WIC Nutrition Assessment and Tailoring Study (WIC NATS)

This is the first study to provide a comprehensive account of the WIC nutrition assessment and tailoring process. The nutrition and breastfeeding assessment process is critical to the delivery of individualized nutrition services and to meeting WIC’s mission. Study findings will inform FNS and WIC state and local agencies about how to enhance service delivery and improve retention of WIC participants.

Findings from this study are summarized in a two-part report series. Part 1 examines how the pre-pandemic nutrition assessment and tailoring processes are described at the state agency level, identifies variation in the implementation of these processes at the local agency level, and uses state agency management information system (MIS) data to characterize WIC program tailoring practices. Part 2 explores the differences between virtual and in-person nutrition assessment processes and benefit tailoring services and staff and participant perceptions of WIC services.

Key Findings

• Local agencies report their WIC staff modify food quantities in the food packages either because it is medically or nutritionally warranted or because the participant cannot use the full benefit.
• Over 70 percent of local agency staff report using the information obtained in the nutrition assessment to tailor the format or content of nutrition education.
• Sixty percent of local agency directors report their MIS helps facilitate tailoring of program benefits based on the results of the nutrition assessment.
• The five most common nutrition risk codes in order of frequency were: inappropriate nutrition practices for children, overweight woman, low hematocrit/hemoglobin, preterm or early delivery, and postnatal enrollment.
• Compared with in-person, remote appointments were about 15 minutes shorter, height/weight and hemoglobin/hematocrit test results were less frequently available, and some local agency staff reported challenges with participant communications.
• While local agency staff and participants rated WIC nutrition assessments highly, they reported food package tailoring could be improved.
• Eighty percent of WIC staff received cultural training; however, findings varied as to whether WIC staff explored participants’ culture and beliefs during the nutrition assessment.