Use of WIC cash value vouchers (CVV) in Arizona: A qualitative study of facilitators and barriers

In Arizona, cash value voucher (CVV) redemption as part of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) remains variable by WIC population category. Although a number of general barriers related to WIC CVV use have been identified, Arizona's WIC population is demographically unique compared to other states, and as-yet unexplored factors, such as cultural attitudes or use of technology, might affect how and where CVV is used by WIC participants. We conducted 8 focus groups with both English- and Spanish-speaking WIC participants to examine trends and attitudes related to CVV use, specifically related to preferences in relation to food choice; perceived availability of preferred and culturally appropriate foods; habits related to use of WIC CVV purchases; self-reported purchasing behaviors; facilitators of, and barriers to, using WIC CVV; and perceived value of WIC CVV. Among other findings, participants reported the value of CVV was worth occasionally considerable effort to use them, specifically employing strategies to maximize their value including purchasing at stores with “gas points” or price-matching. A number of participants noted using mobile phones for calculations within the store to facilitate CVV purchases. Barriers included perceived hostility at the checkout counter from both cashiers and fellow shoppers, as well as lack of knowledge about where CVV could be redeemed. Several participants noted unfriendly interactions as reasons to leave the store without purchasing fruits and vegetables. Most participants also reported never having used CVV at farmers' markets because they were unaware that this was a possibility.