Joanne F. Guthrie

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides supplemental foods and nutritional education to low-income women and children up to the age of five. Despite evidence that WIC improves diet and nutrition and the nationwide availability of this program, many participants exit WIC before they are no longer eligible for benefits. To date no study has systematically reviewed factors that influence participants’ exits from WIC. The study systematically reviewed the relevant literature to identify factors related to discontinuing participation in WIC before children reach the age of five and 1503 citations were reviewed, 19 articles were read for full text review and eight studies met inclusion criteria. Participants’ higher socioeconomic status, attitudes and behaviors around breastfeeding, having shorter prenatal participation in WIC, administrative barriers, confusion regarding program eligibility, feelings of stigma and embarrassment at the store checkout lines, personal and family challenges, dissatisfaction with insufficient fruit and vegetables benefits and living in suburban areas or in the Southern US were salient factors that influenced WIC exits. These findings will be of interest to policymakers and stakeholders as they consider ways to increase participation and retention through program modernization and innovations.

Objective:Produce sold as plastic-wrapped packs of two to four individual items (i.e., produce micro-packs) that are low-cost and placed at checkout may appeal to shoppers with budget constraints and provide a second chance to purchase items available elsewhere in the store. This study examined the impact of an intervention that placed produce micro-packs at checkout and promoted them in grocery stores across New Mexico, United States of America (USA).Design:This quasi-experimental study placed produce micro-packs at checkout end-caps in 13 stores (group 1), with eight stores serving as controls (group 2) from July 1, 2019 through January 31, 2020 (first phase). The intervention was extended to group 2 stores from February 1, 2020 through June 30, 2020 (second phase). Cashiers were directed to upsell the micro-packs to Special Supplemental Nutrition Program for Women, Infants, and Children recipients who had unspent cash value benefits for produce purchases.Setting:Twenty-one grocery stores across New Mexico.Participants:Twenty-one produce items sold as micro-packs in stores from July 2019 through June 2020.Results:A random effects model showed that the daily sales of micro-packs increased by 47% during each intervention period. Group 2 stores had lower sales than group 1 stores during the first phase of the intervention. Once extended to group 2 stores, sales of micro-packs in those stores increased and sales in group 1 stores continued at the higher level.Conclusions:Placing produce micro-packs at checkout may increase produce sales and support health promotion efforts by public and private stakeholders.

We conducted a natural field experiment to estimate the impact of including recipes and nutrition tips in a monthly food-box pre-ordering program on produce orders. Customers were randomized at order pickup to receive recipes and nutrition tips (n = 125), or not (n = 120), and received reminder calls to place next month’s order. We observed type(s) and number of boxes ordered. Customers receiving recipes and nutrition tips allocated significantly more (15.7%) of their next month’s purchase to fruit (P = 0.04). Customers (33.3%) in this intervention group also increased the amount of produce in their next month’s order (P = 0.01) compared to the control group (15.8%).