State & Local Burden

Appendix A-3
Key Definitions for the WIC State Survey

Key Word Definitions for the WIC Breastfeeding Peer Counseling Study
Federal Fiscal Year (FFY):
The fiscal year that covers the time period from October 1st to September 30th.
FTEs (Full Time Equivalents):
FTE is a measure of staff work year effort. One FTE is equivalent to 2,080 hours of work, which could
reflect, for example, one employee on a full time schedule of 40 hours per week each year, or two part
time employees for 20 hours per week each year. An employee working 30 hours per week for a year is
counted as .75 FTE. FTEs are not employee head counts.
Nutrition Services and Administration (NSA) Funds:
NSA funds are the non-food component of the WIC funds provided by the U.S. Department of
Agriculture’s Food and Nutrition Service. NSA funds are used for a variety of activities including certifying
women, infants and children for WIC benefits, providing nutrition education, and conducting breastfeeding
promotion and support activities.
Paraprofessional:
For the purposes of this study, a paraprofessional is someone without extended professional training who
is selected from the group to be served and is trained and given ongoing supervision to provide a basic
service or function.
Ten components of Loving Support:
Required Components of a Peer Counseling Program
I.
Appropriate Definition of Peer Counselor.
• Paraprofessional
• Recruited and hired from target population
• Available to WIC clients outside usual clinic hours and
outside the WIC clinic environment.

II.
III.

Designated breastfeeding peer counseling program
managers/coordinators at State and/or local level.
Defined job parameters and job descriptions for peer
counselors.

Recommendations from the Research
Ideal Peer Counselor:
• Enthusiasm for breastfeeding
• Basic communication skills
• Previous breastfeeding experience (6 months)
• Similarities with WIC participants served
• Current or previous WIC participant
• Similar ethnic background
• Similar age
• Same language spoken.
Use sample job description provided in the Using Loving Support to
Manage Peer Counseling Programs Training Manual.
Job parameters:
• Settings for peer counselors should include telephone contacts
from home; and clinic, home and hospital visits
• Frequency of contacts with pregnant. and breastfeeding women
is important. Refer to Section 6 (Scope of Practice for Peer
Counselors) of “Using Loving Support to Manage Peer
Counseling Programs” Training Manual for recommended
contact frequency during the prenatal and postpartum period.
Job descriptions:
Use sample job descriptions provided in the Using Loving Support
to Manage Peer Counseling Programs Training Manual.

Key Word Definitions

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Required Components of a Peer Counseling Program
IV. Adequate compensation and reimbursement of peer
counselors.

V.

Training of appropriate WIC State/local peer counseling
management and clinic staff.

Recommendations from the Research
Many current peer counseling programs report paying peer
counselors the same general hourly part-time rate typical of other
entry level positions such as WIC clerical position. This is often
around $5.50 to $7 per hour. However, nearly all programs share
the belief that peer counselors should be paid more.
Other recommendations:
• Provide travel allowance for home/hospital visits/meetings
• Cover training expenses
• Provide benefits if possible
• Reimburse for telephone and other expenses.
Cross-train so that peer counselors are familiar with WIC services
and WIC staff are trained in breastfeeding support.

• State and local program managers receive training in how to
manage peer counseling programs through “Using Loving
Support to Manage Peer Counseling Programs” training
curriculum.
• WIC clinic staff receive training about the role of the WIC
peer counselor through “Peer Counseling: Making a
Difference for WIC Families,” a PowerPoint presentation
included in the “Using Loving Support to Manage Peer
Counseling Programs” training curriculum.
• State and local staff involved in the training of peer
counselors attend the 2005 Regional train the trainer session
“Loving Support through Peer Counseling.”
• WIC clinic staff are trained in basic breastfeeding support
and receive the training “Loving Support through Peer
Counseling.”
VI. Establishment of standardized breastfeeding peer
counseling program policies and procedures at the State
and local level as part of Agency nutrition education plan.

Involve both State and local stakeholders in developing policies and
procedures for a peer counseling program.

VII. Adequate supervision and monitoring of peer counselors

The mentor/supervisor transition has been reported to be effective
for many successful programs. Refer to Section 8 (Supervision and
Monitoring) of “Using Loving Support to Manage Peer Counseling
Programs” Training Manual.
Conduct weekly phone contacts; regular review of contact logs; and
spot checks.

VIII. Establishment of community partnerships to enhance the
effectiveness of a WIC peer counseling program.

(Use sample Peer Counselor Contact Log and sample Weekly
Activity Report Form provided in the “Using Loving Support to
Manage Peer Counseling Programs” Training Manual).
Potential partnerships to consider:
Breastfeeding coalitions; businesses, community organizations;
cooperative extension program; international board certified
lactation consultants; La Leche League; home visiting programs;
private clinics; hospitals

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Required Components of a Peer Counseling Program
IX. Provision of the following to peer counselors:

Recommendations from the Research

• Timely access to breastfeeding coordinators and other
lactation experts for assistance with problems outside of
peer counselor scope of practice
• Regular, systematic contact with supervisor
• Participation in clinic staff meetings and breastfeeding inservices as part of the WIC team
• Opportunities to meet regularly with other peer counselors.
X.
•

•

Provision of training and continuing education of peer
counselors:
Peer counselors receive standardized training using
“Loving Support through Peer Counseling” training
curriculum.

Provide formal instruction in addition to home study.
Provide opportunities to “shadow” or observe other peer counselors
and lactation experts.
Provide career path options (e.g., training/experience to become
senior level peer counselors; training to become IBCLC).

Peer counselors receive ongoing training at regularly
scheduled meetings.

Key Word Definitions

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