November 27, 2018

A team led by researchers from the UNC Gillings School of Global Public Health examined the retail experience of customers of the federal Special Supplemental Nutrition Program for Women, Infants and Children (WIC) program and identified ways in which the experience of WIC recipients could be improved.

The findings, “WIC Recipients in the Retail Environment: A Qualitative Study Assessing Customer Experience and Satisfaction,” were published online Nov. 27 in the Journal of the Academy of Nutrition and Dietetics.

Christina Chauvenet

Christina Chauvenet

“Our study is one of the first to use qualitative research to explore the experience of using WIC benefits in the grocery store,” said the paper’s first author, Christina Chauvenet, MSc MSPH, doctoral candidate in maternal and child health, with a minor in health behavior, at the Gillings School. Chauvenet worked on the project as a research assistant at the UNC Center for Health Promotion and Disease Prevention (HPDP) under the guidance of paper co-authors Alice S. Ammerman, DrPH, HPDP director and Mildred Kaufman Distinguished Professor of nutrition at the UNC Gillings School and UNC School of Medicine, and Molly De Marco, PhD, assistant professor of nutrition and principal investigator at HPDP.

For the study, which was conducted as part of the Duke-UNC USDA Center for Behavioral Economics and Healthy Food Choice Research, the three Gillings researchers were joined by Carolyn Barnes, PhD, assistant professor at Duke University’s Sanford School of Public Policy.

“This research is part of a larger study to determine how to employ behavioral economic strategies to encourage healthier food choices in retail settings,” said De Marco. “Understanding how people who use WIC experience the retail environment will help us to craft effective interventions.”

Knowing that WIC is an important intervention for prevention and treatment of obesity and food insecurity and that participation among eligible populations dropped between 2009 and 2015, the researchers explored the retail experience, as it is a critical element of program satisfaction.

To do this, Chauvenet and her colleagues conducted listening sessions and semi-structured interviews with a large, diverse sample of WIC recipients from Illinois, North Carolina, Oregon and Texas. Researchers conducted interviews with 28 individuals and four focus groups comprised of a total of 27 people. All study participants were WIC recipients or had a partner or child who was a WIC recipient, and were one of the primary food shoppers for their household.

The research team found that identifying and purchasing WIC-eligible items can be challenging. When making purchases using WIC, many participants felt stigmatized by store employees and customers due to the extra paperwork and time required. Finding WIC-eligible foods, which are scattered throughout the store, also can be challenging. Having WIC-eligible items clustered together in one area of an existing store or having a WIC-only store is helpful in identifying eligible items.

“Our research identifies key areas for improvement of the retail environment for WIC participants, including better signage to indicate which items are eligible for purchase and a smoother check-out process,” said Chauvenet. “Improving the experience for WIC recipients is critical to reducing program attrition and making sure that WIC participants maximize their benefits.”

Ammerman agreed.

“The study has important implications for policy that reduce stigma while ensuring that WIC recipients receive maximum benefit from the program in terms of food access,” she said.


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