Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
PolicyLab and Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Pediatrics. 2024 Nov 1;154(5). doi: 10.1542/peds.2024-067012.
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and Supplemental Nutrition Assistance Program (SNAP) provide essential nutrition support for low-income families. However, many eligible families do not receive or fully redeem these benefits. We aimed to understand current and former WIC and SNAP beneficiaries' perceptions of and suggestions for improving both programs.
We conducted semistructured phone interviews with caregivers of pediatric patients who were current or former WIC and SNAP beneficiaries at 2 academic pediatric primary care clinics. Interviews were recorded, transcribed, and coded by 2 independent coders using thematic analysis, resolving discrepancies by consensus. Interviews continued until data saturation was reached.
We interviewed 40 caregivers who were predominantly Black (88%) mothers (90%), with 53% and 83% currently using WIC and SNAP, respectively. We identified 4 themes related to participation barriers: (1) limited product variety available through WIC, (2) inconvenience and stigma associated with purchasing WIC products, (3) SNAP income-based eligibility criteria, and (4) burdensome SNAP enrollment and recertification processes. We identified 3 themes related to suggestions for improvement: (a) decreasing stigma associated with participation, (b) allowing online or phone-based enrollment, and (c) improving coordination with health care systems.
WIC and SNAP beneficiaries identified several modifiable barriers to enrollment and benefits redemption. Pediatric providers should advocate for programmatic improvements that make it easier for families to access and redeem benefits and should consider implementing innovative cross-sector interventions like medical-financial partnerships, direct WIC and SNAP referrals, and data sharing with government assistance offices.
妇女、婴儿和儿童特别补充营养计划（WIC）和补充营养援助计划（SNAP）为低收入家庭提供必要的营养支持。然而，许多符合条件的家庭没有获得或充分兑换这些福利。我们旨在了解当前和以前的 WIC 和 SNAP 受益人的看法以及对改善这两个计划的建议。
我们在 2 家学术儿科初级保健诊所对儿科患者的看护人进行了半结构化电话访谈，这些看护人是当前或以前的 WIC 和 SNAP 受益人。访谈由 2 位独立的编码员使用主题分析进行记录、转录和编码，通过共识解决差异。访谈继续进行，直到达到数据饱和。
我们采访了 40 位看护人，他们主要是黑人（88%）母亲（90%），分别有 53%和 83%的人目前在使用 WIC 和 SNAP。我们确定了 4 个与参与障碍相关的主题：（1）WIC 可提供的产品种类有限，（2）购买 WIC 产品的不便和耻辱感，（3）SNAP 基于收入的资格标准，（4）繁琐的 SNAP 注册和重新认证流程。我们确定了 3 个与改进建议相关的主题：（a）减少与参与相关的耻辱感，（b）允许在线或电话注册，（c）改善与医疗保健系统的协调。
WIC 和 SNAP 的受益人确定了一些可修改的入籍和福利兑换障碍。儿科医生应该倡导进行计划改进，使家庭更容易获得和兑换福利，并考虑实施创新的跨部门干预措施，如医疗金融伙伴关系、直接 WIC 和 SNAP 转介，以及与政府援助办公室的数据共享。
