Search Results (12)

Background/Objectives: The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) improves the health of nutritionally at-risk populations. However, engagement challenges, such as missed appointments and unredeemed food benefits, may limit program efficacy. Barriers to engagement are heightened among American Indian populations, who often experience disproportionately high levels of participation-related challenges. This study assessed whether newly developed health communication theory-based text messages incorporating persuasive language and different message framing (i.e., gain-framed and loss-framed) improved WIC appointment attendance and food benefit redemption rates, above and beyond standard information-based reminders. Methods: The sample included participants served by the Inter Tribal Council of Arizona WIC between the months of September 2022 and February 2023 who (a) had an appointment during the intervention period (n = 7584) or (b) were eligible to receive a reminder text about unused food benefits during the intervention period (n = 2177). A three-phase intervention design was used, with each phase lasting six weeks. During the baseline phase, participants received standard information-based text messages, while during the two intervention phases, participants received newly developed messages using (1) gain-framed and (2) loss-framed persuasive language. Difference-in-difference regression analyses compared whether differences in outcomes (i.e., appointment attendance and monthly food benefit redemption rates) between participants who received reminder messages and those who did not differed over intervention phases. Results: Receipt of both gain-framed and loss-framed theory-based messages was associated with higher appointment attendance, when compared to receipt of standard information-based messages during baseline (p = 0.003 and p = 0.01, respectively). Neither the gain-framed nor loss-framed messages were associated with higher food benefit redemption rates than standard messages. Conclusions: Results indicated that persuasive communication theory-based text reminders may be an effective, low-cost strategy to boost WIC appointment attendance among American Indians. Full article

Background: On 18 April 2024, the United States Department of Agriculture (USDA) published the first food package changes to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in over a decade, which reduced some food benefits (juice, milk, canned fish, and infant fruits and vegetables) and offered substitutes (cash-value vouchers (CVVs) or cash-value benefits (CVBs) to redeem for fruits and vegetables, cheese, soymilk, or other dairy products). Methods: To assess the impact of the changes on the consumption and redemption of these food groups, a systematic search was conducted, identifying 23 peer-reviewed publications between 2010 and 2024. Results: They revealed significant shifts in consumption after the 2009 food package changes; e.g., a decline in 100% juice intake following reductions in juice allowances. Additionally, the review highlighted that the 2009 WIC food package revision was associated with more fruit and vegetable consumption after the increase in CVV allowance. While including milk alternatives like soy-based beverages or lactose-free milk or cheese may improve redemption rates and WIC program satisfaction, the long-term impacts of these proposed changes remain unknown. No research was identified on the consumption of canned fish. Conclusions: This review contributes to understanding the changes in redemption and consumption after the last WIC food package changes, identifies the knowledge gap about prospective impacts, and recommends that the WIC agencies implement appropriate evaluations to promote health and nutrition among vulnerable populations. Full article

By the end of the nineteenth century, the view of labour as control of the environment for human benefit was being re-evaluated. In the United States, the conservation movement of the Progressive era (1890–1920) brought new attention to the problem of the ‘wise use’ of resources. Progressive social movements also developed a concern with holistic health and social conditions in rapidly industrialising cities. This paper argues that the formation of the new allied health science of occupational therapy in the early 20th century can be understood as a response to the health and conservation implications of changing relations between labour and resources. An analysis of published sources on the aims of occupational therapy in the Progressive era concluded that the early stage of the profession was structured by dominant Western narratives about humans and nature. Those narratives included the trope of redemption or transformation through labour and the importance of conservation as a response to the squandering of resources, both natural and human. I argue that the early development of occupational therapy was significantly influenced by environmentalist discourse as a therapeutic response to industrialisation and emerging Anthropocene awareness. Full article

Food prescription programs (Food Rx) have the potential to improve management of diet-related chronic diseases or underlying conditions such as type 2 diabetes (T2D), hypertension, and high body mass index (BMI) among food-insecure patients. The purpose of this study was to examine the effectiveness of a Food Rx program implemented in two community-based clinics in Florida. Data were collected through researcher-administered surveys (food insecurity, demographics, and socio-economic variables) and biometric data (HbA1c, blood pressure, and BMI). Key results include the following: (1) Hispanic patients are more likely to utilize the program than their Black and White counterparts (p < 0.001); (2) older patients (≥50 years) have a higher food redemption rate when compared to younger patients (36–49.9 years); (3) food redemption rate is negatively associated with food security scores indicating improvements in food security status over time (r² = −0.184, p = 0.036); (4) diabetic patients with higher baseline HbA1c (>9%) have significant reductions in glycated hemoglobin (p = 0.011) over time as compared to patients with lower baseline values (<7%); and (5) patients enrolled in the program for at least 6 months have a significant reduction in systolic blood pressure (p = 0.051). Changes in BMI were not significantly associated with redemption rates. This study is significant as it offers insights into the potential benefits and challenges of implementing Food Rx programs to address diet-related chronic diseases among underserved populations. Full article

Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participants faced unprecedented challenges during the coronavirus disease 2019 (COVID-19) pandemic including financial concerns, a national infant formula shortage, and rising food costs. To mitigate these challenges, the United States Department of Agriculture implemented WIC program waivers and flexibilities aiming to simplify program operations (e.g., remote appointments and food package substitutions). However, little is known about WIC participants’ perceptions of these changes and their impact on in-store benefit redemption. As such, this study aimed to characterize how pandemic-related events impacted Delaware WIC participants’ shopping experiences and program perceptions. The authors conducted semi-structured interviews with 51 WIC participants in Wilmington, Delaware. Survey measures included demographic questions, the Hunger Vital Sign, and open-ended questions regarding WIC program participation experiences during the pandemic. Data were analyzed using a hybrid inductive and deductive coding approach. The results demonstrate that WIC participants benefitted from the pandemic program’s flexibilities. However, they continued to experience burdensome shopping trips as well as concerns about their ability to feed their families due to infant formula shortages and inflation. These findings indicate the importance of extending existing WIC flexibilities and providing continued support for both participants and WIC-authorized retailors. Full article

The COVID-19 pandemic is worsening the disparities in food access in the United States. As consumers have been increasingly using grocery online ordering services to limit their exposure to the COVID-19 virus, participants of federal nutrition assistance programs lack the online benefit redemption option. With the support of the US Department of Agriculture (USDA), retailers are pilot-testing online food benefit ordering in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). By combining the Oklahoma WIC administrative data, the online ordering data from a grocery store chain in Oklahoma, and the COVID-19 data in Oklahoma, this study examines how WIC participants responded to the online food benefit ordering option and how their adoption of online ordering was associated with the COVID-19 incidence. Results show that from July to December 2020, 15,171 WIC households redeemed WIC benefits at an Oklahoma chain store, but only 819 of them adopted online ordering. They together completed 102,227 online orders, which accounted for 2.7% of the store visits and 2.6% of the monetary value of WIC redemptions at these stores. There was no significant relationship between WIC online ordering adoption and COVID-19 incidence in Oklahoma. Full article

Many mothers are vulnerable to poor diet quality, particularly those living in low-income households. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides nutrient-rich foods through its benefits packages, but many WIC participants are not redeeming them. We assessed the feasibility and acceptability of a digital intervention to support redemption and consumption of WIC-approved foods to ultimately improve diet quality. We enrolled 54 maternal–child dyads receiving WIC benefits to receive three to four weekly text messages for 12 weeks focused on behavioral goals to improve consumption of WIC-approved foods. We assessed engagement with weekly tracking messages and satisfaction and collected 24 h dietary recalls to assess preliminary efficacy on dietary intake. Participants were mostly non-Hispanic white (63%) and working (63%), and responded to 7.4 (standard deviation: 4.6) of the 12 weekly messages. Half (n = 27) were high engagers (responded to 80% or more of weekly messages), with 28% (n = 15) responding to all messages. Most felt the feedback (94%) and tips (87%) were helpful and would recommend the program (91%). More were consuming leafy green vegetables compared to baseline (p = 0.01). Mothers of children enrolled in WIC found a text messaging intervention focused on consumption of WIC-approved foods enjoyable and helpful. Full article

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is now expected to allow participants to redeem their food benefits online, i.e., via online ordering, rather than only in-store. However, it is unclear how this new benefit redemption model may impact participants’ welfare since vendors may have an asymmetric information advantage compared with WIC customers. The WIC online ordering environment may also change the landscape for WIC vendors, which will eventually affect WIC participants. To protect WIC consumers’ rights in the new online ordering model, policymakers need an appropriate legal and regulatory framework. This narrative review provides that framework by reviewing the literature, legal treatises, and reports on enforceable laws and regulations in the U.S. relevant to digital marketing. The results identify key issues that may arise with adopting WIC online ordering. This paper suggests “privacy, transparency, and fairness” as guiding principles to protect the welfare of WIC participants in WIC online ordering. Full article

