Nutritional Sciences Program, School of Public Health, University of Washington, Seattle, WA.
Department of Health Systems and Population Health, University of Washington, Seattle, WA.
J Acad Nutr Diet. 2022 Dec;122(12):2228-2242.e7. doi: 10.1016/j.jand.2022.03.013. Epub 2022 Mar 23.
In response to the COVID-19 pandemic, Washington State's Supplemental Nutrition Program for Women, Infants, and Children (WA WIC) adopted federal waivers to transition to remote service delivery for certification and education appointments. WA WIC also expanded the approved food list without using federal waivers, adding more than 600 new items to offset challenges participants experienced accessing foods in stores.
This study aimed to assess the reach and effectiveness of the programmatic changes instituted by WA WIC during the COVID-19 pandemic; the processes, facilitators, and challenges involved in their implementation; and considerations for their continuation in the future.
A mixed-methods design, guided by the RE-AIM framework, including virtual, semi-structured focus groups and interviews with WA WIC staff and participants, and quantitative programmatic data from WIC agencies across the state.
PARTICIPANTS/SETTING: This study included data from 52 state and local WIC staff and 40 WIC participants across the state of Washington and from various WA WIC programmatic records (2017-2021). The research team collected data and conducted analyses between January 2021 and August 2021.
An inductive thematic analysis approach with Dedoose software was used to code qualitative data, generate themes, and interpret qualitative data. Descriptive statistics were calculated for quantitative programmatic data, including total participant count, percent increase and decrease in participation, percent of food benefits redeemed monthly, and appointment completion rates.
All WA WIC participants (n = 125,279 in May 2020) experienced the programmatic changes. Participation increased by 2% from March to December 2020 after WA WIC adopted programmatic changes in response to the COVID-19 pandemic. Certification and nutrition education completion rates increased by 5% and 18% in a comparison of June 2019 with June 2020. Food benefit redemption also increased immediately after the food list was expanded in April 2020. Staff and participants were highly satisfied with remote service delivery, predominantly via the phone, and participants appreciated the expanded food options. Staff and participants want a remote service option to continue and suggested various changes to improve service quality.
Participation in WIC and appointment completion rates increased after WA WIC implemented service changes in response to the COVID-19 pandemic. Staff and participants were highly satisfied with remote services, and both desire a continued hybrid model of remote and in-person WIC appointments. Some of the suggested changes to WIC, especially the continuation of remote services, would require federal policy change, and others could be implemented under existing federal regulations.
为应对 COVID-19 大流行，华盛顿州妇女、婴儿和儿童补充营养计划（WA WIC）采用了联邦豁免权，将认证和教育预约转为远程服务。WA WIC 还扩大了批准的食品清单，没有使用联邦豁免权，增加了 600 多种新食品，以弥补参与者在商店购买食品时遇到的挑战。
本研究旨在评估 WA WIC 在 COVID-19 大流行期间实施的计划变更的覆盖范围和有效性；实施这些变更所涉及的过程、促进因素和挑战；以及未来继续实施这些变更的考虑因素。
一项混合方法设计，以 RE-AIM 框架为指导，包括虚拟、半结构化焦点小组和对华盛顿州各地的 WA WIC 工作人员和参与者的访谈，以及该州各地 WIC 机构的定量项目数据。
参与者/设置：本研究包括来自华盛顿州各地 52 个州和地方 WIC 工作人员和 40 名 WIC 参与者的数据，以及来自各种 WA WIC 项目记录（2017-2021）的数据。研究团队于 2021 年 1 月至 8 月期间收集数据并进行分析。
使用 Dedoose 软件的归纳主题分析方法对定性数据进行编码、生成主题和解释定性数据。对定量项目数据（包括 2020 年 5 月的 125279 名 WA WIC 参与者总数、参与率的增减百分比、每月食品福利的赎回百分比以及预约完成率）进行描述性统计。
所有 WA WIC 参与者（2020 年 5 月为 125279 名）都经历了项目变更。在 WA WIC 针对 COVID-19 大流行采取项目变更后，2020 年 3 月至 12 月期间参与率增加了 2%。与 2019 年 6 月相比，2020 年 6 月认证和营养教育完成率分别增加了 5%和 18%。在 2020 年 4 月扩大食品清单后，食品福利的赎回立即增加。工作人员和参与者对远程服务交付（主要通过电话）非常满意，参与者赞赏扩大的食品选择。工作人员和参与者希望继续提供远程服务，并提出了各种改进服务质量的建议。
在 WA WIC 针对 COVID-19 大流行实施服务变更后，WIC 的参与率和预约完成率有所增加。工作人员和参与者对远程服务非常满意，双方都希望继续采用远程和面对面 WIC 预约的混合模式。WIC 的一些建议变更，特别是远程服务的延续，需要联邦政策的改变，而其他变更可以在现有的联邦法规下实施。
