for 40 states, self-reported data from samples of 1,300–3,400 women per state per year, from 1988–2009 | Mailed questionnaire with multiple followups by mail and telephone Questions: Barriers to and content of prenatal care, obstetric history, maternal use of alcohol and cigarettes, physical abuse, contraception, economic status, maternal stress, and early infant development and health status | Prevalence of prepregnancy obesity in 2009 for women ages 20+, gestational diabetes in 2010 |
| Ross Laboratories Mothers Survey (Ryan, 2005) |
Large prospective national survey conducted by infant formula manufacturer Ross Laboratories. Nearly 1 million surveys sent annually Data collection from 1971–2003 |
Monthly questionnaires sent to mothers when infants reached 1 month, 2 months, and so on up to 12 months. Breastfeeding initiation measured by in-hospital rates | Breastfeeding initiation and exclusivity |
NOTE: CDC = Centers for Disease Control and Prevention; FNS = Food and Nutrition Service; FY = fiscal year; ITFPS = Infant and Toddler Feeding Practices Study; ITO = Indian Tribal Organization; NCHS = National Center for Health Statistics; RBC = red blood cell.
REFERENCES
CDC (Centers for Disease Control and Prevention). 2011a. Pregnancy Nutrition Surveillance System. http://www.cdc.gov/pednss/what_is/pnss (accessed June 1, 2015).
CDC. 2011b. Pediatric Nutrition Surveillance System. http://www.cdc.gov/pednss/what_is/pednss/index.htm (accessed June 1, 2015).
CDC. 2015a. National Immunization Survey. http://www.cdc.gov/nchs/nis.htm (accessed June 2, 2015).
CDC. 2015b. Pregnancy Risk Assessment Monitoring System. http://www.cdc.gov/prams (accessed June 1, 2015).
May, L., C. Borger, S. McNutt, G. Harrison, N. Weinfield, C. MacAllum, and J. Montaquila. 2015. WIC ITFPS-2 infant report: Intention to breastfeed. Rockville, MD: Westat. http://www.fns.usda.gov/sites/default/files/ops/WICITFPS2-Prenatal.pdf (accessed June 1, 2015).
Ryan, A. S. 2005. More about the Ross Mothers Survey. Pediatrics 115(5):1450-1451.
Texas A&M University Institute for Obesity Research and Program Evaluation. 2013. National Food and Nutrition (NATFAN) questionnaire—WIC food package revisions. http://orin.tamu.edu/research/natfan/ (accessed May 18, 2015).
USDA/ARS (U.S. Department of Agriculture/Agricultural Research Service). 2005–2008. What we eat in America, NHANES 2005–2008. Beltsville, MD: USDA/ARS (accessed December 15, 2014).
USDA/ARS. 2011–2012. What we eat in America, NHANES 2011–2012. Beltsville, MD: USDA/ARS. (accessed December 15, 2014).
USDA/FNS (U.S. Department of Agriculture/Food and Nutrition Service). 2010. WIC participant and program characteristics 2008. Alexandria, VA: USDA/FNS. http://www.fns.usda.gov/sites/default/files/pc2008_0.pdf (accessed April 2, 2015).
USDA/FNS. 2013. WIC participant and program characteristics 2012 final report. Alexandria, VA: USDA/FNS. http://www.fns.usda.gov/sites/default/files/WICPC2012.pdf (accessed December 20, 2014).
