VENA (Value Enhanced Nutrition Assessment) in WIC: Gateway to WIC's obesity prevention initiatives

"...Evidence exists to conclude that nearly all low-income women in the childbearing years and children ages 2 to 5 years [in the U.S.] are at dietary risk, are vulnerable to nutrition insults, and may benefit from WIC's services.... By presuming that all who meet the categorical and income eligibility requirements are at dietary risk, WIC retains its potential for preventing and correcting nutrition-related problems...." Thus summarizes the Institute of Medicine's (IOM) Committee on Dietary Risk Assessment in the WIC Program in its Report, Dietary Assessment in the WIC Program ¹ to the United States Department of Agriculture (USDA). This report resulted in a new USDA policy, referred to as Value-Enhanced Nutrition Assessment (VENA) that has freed WIC staff from the traditional counting of servings in food groups and instead created the opportunity to focus on "promoting efforts to address childhood obesity by build[ing] on previously-developed WIC-specific obesity prevention interventions." (Program Assessment Rating Tool [PART] Report on the WIC Program, Office of Management and Budget [OMB] 2007). As an outgrowth of VENA policy, California WIC sites focus activities on "Healthy Eating and Active Living”, stressing healthy habits for life and strategies to prevent overweight. Program participants still complete an assessment questionnaire, and the assessment questions are mostly open-ended to encourage dialogue. Staff still obtains height, weight and blood test results, but uses critical thinking skills to integrate discussion of those results into topics the participant identifies as important. Data entered in California WIC's automated management system assists the educator in prioritizing conversation topics in addition to assessing for program eligibility. Lastly, staff provides participants choices in topics pertinent to the developmental stage of the child or pregnancy as an opening to the conversation. The outcome is a complete nutrition assessment that satisfies WIC program requirements and supports the WIC nutrition educator in initiating a dialogue with participants about the real-life challenges they face in feeding themselves and their families.