Understanding the WIC Shopping Experience Wednesday, June 29 2016 Presented by Elizabeth Racine, DrPH, RD
Project Team Acknowledgments Meredith Ledford, MPP Corliss Allen, MPH Katelin Hudak, MS Ashley Kennedy, MS Dmitry Shapiro, PhD Arthur Zillante, PhD Ameena Batada, PhD (UNC Asheville)
Funding Sources Cabarrus Partnership for Children North Carolina Smart Start Duke-UNC USDA Center for Behavioral Economics and Healthy Food Choice Research through grant 59-5000-4-0062 from the U.S. Department of Agriculture. The views expressed in this presentation are those of the authors and cannot be attributed to the U.S. Department of Agriculture, its Economic Research Service, or its Food and Nutrition Service.
North Carolina Cabarrus County
Weight status of WIC children 2-4 yrs, 2011* County Overweight Obese Cabarrus 19% 19% North Carolina 16% 15% US 16% 14% *Pediatric Nutrition Surveillance System (PedNSS) http://www.nutritionnc.com/pdfpregped/pnss/pednss2011statetable s.pdf
How Cabarrus Compares to the US and NC WIC Population of children ages 2-4, PedNSS 2011 NH White NH Black Hispanic Other Cabarrus County 38% 22% 37% 3% North Carolina 37% 32% 29% 2% US 36% 21% 39% 4% http://www.nutritionnc.com/pdfpregped/pnss/pednss2011countytables.pdf http://www.nutritionnc.com/pdfpregped/pnss/pednss2011statetables.pdf http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6231a4.htm
Project Components Literature review: factors associated with food choice among low-income families Interviews with families to explore their thoughts on meal preparation, shopping and WIC spending experience Intervention and Research Ideas
Low-Income Family Food Choice Articles were eligible if they emphasized food purchasing behaviors of low-income families 23 articles included in the review Sources* Google Scholar (n=17) Pub Med (n=9) USDA Economic Research Services (n=2) Food Research and Action Center (n=3) *8 of these were excluded after review because the majority of the sample was not low-income
Themes Affordability Budgeting Available Resources Strategies to maximize purchasing power Time scarcity Lack of flexibility Atypical work hours Transportation Prices in neighborhood stores
Interviews 49 interviews with parents in Cabarrus County, NC (30 participated in WIC ) Moderators guide: adapted guide developed by UNC Time period: May and June, 2015 Interview length: 15-25 minutes Responses summarized by question Clustered by theme
Parents Thoughts Based on interviews with 49 women with children in childcare in Cabarrus County THEMES Perceptions on healthy meals Child food consumption guilt Meal planning
Perceptions on healthy meals I always think balance, like some kind of meat, protein, some kind of veggie. When I cook for my family it s healthy. When it s just me, not always. I think, like I said we do eat healthy, but we would eat more healthy if I did plan. But I m not a planner...
Child food consumption guilt I don t have time. I put my kids to bed at about 8:30 so they only have 4 hours from when they get home from school and everything you have to do I try. Time and energy. I have good intentions, but the falling through sometimes falls flat. I d like less breads and like my oldest loves bread and starch. She and I are having the hardest time with weight management.
Meal planning I make a list. I look at different ads. I see what they have on sale. Sometimes I base what I buy on what is on sale. Last night I stopped by the grocery store on the way home and picked up the rotisserie chicken. So I appreciate that there are those healthier options as opposed to McDonald s and double cheeseburgers. the biggest thing for us is just taking the time to plan and prep on the weekends so that during the week we re ready to go.
What store and why? Primarily redeem WIC benefits at their regular grocery store typically low cost retailers Go to stores that label WIC items well or have rewards programs Very few go to convenience stores and if so, only when the voucher only includes a few items. One voucher can have the list of everything: eggs, milk, cheese, bread, beans, all that stuff. Then you have some that just have milk and eggs. So, yeah, I use it right up the street [at the convenience store] when I don t have to use a whole [voucher].
What store and why? Inconsistent knowledge of WIC approved items at the store (scanner and aisle labels) [Store A] is the one that keeps up with their labels. I went to [Stores B] and [spent] my last [WIC voucher] and there was this sweet potatoes and corn mixture, that they have at [Store A] with a WIC label in front of it, but then they ran it up at the [Store B] register and it didn t go.
What store and why? Avoid getting the wrong items causes inconvenience for the WIC participants, the store staff, and other shoppers I can go back but if I see people behind me and they are making faces and stuff like that, I ll just let it go.
Use loyalty cards? Why? Yes Helps increase the amount of fruit and vegetables that can be purchased Purchase applies to the stores rewards program Applies coupons like buy one, get one deals [The loyalty card] knocks the price down and helps on produce. [I spend my vouchers at Store C] so I can get the fuel perks and can use coupons with the voucher.
How to know what s WIC approved? Hard at first, easy once you understand what is acceptable. Difficult when there are changes Determining the appropriate sizing is the most confusing..in the beginning it takes forever, then we just buy the same things after that. Then the size or brand will change and that throws you off. The booklet is helpful but it changes... [Store A] tends to just WIC label their store brand only.
Consider price? Yes---for fruits and vegetables No--- for other WIC items No, I don t consider the prices, because if I did I would be stressed out. It s already stressful making sure I have the correct oz., containers, and brands. No I don t really look at price. The only time I look is when I can use coupons with my WIC items to get buy one, get one free items on the cereal and peanut butter.
Buy WIC items with SNAP or cash? Yes staples like milk and bread Will buy food items to compliment WIC items I use the WIC and get Chex cereal and make trail mix for [the children]. And use my money for the cereal [the children] like. I use the WIC for the 1% milk but buy the Nestle Quick Strawberry or Chocolate Mix with my money and then they ll drink it.
Consider children s preferences? Many respondents said no Some respondents said they purchase foods they think the children will eat
Purchase everything on the voucher? Most said yes A couple said they avoid foods if there is an allergy in the household (ex. peanut butter) Many said that their children don t eat the WIC cereals Yes [I buy everything listed on the voucher], it just takes a while to use sometimes. I have a stockpile of beans.
Purchase everything? A few said that they give some of the items away. "I do [purchase all the WIC items] because they have a box here (at the childcare center) that you can put stuff in.
Considerations Results may not be generalizable to WIC participants across the country, because: These were all WIC participants from just one county NC WIC uses vouchers not EBT All interviewed had children in childcare All interviews were in English
Intervention and Research Ideas WIC starter bundles WIC staff to assist participants pre-order WIC foods Work with low cost stores in low-income areas to get WIC approved Simplified WIC-approved food lists Conduct qualitative interviews with store staff to understand WIC purchasing issues from the store perspective
Thank you