Barriers and facilitators to early childhood participation in WIC: Lessons learned from formative research in New York state and Illinois

Nationally, it is estimated that 45% of WIC eligible infants and children do not enroll and/or terminate participation in WIC before their first birthday. Although some speculate that families leave WIC because they no longer need formula, research studies examining barriers and facilitators to WIC retention are limited. This is the first study to have focused on collaborative WIC retention efforts beyond individual states. Qualitative data including 25 focus groups, 50 individual interviews, and over 150 surveys were conducted with local WIC agency staff /coordinators, vendors, WIC clients, and Head Start staff across NYS and IL. Inductive content analysis was used to identify themes within and across participant categories. Descriptive and bivariate statistics were performed using SPSS.The most commonly reported barriers across all participant categories were; lack of time/scheduling difficulties/hectic lifestyles, negative shopping and clinic experiences, and the low perceived value of WIC services/benefits. Innovative facilitators suggested by participants were: better preparation for shopping with WIC checks, improving the WIC-acceptable Foods list, switching from paper-based checks to electronic benefits transfer (EBT) card, creating smart phone apps, automated text message reminders, strategic partnerships with healthcare and childcare providers, clinic environment activities for children, and a progressive statewide marketing campaign of the WIC program. Facilitators that can be implemented within a six-month period will be piloted at selected WIC local agencies across the states. Results from the piloted facilitators can be used by the NYS and IL WIC program to reduce barriers identified by the focus group participants.