(P24-094-23) Factors Influencing Access, Reach, and Participation of the Supplemental Nutrition Program for Women, Infants, and Children (WIC): A Systematic Review

Objectives: This review aimed to synthesize evidence on perspectives of the WIC program from WIC vendors, WIC participants, and WIC-eligible non-participants.

Methods: Qualitative, quantitative, and mixed methods studies published in peer-reviewed journals were included. All studies were published in English, recruited at least 12 participants, and were based in the U.S. We performed a systematic literature search of articles from Jan 2000-Feb 2021 in MEDLINE, PsycINFO, the Cochrane Library, Web of Science Core Collection, and Scopes. Screening and data extraction were conducted using Covidence. The Mixed Methods Appraisal Tool was used for quality assessment.

Results: Six (6) mixed-methods studies, 14 qualitative studies, and 18 quantitative studies met inclusion criteria, for a total of 38 studies. Thirty-three (33) studies focused on WIC participants and WIC-eligible non-participants, 4 studies focused on vendors (e.g., store managers), and 1 study focused on both. Eighty-two percent (82%) of studies were cross-sectional and 53% of studies had majority BIPOC individuals. Studies covered different aspects of the WIC and farmers market nutrition program including the enrollment process, satisfaction with nutrition education, program participation, and voucher redemption. The most common barriers were stigma faced at the grocery store and challenges in identifying WIC-eligible foods. Most studies examining the perspectives from WIC participants in the WIC clinic reported positive interactions with staff. Grocery store vendors mentioned administrative challenges in accepting WIC vouchers. However, most vendors also reported increased profits through WIC as a positive effect.  

Conclusions: These findings indicate a need for additional longitudinal WIC studies, as many individuals stop using WIC after their child’s 1st birthday. Additional studies are also needed to assess the perspectives from WIC staff and vendors to improve program implementation. Simplifying the process of redeeming WIC at grocery stores may help to reduce stigma among participants and streamline the redemption process for vendors. Online grocery services may be helpful in mitigating some of these challenges for WIC participants and vendors.

Funding Sources: None