Priyanka Patel

Background: The continued reliance on single‐category self‐reported demographic data (e.g., race/ethnicity) reflects conceptual limitations that hinder the study and understanding of health outcomes research. There is a pressing need for more precise measures of social privilege that conceptualize privilege and oppression while enabling the examination of their effects on health outcomes in the United States (US) healthcare system. Objective: The purpose of this scoping review was to review the literature, determine how researchers have measured aspects of privilege and oppression, and develop a conceptual framework to study patients’ social privilege in the US healthcare system and public health research. Methods: Authors used Arksey and O’Malley’s Methodological Framework for Scoping Reviews and the SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, Research type) Framework to identify relevant studies. In August 2024, we searched seven databases using key phrases such as “social privilege,” “intersectional privilege,” and “structural privilege” paired with “measures,” “surveys,” “psychometrics,” and other like terms. Studies were included if they were peer‐reviewed, published in the English language, conducted in the US, and included adult populations. Studies were excluded if they measured adverse childhood experiences (ACE), systemic or structural racism, and/or color blindness. Results: Our scoping review resulted in a final sample of seven articles published between 2003 and 2024. The majority of research studies measured race/racism, white privilege, or racial identity ( n = 6), gender or sexism ( n = 5), and/or sexual orientation or heterosexism ( n = 5). Based on the results, we offer a preliminary definition of social privilege and a conceptual framework to begin studying social privilege in public health research and potentially primary care. Conclusions: These studies aimed to make various types of privilege more visible in psychology and counseling. Thinking innovatively, public health and health services researchers could build on our preliminary definition, domains, and conceptual framework to develop a reliable and validated social privilege index (SPI). This measure would include privileges associated with policy and politics, power and influence, social identity, intersectionality, access and opportunities, etc. that produce a social privilege score and determine its relationship to the likelihood of poor health outcomes.

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.

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a nutrition assistance program in the U.S. WIC served 2.5 million eligible Hispanic women, infants, and children under the age of five in 2021, which is WIC’s largest racial/ethnic group. However, limited research has been conducted to understand Hispanic WIC participants’ perceptions of WIC breastfeeding recommendations and their breastfeeding decisions. For this qualitative study, we interviewed 18 of these pregnant and postpartum WIC participants on their experiences and decision-making processes related to breastfeeding. Hispanic cultures and home country norms were identified as prominent influences on breastfeeding decisions, along with perceptions of WIC’s breastfeeding support. These results can help the WIC program to refine its breastfeeding education to better meet the needs of Hispanic participants.

Nearly half of newborns in the United States are enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Promoting breastfeeding is a programmatic priority, although formula vouchers are provided for those who do not exclusively breastfeed. Previous literature suggests that participant perception of WIC’s breastfeeding recommendations is a significant factor predicting breastfeeding initiation, duration, and exclusivity outcomes. However, little is known about how participants’ perceptions of WIC’s breastfeeding recommendations are formed. To address this knowledge gap, we conducted a qualitative pilot study in Nevada, interviewing 10 postpartum WIC mothers and 12 WIC staff who had interacted with participants regarding infant feeding. Results showed participants and staff reported various perceptions of what WIC recommends, the factors that contribute to these perceptions, and how these perceptions affect breastfeeding practices. Respondents also described that WIC has a negative legacy as the “free formula program,” and that environmental factors, such as the recent formula recall, have had an impact on participants’ infant feeding practices. More effective public campaigns and programmatic strategies are needed to target participants’ prenatal self-efficacy and to communicate the availability of skilled lactation support in the early postpartum period to improve participants’ perceptions of WIC’s position on breastfeeding.

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) plans to allow participants to redeem their food package benefits online, i.e., online ordering. As grocery shopping online has become more common, companies have developed strategies to market food products to customers using online (or mobile) grocery shopping platforms. There is a significant knowledge gap in how these strategies may influence WIC participants who choose to shop for WIC foods online. This review examines the relevant literature to (1) identify food marketing strategies used in online grocery shopping platforms, (2) understand how these strategies influence consumer behavior and consumer diet, and (3) consider the implications for WIC participants. A total of 1862 references were identified from a systematic database search, of which 83 were included for full-text screening and 18 were included for data extraction and evidence synthesis. The included studies provide policymakers and other stakeholders involved in developing WIC online order processes with valuable information about the factors that shape healthy food choices in the online food retail environment. Findings indicate that some marketing interventions, such as nutrition labeling and food swaps, may encourage healthier food choices in the online environment and could potentially be tailored to reinforce WIC messaging about a healthy diet.

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.

Purpose/objectives: To pilot an online interprofessional education (IPE) applied learning activity (ALA), to understand students’ socialization and values towards IPE teams, and evaluate the IPE learning activity for future implementation.Methods: A pre‐and post‐test design was used to assess interprofessional socialization and values utilizing the (ISVS‐9A/9B) surveys before and after the IPE ALA among dental hygiene (DH) and Master of Public Health (MPH) students (n = 86). Three statements from the ISVS‐9A/9B surveys were not included due to the nature of the activity. The IPE ALA was a case study related to a federally funded community health center seeking funding for a dental van within 14 local targeted communities (i.e., children, senior citizens, special needs). Student groups were randomly assigned to one targeted community and completed questions that required application of prevention, systems thinking and management and solutions of oral health issues. Students collaboratively developed an executive summary and presentation through an online learning platform.Results: A total of 73 DH (n = 38) and MPH (n = 35) students (84.8% response rate) completed the ISVS 9‐A (modified), and 57 students DH (n = 33) and MPH (n = 24) students (66.3% response rate) completed the ISVS‐9B (modified) and IPE activity evaluation. A positive change (pre‐post) was observed based on the students’ responses (p < 0.05) and 64% agreed that the skills obtained from the IPE ALA would help them in their careers.Conclusions: Overall, student learners’ ISVS toward IPE improved after engaging in the online ALA. The use of online platforms is one low resource strategy to integrate IPE experiences into allied health and dental education.