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Dietary Risk Assessment in the WIC Program
Nutrition Education and Counseling
Federal regulations require nutrition education to be offered to each participant at least twice in each certification period (generally about 6 months). There are two broad goals of WIC nutrition education: (1) “to stress the relationship between proper nutrition and good health, with special emphasis on the nutritional needs of the program’s target populations; and (2) to assist individuals at nutritional risk in achieving a positive change in food habits, resulting in improved nutritional status and the prevention of nutrition related problems” (Fox et al., 1998). The forms of education vary widely among agencies and types of participants. Frequently reported methods include individual counseling, group discussions, written materials, use of food models, food demonstrations, and video or slide show presentations (Bartlett et al., 2000). Education may be provided by a competent professional authority (CPA), who may be a professional or a paraprofessional staff member who has received basic training. Most education for high-risk individuals is provided by professional nutritionists. Nutrition education topics vary among types of participants and sites. Examples of commonly covered topics include the Food Guide Pyramid, diet for pregnancy, breastfeeding, and strategies to prevent or manage overweight.
An individual’s self-described eating habits or patterns, in any form, can often be helpful to the CPA when choosing a starting place for nutrition education. Discussions of usual intake may help to establish rapport and also can uncover participant eating practices, disorders, or concerns to which WIC staff can respond appropriately with education or referral.
Food Package Tailoring
WIC participants receive supplemental food packages or instruments (vouchers or checks to be redeemed in retail grocery stores) in order to increase their intake of selected nutrients. Seven food packages are available for WIC participants: two for infants (age dependent); one for children 1–4 years of age; one for pregnant and breastfeeding women; one for postpartum, nonbreastfeeding women; an enhanced package for breastfeeding women; and specially tailored packages for women or children with special needs. The foods that make up the different packages are high in one or more nutrients that historically have been low in the diets of the program’s low-income target population (i.e., protein, calcium, iron, and vitamins A and C). The foods provided include ironfortified infant formula and infant and adult cereal, vitamin C-rich fruit and vegetable juices, eggs, milk, cheese, peanut butter, dried beans or peas, tuna fish, and carrots.
Approximately 98 percent of state WIC agencies adjust the contents of food packages to accommodate a participant’s particular nutritional needs or preferences (Bartlett et al., 2000). Examples of the types of tailoring that are