Effects on Benefit Redemption When 2% Milk is Issued After WIC Participants Refuse 1% or Fat Free Milk

Background: The Special Supplemental Nutrition Program for Women, Infant andChildren (WIC) provides participants with a supplemental food package that follows the Dietary Guidelines for Americans (DGA’s). The WIC food package has been shown to improve the diet quality and overall health status of WIC participants. Since the 2009 WIC food package revision, standard issuance of 1% or fat-free milk has been practiced for participants 24 months or older. Improving the value that participants have on the WIC foods can be an effective method to improve redemption of WIC foods and improve overall participation. The aim of this study was to examine if allowing issuance of 2% milk when clients refuse issuance of 1% or skim milk would affect benefit redemption of milk and other WIC foods. The study also examined how providing clarification through training on policy change for issuance of 2% milk would improve staff and director knowledge of this change in policy. Methods: This study was an observational, longitudinal study that used linear regression analysis of aggregated data at the local agency-level from the Arizona WIC program. Redemption data were analyzed using the Arizona WIC Health and Nutrition Delivery System (HANDS) at three different intervals throughout the study. The three months prior to the policy introduction (March-May 2020), redemption after policy introduction (July-September 2020), and redemption after policy clarification with 2% milk policy trainings (December 2020-February 2021). Redemption was measured as benefits issued versus benefits redeemed. Two separate surveys were delivered (via Qualtrics) to the 18 local agency directors (n=18) and their staff members (n=287). These surveys were used for descriptive purposes. Results: The results of this study found that there was a decrease in redemption of 2% milk and all foods at the post intervention stage of the study. WIC staff were found to have a better understanding of policy to issue 2% milk. Conclusion: Although these findings are consistent with other current research, further research is needed to examine how changing policy on current food restrictions placed on WIC foods affects redemption and how this may improve overall participation.