The first rule in most behavior change models is to adapt the approach so as to best meet the participants’ needs. Studies on participant needs have shown that 80 to 95 percent of WIC participants indicated satisfaction with the nutrition education (Nestor et al., 2001; USDA/FNS, 2000), but they also identified barriers, such as repetition and a lack of activities available for the children while they were waiting for their mothers (Woelfel et al., 2004). Participant preferences included child care, facilitated discussions, more talking by the participants, and cooking classes.
Most of the studies on approaches have been of the type called WIC plus studies, in which augmented WIC services are compared with the usual services using convenience samples. Findings from these studies can be used to inform efforts to improve the delivery of WIC nutrition education, but these studies are not necessarily representative of usual practice or the