Table Of ContentHistoric, Archive Document
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WIC
ysg^
Nutrition Education
Assessment
Study
United States
Departmentof
Agriculture
Foodand
Nutrition
Service
Officeof
Analysisand Final Report
Evaluation
United States
Department of
Agriculture
I 1
National Agricultural Library
WIC
Nutrition
Education
Assessment Study
Final Report
February 1999
Preparedfor:
Janet Tognetti Schiller
U.S. Dept. ofAgriculture
Food and Nutrition Service
3101 Park Center Drive
Alexandria, VA 22302
Preparedby:
Mary Kay Fox
Nancy Burstein
Jenny Golay
Cristofer Price
Abt Associates Inc.
55 Wheeler Street
MA
Cambridge, 02138
Table of Contents
Page
List ofExhibits iii
Acknowledgments vi
Executive Summary vii
Chapter 1: Introduction 1-1
The WIC Program 1-1
Overview of the Study 1-4
The Study Sample 1-10
Organization ofThis Report 1-12
Chapter 2: Characteristics ofWIC Nutrition Education Offered in
Study Sites 2-1
Nutrition Education Observations 2-1
General Characteristics of Nutrition Education Contacts 2-2
Nutrition Education Staff 2-6
Breastfeeding Promotion Programs 2-8
Staff/Participant Interactions 2-9
Physical Environment 2-12
Topics Covered in WIC Nutrition Education Contacts 2-15
Referrals to Health and Social Services 2-17
Chapter 3: Participants' Receipt ofNutrition Education Contacts 3-1
Number ofWIC Nutrition Education Contacts Received 3-1
Information and Advice Provided by WIC Staff 3-5
Relationship Between Nutrition Education Offered and Received 3-13
Chapter 4: Changes in Participants' Knowledge, Attitudes, and Behaviors
Over Time 4-1
Data Sources and Variables 4-1
Nutrition Knowledge 4-2
Nutrition-related Attitudes and Perceptions 4-10
Nutrition-related Behaviors 4-15
Other Behaviors 4-24
Changes Among Selected Subgroups 4-28
AbtAssociates Inc. Table ofContents i
Table of Contents
(continued)
Page
Chapter 5: Participants' Satisfaction with WIC Nutrition Education 5-1
Satisfaction with Components ofWIC Nutrition Education 5-1
Knowledge Gained from WIC 5-4
Best and Worst Aspects ofthe WIC Program 5-7
Suggestions for Improvement 5-11
Overall Satisfaction with WIC Nutrition Education 5-13
Relationship Between Satisfaction and Nutrition Education Experiences .... 5-15
Chapter 6: Attitudinal and Social Influences on Selected Behaviors 6-1
Factors Influencing Women's Breastfeeding Intentions and Behaviors 6-1
Influence of Social Support on Behaviors During Pregnancy 6-7
References
Appendix A Prenatal Survey
Appendix B WIC Record Abstraction Form
Appendix C Nutrition Education Observation Forms
Appendix D Supplementary Exhibits
AbtAssociates Inc. Table ofContents ii
List of Exhibits
Page
Exhibit 1.1 Data Collection Components, Timing, and Schedule 1-8
Exhibit 1.2 Sample Sizes and Response Rates by Data Collection Component 1-11
Exhibit 1.3 Demographic Characteristics ofBaseline Sample 1-13
Exhibit 1.4 Household Characteristics of Baseline Sample 1-15
Exhibit 1.5 Characteristics of Baseline Sample Members in Comparison to Data from
1994 Census ofWIC Participants 1-17
Exhibit 2.1 Characteristics of Prenatal Nutrition Education Contacts in Study Sites .... 2-3
Exhibit 2.2 Characteristics of Postpartum Nutrition Education Contacts in Study Sites 2-7
. .
Exhibit 2.3 Characteristics ofBreastfeeding Promotion Programs in Study Sites 2-9
Exhibit 2.4 Quality of Staff/Participant Interactions in Observed Nutrition
Education Contacts 2-11
Exhibit 2.5 Quality ofStaff/Participant Interactions Related to Breastfeeding Promotion 2-13
.
Exhibit 2.6 Environmental Characteristics ofObserved Nutrition Education Contacts 2-14
Exhibit 2.7 Topics Covered in Prenatal Certifications 2-16
Exhibit 2.8 Referrals Made During Observed Nutrition Education Contacts 2-18
Exhibit 3.1 Prenatal Nutrition Education Contacts: Opportunity For and Receipt
ofTwo Contacts 3-2
Exhibit 3.2 Reported Frequency of Proxy Voucher Pick-ups Between Certification
and the Prenatal Survey 3-4
Exhibit 3.3 Frequency and Timing ofPostpartum Certification 3-6
Exhibit 3.4 Receipt ofTwo Postpartum Nutrition Education Contacts 3-7
Exhibit 3.5 Nutrition Education Topics Assessed in Prenatal and Postpartum Surveys 3-8
. .
Exhibit 3.6 Participant Self-Reports About Referrals Received From WIC Staff 3-12
Exhibit 3.7 Participant Self-Reports About Follow-up on Referrals Received from
WIC Staff 3-13
AbtAssociates Inc. Listof Exhibits iii
List of Exhibits
(continued)
Page
Exhibit 4.1 Sample Sizes for Analyses Comparing Baseline and Follow-up Measures
ofKnowledge, Attitudes, and Behaviors 4-2
Exhibit 4.2 Items Used to Assess Nutrition Knowledge 4-3
Exhibit 4.3 Overall Nutrition Knowledge Scores 4-5
Exhibit 4.4 Knowledge About Breastfeeding 4-6
Exhibit 4.5 Knowledge About Recommended Infant Feeding Practices 4-7
Exhibit 4.6 General Nutrition Knowledge 4-8
Exhibit 4.7 Knowledge About Healthy Practices During Pregnancy 4-9
Exhibit 4.8 Mean Baseline Knowledge Scores by Prior WIC Participation 4-11
Exhibit 4.9 Nutrition Attitude Measures: Mean Scores 4-12
Exhibit 4.10 Use ofPrenatal Vitamins 4-16
Exhibit 4.11 Use ofPrenatal Iron Supplements 4-17
Exhibit 4.12 Reported Daily Consumption ofWIC Foods 4-18
Exhibit 4.13 Reported Daily Consumption ofNon-WIC Foods 4-21
Exhibit 4.14 Breastfeeding Intentions and Behaviors 4-22
Exhibit 4.15 Food Items Included in Infant Feeding Inventory 4-24
Exhibit 4.16 Prevalence ofUndesirable Infant Feeding Practices Before
Two Months ofAge 4-25
Exhibit 4.17 Prevalence ofUndesirable Infant Feeding Practices Before
Four Months ofAge 4-26
Exhibit 4.18 Self-Reported Use ofCigarettes and Alcohol 4-27
Exhibit 4.19 Reported Use ofOver-the-Counter Medications 4-29
Exhibit 4.20 Summary of Significant Changes for Key Subgroups 4-31
AbtAssociates Inc. ListofExhibits iv
