VENA (Value Enhanced Nutrition Assessment) in WIC: Creating new policy and guidance to maximize WIC's role as a premier public health nutrition program

Value Enhanced Nutrition Assessment (VENA) is a new initiative from the United States Department of Agriculture's Food and Nutrition Service (FNS), designed to improve nutrition services in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). As a result of the 2002 Institute of Medicine (IOM) report: Dietary Assessment in the WIC Program¹, FNS developed and issued VENA policy and guidance, utilizing a Federal/state/local collaborative effort. While the IOM report was specific to dietary assessment, FNS took the opportunity to enhance the entire nutrition assessment process. Since its inception, the WIC Program has required a nutrition assessment for all applicants to determine nutrition risk, as a criterion for program eligibility. VENA reaffirms the premise that in order to provide a personalized nutrition intervention, it is first necessary to conduct a complete nutrition assessment – one that collects anthropometric, biochemical, medical, social/environmental, and dietary information. A significant change that VENA brings to a WIC nutrition assessment, is its emphasis on a more qualitative rather than quantitative dietary assessment. VENA promotes a participant-centered, positive approach to nutrition assessment – one that is based on desired health outcomes rather than deficiency findings. The goal of VENA is to expand the focus of nutrition assessment beyond program eligibility determination and toward the delivery of targeted nutrition interventions that assist participants in making healthy lifestyle and dietary choices. In addition to VENA policy and guidance, FNS developed a phased implementation process, to assist states agencies in developing enhanced WIC nutrition assessment protocols. WIC state agencies were required to complete a self-evaluation before developing a VENA implementation plan. This is a shift from the traditional FNS management style of policy implementation - by meeting state agencies where they are (as identified through the self-evaluation), and allowing them to develop individualized strategies rather than establishing uniform implementation requirements. VENA serves to enhance WIC nutrition services and to ensure the continued integrity of the WIC Program as a premier public health nutrition program.