Preschool enrollment is associated with lower odds of childhood obesity among WIC participants in LA County.

The prevalence of obesity among children in the United States has increased rapidly during the past few decades. Research into social and behavioral determinants of obesity could lead to innovative strategies for prevention. The objective of the present study was to examine the association between childhood obesity and preschool enrollment and number of hours in child care among low-income preschool-aged children who were participants in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). We conducted a case-control study including 556 3- to 4-year-old children who were either obese (BMI > 95th percentile of reference standard) or normal-weight (BMI 25-75th percentile). The population was largely (96%) Hispanic, an ethnic group that has one of the highest rates of overweight and obesity in adults and children in the US. In multiple logistic regression analysis, controlling for a variety of psychosocial and cognitive home environment variables, key demographics and maternal variables, the odds ratio of being obese was 0.61 for children who attended preschool more than 4 days a week (95% CI: 0.41-0.90). Watching television or videos for an hour or more on a typical day (odds ratio 1.71 (95% CI 1.07-2.75)), and higher maternal BMI (odds ratio 1.08 (95% CI 1.05-1.11)) were independently related to odds of obesity. The impact of preschool attendance and TV viewing are potentially instructive in terms of preventive interventions for children at this age.

Literacy promotion for families participating in the women, infants and children program.

OBJECTIVE: This article describes the impact of a bilingual literacy intervention conducted with nearly 118,000 children in Special Supplemental Nutrition Program for Women, Infants and Children (WIC) sites in Los Angeles County, California. METHODS: All WIC participants at 6 WIC sites in Los Angeles County participated in the literacy intervention. Three cohorts of participants were selected to participate in the evaluation of the intervention. A control group of 200 families received no intervention, 103 families received 2 years of intervention, and 102 families received 4 years of intervention. Participants were predominantly Hispanic (92%), 3- to 4-year-old children and their parents. All families had low income levels, and more than one-half were Spanish-speaking. School readiness assessments were conducted with the children; parent literacy resources and activities at home were observed. Structural equation modeling was used to allow for simultaneous testing of relationships between variables. RESULTS: The Spanish-speaking subset showed a strong intervention effect. Among Spanish speakers, the 4-year intervention group (P < .001) and the 2-year intervention group (P < .05) had significantly higher school readiness scores, compared with the control group. The structural equation model revealed that exposure to the intervention significantly enhanced literacy resources and activities at home, which in turn led to greater school readiness. CONCLUSION: WIC-based literacy intervention significantly increased low-income, Spanish-speaking children's school readiness.

A WIC-based intervention to prevent early childhood overweight.

OBJECTIVE: To evaluate the impact of a Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)-based intervention on the food and beverage intake, physical activity, and television watching of children ages 1-5. DESIGN: Longitudinal surveys of intervention and control participants at baseline, 6 months, and 12 months. RESULTS: Analysis of variance tests showed that the intervention had a small but significant impact on TV watching and fruit intake. The intervention was most protective for children younger than 2 years of age. CONCLUSIONS AND IMPLICATIONS: Although the impact of the intervention was relatively small and limited to the youngest children served by WIC, findings suggest that the WIC setting is appropriate for improving healthful behaviors that are linked to reducing the rates of early childhood overweight.

The association between an electric pump loan program and the timing of requests for formula by working mothers in WIC.

An electric pump loan program designed to facilitate breastfeeding for low-income mothers returning to full-time work was evaluated. All mothers were WIC participants in the Los Angeles area. Electric pump loans were made until the infant's first birthday or until the mother requested formula from WIC. Information was provided to employers on supporting breastfeeding in the workplace. A subsample of mothers who received an electric pump on return to full-time work was compared with counterparts in a wait list control group. Mothers who received an electric pump as soon as requested did not request formula until 8.8 months on average, whereas those who did not receive an electric pump requested formula on average at 4.8 months (P < .0001). Mothers who received an electric pump when requested were 5.5 (95% CI 2.0-15.1) times as likely as mothers who did not receive an electric pump to not request formula at 6 months.

Effect of a targeted subsidy on intake of fruits and vegetables among low-income women in the Special Supplemental Nutrition Program for Women, Infants, and Children.

OBJECTIVES: Intake of fruits and vegetables protects against several common chronic diseases, and low income is associated with lower intake. We tested the effectiveness of a subsidy for fruits and vegetables to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). METHODS: Women who enrolled for postpartum services (n=602) at 3 WIC sites in Los Angeles were assigned to an intervention (farmers' market or supermarket, both with redeemable food vouchers) or control condition (a minimal nonfood incentive). Interventions were carried out for 6 months, and participants' diets were followed for an additional 6 months. RESULTS: Intervention participants increased their consumption of fruits and vegetables and sustained the increase 6 months after the intervention was terminated (model adjusted R(2)=.13, P<.001). Farmers' market participants showed an increase of 1.4 servings per 4186 kJ (1000 kcal) of consumed food (P<.001) from baseline to the end of intervention compared with controls, and supermarket participants showed an increase of 0.8 servings per 4186 kJ (P=.02). CONCLUSIONS: Participants valued fresh fruits and vegetables, and adding them to the WIC food packages will result in increased fruit and vegetable consumption.

Choices made by low-income women provided with an economic supplement for fresh fruit and vegetable purchase.

Vouchers for fresh fruit and vegetable purchase were provided to low-income women participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Los Angeles, CA. As the program is currently constituted, the supplemental foods provided contain no fresh produce except for carrots for exclusively breastfeeding women. This study investigated whether providing supplemental financial support specifically for purchase of fresh fruits and vegetables would result in high uptake of the supplement, and what the individuals would choose to purchase. A total of 602 women enrolling for postpartum services at three selected WIC program sites in Los Angeles were recruited. Sites were assigned to intervention with vouchers redeemable at a local supermarket, a nearby year-round farmers' market, and a control site with a minimal nonfood incentive. Vouchers were issued bimonthly, at the level of US $10/wk, and carried out for 6 months. Of 454 participants who completed the study (75.4%), 86% were Hispanic, 7% non-Hispanic black, and 7% of other ethnic backgrounds. Assessment of uptake was by voucher redemption rates and was approximately 90% for both groups. Participants reported purchasing a wide variety of items at both sites. The 10 most frequently mentioned items were oranges, apples, bananas, peaches, grapes, tomatoes, carrots, lettuce, broccoli, and potatoes. In conclusion, low-income women used the supplement provided almost fully, and purchased a wide variety of fresh fruits and vegetables for their families. No particular barriers arose to redemption of the vouchers by either the participants or the retail vendors.

Predictors of breastfeeding duration for employees of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

During the past decade there has been increasing breastfeeding support within the Women, Infants, and Children (WIC) program. For this study, it was hypothesized that employees at WIC would initiate and continue to breastfeed significantly longer than the National averages. Female employees, mostly paraprofessionals, from six Los Angeles County WIC agencies participated in the study to determine breastfeeding rates and predictors of breastfeeding success. As expected, 99% of WIC employees initiated breastfeeding and 68.6% continued to breastfeed to one year, significantly exceeding National averages. Four variables accounted for 30% of the variance in duration of breastfeeding: intent to exclusively breastfeed, delayed introduction of infant formula, attendance at breastfeeding support groups and availability of work-site breastpumps. Given that nearly 70% of the study participants reached the American Academy of Pediatrics goal of breastfeeding to 12 months or more, it is clear that full-time employment and breastfeeding can be compatible given appropriate work-site support.