The United States Department of Agriculture approved an increase to the Cash Value Benefit (CVB) for the purchase of fruits and vegetables issued to participants receiving an eligible Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food package. In order to understand satisfaction, perceptions, and the overall impact of additional benefits for fruits and vegetables at the household level, a qualitative study consisting of structured phone interviews was conducted with families served by WIC in Southern California from November to December 2021 (n = 30). Families were selected from a large longitudinal study sample (N = 2784); the sample was restricted by benefit redemption and stratified by language and race. WIC participants were highly satisfied with the CVB increase, reporting increased purchasing and consumption of a variety of fruits and vegetables. Respondents noted the improved quality and variety of fruits and vegetables purchased due to the increased amount. Findings are expected to inform policy makers to adjust the CVB offered in the WIC food package with the potential to improve participant satisfaction and increase participation and retention of eligible families with benefits from healthy diets supported by WIC. Full article

Few produce prescription programs have taken place in rural areas, in the context of existing public health programs. Thus, the purpose of this mixed-methods study was to examine voucher redemption rates, change in fruit and vegetable intake, and suggestions for improvement among participants enrolled in a produce prescription program occurring in existing public health programs throughout rural eastern North Carolina. We examined voucher redemption rates and conducted pre- (n = 125) and post-intervention surveys assessing fruit and vegetable intake. t-tests were used to examine changes in intake pre- versus post-intervention among 50 participants. Participants (n = 32) also completed a semi-structured, telephone interview. Qualitative data were thematically analyzed to determine potential improvements. The overall voucher redemption rate was 52%. There was a 0.29 (standard deviation = 0.91, p = 0.031) cup increase in self-reported fruit intake comparing post- to pre-intervention data. Qualitative analyses indicated that participants enjoyed the financial benefits of the program and wanted it to continue. The produce prescription program was successful in increasing self-reported fruit intake among participants. More research is needed to determine if changes in intake persist when measured objectively, and on best methods for the program’s financial sustainability. Full article

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a nutrition assistance program in the United States (U.S.). Participants in the program redeem their prescribed food benefits in WIC-authorized grocery stores. Online ordering is an innovative method being pilot-tested in some stores to facilitate WIC participants’ food benefit redemption, which has become especially important in the COVID-19 pandemic. The present research aimed to examine the online ordering (OO) behaviors among 726 WIC households who adopted WIC OO in a grocery chain, XYZ (anonymous) store, in Oklahoma (OK). These households represented approximately 5% of WIC households who redeemed WIC benefits in XYZ stores during the study period, which was 1 July to 31 December 2020. This period was during the COVID-19 pandemic but after the temporary lockdown in Oklahoma had been lifted. Descriptive statistics were estimated for WIC OO households’ adoption behaviors and their orders. The Cox proportional hazard model and zero-truncated negative binomial regression were applied to examine the relationship between participants’ socio-demographics and the length of time between 1 July 2020, and their first OO, as well as the number of WIC online orders. About 80% of these online orders were picked up without any changes. Minority households had a significantly longer time before adopting their first OO (hazard ratio (HR) < 1, p < 0.001), while households with a child or a woman participant, or more participants, had a shorter time before adopting OO (HR > 1, p < 0.05). Non-Hispanic black households had a fewer number of OOs than non-Hispanic white households (B = −0.374, p = 0.007). OO adoption varied across socio-demographics. More efforts are needed to ensure equal access and adoption of WIC OO. Full article

Mobile coupons have significantly enhanced marketing and e-commerce. To assess the benefits of mobile coupon apps, which are unavailable with traditional coupons, we examined users’ motivations for obtaining and redeeming mobile bonus coupons from a customer value perspective. We collected coupon issue and redemption data from a mobile coupon app and used it to analyze the effects of various factors on coupon issue and redemption. Using the days of coupon issue as a control variable, we tested bonus-type and buy-one-get-onefree- type coupons separately. We applied negative binomial regression for the tests and used a standardized number of issuing days, face value, price, and brand popularity. Our findings indicate that a coupon’s functional (face value and product price) and social (brand popularity) values significantly affect mobile coupon issue and redemption. Furthermore, the effects of social value on coupon issue and redemption vary by coupon type-bonus or buy-one-get-one-free. These results can help marketing and e-commerce practitioners to take advantage of the benefits of issuing the optimal mobile coupons for the right products. Full article