Mixed methods evaluation of the COVID-19 changes to the WIC cash-value benefit for fruits and vegetables.

Introduction: Recent cash-value benefit (CVB) increases are a positive development to help increase WIC participant fruits and vegetables (FV) access. Little is known about the impacts of the CVB changes on FV redemptions or about implementation successes and challenges among WIC State and local agencies. This mixed method study aimed to evaluate (a) the CVB changes' impact on FV access among WIC child participants measured by CVB redemption rates, (b) facilitators and barriers to CVB changes' implementation, and (c) differences in FV redemption and facilitators and barriers by race/ethnicity. Methods: We requested redemption data from all 89 State agencies for April 2020 to September 2022 and utilized descriptive statistics, interrupted time series analysis (ITS), and generalized linear regression analysis. Additionally, we recruited State agencies, local agencies, and caregivers across the U.S. for interviews and used rapid qualitative analysis to find emerging themes anchored in policy evaluation and implementation science frameworks. Results: We received redemption data from 27 State agencies and interviewed 23 State agencies, 61 local agencies, and 76 caregivers of child WIC participants. CVB monthly redemptions increased at $35/child/month compared to $9/child/month; however, adjusted ITS analyses found a decrease in redemption rates at $35/child/month. The decrease was not significant when the transition/first implementation month was excluded with rates progressively increasing over time. Differences were found among racial/ethnic groups, with lower redemption rates observed for non-Hispanic Black caregivers. Overall, WIC caregivers reported high satisfaction and utilization at the $35/child/month. The frequent and quick turnaround CVB changes strained WIC agency resources with agencies serving higher caseloads of diverse racial and ethnic populations experiencing greater issues with implementing the CVB changes. Conclusion: Despite implementation challenges, the increased CVB shows promise to improve WIC participant FV access and satisfaction with WIC. WIC agencies need adequate lead time to update the CVB amounts, and resources and support to help ensure equitable distribution and utilization of the FV benefits.

State Agencies' Perspectives on Planning and Preparing for WIC Online Ordering Implementation.

Online ordering for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) has the potential to alleviate some of the barriers faced by WIC participants when shopping with their WIC food benefits. WIC State agencies are the leaders in planning, preparing, implementing, maintaining, and expanding WIC online ordering. Cross-sectional web-based survey research was utilized to identify barriers to implementing WIC online ordering, as well as the support needed to overcome those barriers, from a WIC State agency perspective. Web surveys were administered to 81 WIC State agencies from 31 January 2022 to 1 April 2022. Descriptive statistics, independent samples t-test, and one-way analysis of variance were used to analyze the findings. Open-ended responses were analyzed using a qualitative iterative approach. WIC State agencies noted several barriers to implementing WIC online ordering, including limited staff capacity, WIC retailer interest, and technological capabilities.

Key Informant Interviews to Inform Nutrition and Physical Activity Recovery Efforts in Child Care Settings amid the COVID-19 Pandemic in the United States.

Purpose: The COVID-19 pandemic created a series of challenges for children's health, including several challenges related to nutrition and physical activity in child care settings. Thus, this study explored: 1) how COVID-19 impacted nutrition and physical activity in child care settings and how to address these challenges moving forward; 2) potential best practices in child care that emerged during the COVID-19 pandemic worth continuing; and 3) future directions for accessing, implementing, and evaluating COVID-19 federal investments in child care settings. Methods: The study utilized a qualitative content analysis approach. In June 2021, the investigators conducted 17 qualitative interviews with federal representatives (n = 4), practitioners (n = 7), and researchers (n = 6). Recruitment continued until saturation was achieved. Virtual interviews lasted approximately 45 to 60 minutes and were recorded, transcribed, and coded for themes and subthemes using thematic content analysis. Results: Primary findings included: 1) COVID-19 likely increased stress and exacerbated prevalence of food insecurity for child care staff and participating families, and decreased diet quality among children both while in and outside of child care; 2) flexibilities to federal child care requirements, outdoor learning opportunities, and meal provision strategies implemented during the pandemic were perceived as positive and could continue post-pandemic; and 3) future efforts could utilize the recovery funds to make changes that are equitable and sustainable, such as conducting equity assessments and collaborating with community organizations, along with evaluating impacts of these efforts on food insecurity and health of child care staff and participating children. Conclusion: Overall, recommendations focused on several social determinants of health, including addressing food insecurity among both children and staff, and infrastructure for nutrition and physical activity. Continued programmatic and public health recovery efforts aimed to mitigate the negative impacts of COVID-19 are critical to fostering health and wellbeing in child care settings.

Maintaining recovery from alcohol use disorder during the COVID-19 pandemic: The importance of recovery capital.

BACKGROUND: The potential impact of the COVID-19 pandemic on recovery from alcohol use disorder (AUD) has received scant attention to date. In response, we investigated the stability of recovery and identified correlates of relapse, with particular interest in differences between women and men. METHODS: Data were obtained in a national survey of adults with resolved alcohol use disorder who were not drinking heavily (n = 1492). We calculated summary statistics and modeled odds of mild relapse (i.e., resolved at the time of data collection), overall and stratified by gender. RESULTS: Equivalent large majorities of women and men reported that the COVID-19 pandemic had not affected their recovery at all (88.9% and 88.8%, respectively). Mild relapse events were infrequent, with only 45 participants (3.1%) reporting a resumption of drinking after being abstinent and 35 participants (2.7%) reporting an increase from previously moderated drinking, with no differences in prevalence between men and women. Recovery capital showed consistent and comparable protective effects for both women and men (adjusted odds ratio [aOR] 0.90; 95% confidence interval [95% CI] 0.84, 0.97; and aOR 0.93; 95% CI 0.88, 0.98, respectively). We did not find any effect of pandemic-related stressors; however, there were a number of distinct correlates of mild relapse for women and men. CONCLUSIONS: Recovery capital showed a consistently protective effect and may serve as a highly suitable intervention target as it is modifiable. Given gender differences, assessments of other key factors and tailored interventions targeting women and men may be necessary to ensure stable recovery.