A Mixed-Methods Study of Perceived Implementation Challenges for WIC Online Ordering and Transactions.

BACKGROUND: Federal food assistance programs are working towards online grocery shopping. Online ordering in Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is emerging following successful implementation in Supplemental Nutrition Assistance Program (SNAP). OBJECTIVE: To identify anticipated challenges, potential solutions, and expected costs of WIC online ordering. DESIGN: Cross-sectional, mixed-methods, web-based, survey research. SUBJECTS AND SETTING: Data were collected from December 2020 to January 2021. Purposeful and snowball sampling included WIC stakeholders involved in developing processes and systems required for WIC online ordering. Respondents represented diverse geographic areas, levels of intraorganizational authority, and WIC benefit card types. STATISTICAL ANALYSES PERFORMED: The research team used a rapid analysis and lean coding approach to identify emergent themes from open-ended survey responses. Descriptive statistics were used to describe the distribution of responses across themes and stakeholder types. RESULTS: Respondents (n = 145) described 812 anticipated challenges within 20 themes grouped into five topic areas: rules and regulations; shopping experience; security, confidentiality, fraud, and WIC State agency processes; training, assistance, and education; and equitable access and buy-in. Addressing anticipated regulatory issues were among the few concrete potential solutions described. The two most frequent costs reported were increased staff time and start-up and ongoing technology costs. CONCLUSIONS: This study identified several, critical anticipated challenges and considerations that will help prepare WIC state agencies for opportunities to expand online ordering to WIC participants.

A cross sectional assessment of basic needs insecurity prevalence and associated factors among college students enrolled at a large, public university in the Southeastern U.S.

BACKGROUND: There is increasing evidence of problematic rates of food insecurity among college students, yet few studies have gone beyond this to examine housing insecurity rates or rates of basic need insecurity (BNI), which is defined as having both food and housing insecurity, among the postsecondary population. BNI may have significant impacts on the mental and social health, and academic outcomes of college students, yet remains understudied. The researchers of this study are among the first to assess the prevalence of food insecurity, housing insecurity, and basic needs insecurity among college students enrolled at a large, public university in the Southeast and to identify factors associated with experiencing food, housing, and basic needs insecurity. METHODS: A cross-sectional online survey was conducted at a large, public university in the Southeast United States. All eligible, enrolled students (n = 23,444) were asked to complete an online survey, 2634 responded (11.2% response rate). Multivariate logistic regression models were used to assess relationships between demographic and financial factors and the outcomes of interest (food, housing, and basic needs insecurity). RESULTS: High rates of food insecurity (48.5%), housing insecurity (66.1%), and basic needs insecurity (37.1%) were identified. After controlling for confounders, factors that were significantly associated with increased odds of students having basic needs insecurity included previous food insecurity (p < 0.001; Odds Ratio (OR) = 3.36; Confidence Interval (CI) = 2.64-4.28), being employed (p < 0.001, OR = 1.70; CI = 1.34-2.17), not receiving family financial support (p < 0.001, OR = 1.61; CI = 1.30-2.00), and living off-campus (p < 0.001, OR = 1.67; CI = 1.25-2.22). Juniors (p < 0.001, OR = 1.78; CI = 1.31-2.42), seniors (p < 0.001, OR = 2.06; CI = 1.52-2.78), Masters (p = 0.004, OR = 1.68; CI = 1.18-2.40), and PhD or EdD (p = 0.029, OR = 1.55; CI = 1.05-2.31) students were significantly more likely to experience basic needs insecurity than sophomore students. CONCLUSIONS: This research identifies high rates of food, housing, and basic needs insecurity among college students enrolled at a large, public university. Financial factors such as being food insecure prior to attending college, working during college, and not having familial financial support were all related to BNI in this sample. Students who were more advanced in their education experienced more BNI than less advanced students. Innovative interventions with enhanced BNI measures, for example, partnering with financial aid offices to screen and refer students to food resources, are likely needed to address this multi-faceted problem.

Food Shopping Frequency of Rural Tennessee Adults With Comparisons by Federal Nutrition Assistance Participation.

OBJECTIVE: To describe food shopping frequency across 7 store types in a rural context and compare food shopping frequency between federal nutrition assistance recipients and nonrecipients. METHODS: This cross-sectional study was conducted at county fairs in rural Tennessee. RESULTS: Reported overall mean food shopping frequency was 18.4 (SD, 13.9) times in the past 30 days. A mean of 3.1 (SD, 1.2) store types were visited, with supermarkets, convenience stores, and dollar stores the most frequented stores. Federal nutrition assistance program recipients shopped significantly less frequently than nonrecipients for overall shopping frequency (P = 0.02), supermarkets (P = 0.02), and farmers' markets (P = 0.04). CONCLUSIONS AND IMPLICATIONS: Educating and counseling individuals on how food shopping frequency may promote nutrition and health may be important. Federal nutrition assistance programs that distribute benefits monthly may impact food shopping frequency.

WIC Participants' Perspectives of Facilitators and Barriers to Shopping With eWIC Compared With Paper Vouchers.

OBJECTIVES: (1) To describe facilitators and barriers to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food shopping via electronic benefits transfer (eWIC) compared with paper vouchers. (2) To explore suggestions that WIC participants had for modifying the program to enhance their overall WIC experience. DESIGN: Qualitative, semistructured, in-depth interviews. SETTING: WIC participants in East Tennessee. PARTICIPANTS: Twenty-four primary food shoppers of WIC-participating households aged at least 18 years were recruited using a purposive sampling strategy. PHENOMENON OF INTEREST: Perceived facilitators and barriers to use of eWIC as compared with paper vouchers. ANALYSIS: Interview transcripts were analyzed using a grounded theory approach to identify emergent themes. RESULTS: Participants identified several ways eWIC has improved their food shopping experience, including ad hoc redemption of WIC benefits and a quicker, more discrete checkout. Participants' chief complaint about eWIC was transaction errors at checkout. Participants identified other barriers to shopping for WIC foods that cannot be addressed by the card alone, such as difficulty identifying WIC items in-store. Participants reported changes to their benefit tracking behaviors and provided suggestions to improve WIC further. CONCLUSIONS AND IMPLICATIONS: The transition to eWIC was viewed favorably among WIC participants, although participants identified a need for additional support in addressing transaction errors. This finding presents an opportunity to modify messages delivered to WIC participants by WIC nutrition educators and enhance collaboration between WIC agencies, retailers, and e-commerce technology providers.

Breakfast Consumption Frequency and Its Relationships to Overall Diet Quality, Using Healthy Eating Index 2010, and Body Mass Index among Adolescents in a Low-Income Urban Setting.

The aim of this study was to describe the relationship of breakfast frequency to diet quality and BMI among low-income, predominantly African American adolescents aged 9-15 (n = 239). Mean frequency of breakfast consumption was 5.0 ± 0.15 times per week. A significant, positive relationship was seen between HEI scores and frequency of breakfast consumption (p = .01). Dairy (p = .02) and whole grains (p < .01) HEI component scores were significantly related to breakfast frequency. No relationship was seen between breakfast frequency and BMI. Research with more rigorous designs should be conducted to assess the potential effects of breakfast consumption on diet quality in this population.