WIC Participant

OMB Approval No. 0584-XXXX

Approval Expires: XX/XX/20XX

APPENDIX I.1

WIC ITFPS-2 Participant Interview

Prenatal - English

WIC PROGRAM AWARENESS, SATISFACTION, UTILIZATION

I’m going to ask you some questions about WIC, including what your WIC site offers and what WIC services you use.

Awareness: WIC Food Packages

Prenatal, 3

First I’m going to read you a few questions and I’d like you to tell me if these things are offered at your WIC office or clinic:

WC1. There is a special WIC food package for breastfeeding women who do not accept infant formula from WIC. Is this food package offered at your WIC office or clinic? [Source: IFPS-1, modified]

Yes 01

No 02

Don’t Know 98

WC2. At your WIC office or clinic does the amount of infant formula you can get from WIC change based on the age of the baby? [Source: New Development]

Yes 01

No 02

Don’t Know 98

WC3. At your WIC office or clinic does the amount of infant formula you can get from WIC change depending on how much breastfeeding the mother is doing? [Source: New Development]

Yes 01

No 02

Don’t Know 98

Awareness: Breastfeeding counseling and education

Prenatal, 3

Now I’m going to ask you some questions about information and services you might have gotten from WIC.

WC4. Do you think that WIC recommends breastfeeding only, formula feeding only, or that both are equally ok? [Source: IFPS-1, modified]

Breastfeeding only 01

Formula feeding only 02

Both are equally ok 03

Don’t Know 98

Utilization: Breastfeeding counseling and education

Prenatal, 3

WC5. Have you received any information from WIC about breastfeeding (during this pregnancy/{CHILD})? [Source: IFPS-1, modified]

Yes 01

No 02

Don’t Know 98

Utilization: Nutrition education and counseling

Prenatal, 3

WC6. Have you received information from WIC about what you should be eating? [Source: New Development]

Yes 01

No 02

Don’t Know 98

Utilization: Food package

Prenatal, 3

WC12. During the last month did you buy all of the WIC foods for which you were issued checks or EBT benefits? [Source: New Development]

Yes 01

No 02

Haven’t shopped yet 03

Don’t Know 98

WC13. During the last month did you buy the full amount of the fruit and vegetable benefit?

Yes 01

No 02

Haven’t shopped yet 03

Don’t Know 98

EXPERIENCE, KNOWLEDGE, ADVICE, BELIEFS

Now I’d like to ask you some questions about your thoughts on breastfeeding, and plans you are making for feeding your baby.

Attitudes/beliefs about benefits and barriers to breastfeeding

Prenatal

KA18. I’ll now read a series of statements about breastfeeding. Please indicate whether you strongly agree, agree, neither agree nor disagree, disagree, or strongly disagree with each statement. [Source: WIC IFPS-1; modified]

NOTE: CATI should randomize the order of the sub-questions

a. Breastfeeding is easier than formula feeding. Would you say that you (interviewer read response options for all items as needed)

Strongly agree 01

Agree 02

Neither agree nor disagree 03

Disagree 04

Strongly disagree 05

b. Breastfeeding helps protect the baby from diseases.

Strongly agree 01

Agree 02

Neither agree nor disagree 03

Disagree 04

Strongly disagree 05

c. Breastfed babies are healthier than formula-fed babies.

Strongly agree 01

Agree 02

Neither agree nor disagree 03

Disagree 04

Strongly disagree 05

d. Breastfeeding brings a mother closer to her baby.

Strongly agree 01

Agree 02

Neither agree nor disagree 03

Disagree 04

Strongly disagree 05

e. Breastmilk alone gives a new baby all he/she needs to eat.

Strongly agree 01

Agree 02

Neither agree nor disagree 03

Disagree 04

Strongly disagree 05

f. Breastfeeding helps women lose weight.

Strongly agree 01

Agree 02

Neither agree nor disagree 03

Disagree 04

Strongly disagree 05

g. Breastfeeding takes too much time.

Strongly agree 01

Agree 02

Neither agree nor disagree 03

Disagree 04

Strongly disagree 05

h. Breastfeeding ties you down.

Strongly agree 01

Agree 02

Neither agree nor disagree 03

Disagree 04

Strongly disagree 05

i. Breastfeeding means no one else can feed your baby.

Strongly agree 01

Agree 02

Neither agree nor disagree 03

Disagree 04

Strongly disagree 05

j. Breastfeeding is painful.

Strongly agree 01

Agree 02

Neither agree nor disagree 03

Disagree 04

Strongly disagree 05

k. Breastmilk leaking onto your clothes is something I worry about.

Strongly agree 01

Agree 02

Neither agree nor disagree 03

Disagree 04

Strongly disagree 05

l. With bottle feeding, the mother knows that the baby is getting enough to eat.

Strongly agree 01

Agree 02

Neither agree nor disagree 03

Disagree 04

Strongly disagree 05

m. Breastfeeding in public is not something I want to do.

Strongly agree 01

Agree 02

Neither agree nor disagree 03

Disagree 04

Strongly disagree 05

n. Breastfeeding reduces the risk of a child becoming overweight.

Strongly agree 01

Agree 02

Neither agree nor disagree 03

Disagree 04

Strongly disagree 05

Intent to breastfeed

Prenatal

KA19. You may not know exactly what your plans are for feeding your baby, but you may have ideas about what you would like or are planning to do. I am going to read you some statements about feeding your baby and I would like you to please choose the answer that most closely matches your opinion. [Source: Nommsen-Rivers Intention measure, modified]

a. I am planning to only formula feed my baby and do not plan to breastfeed at all. Would you say that you:

Strongly agree 01

Agree 02

Neither agree nor disagree 03

Disagree 04

Strongly disagree 05

b. I am planning to breastfeed my baby or at least try. Would you say that you:

Strongly agree 01

Agree 02

Neither agree nor disagree 03

Disagree 04

Strongly disagree 05

c. When my baby is one-month-old, I will be breastfeeding without using any formula or other milk. Would you say that you:

Strongly agree 01

Agree 02

Neither agree nor disagree 03

Disagree 04

Strongly disagree 05

d. When my baby is three-months-old, I will be breastfeeding my baby without using any formula or other milk. Would you say that you:

Strongly agree 01

Agree 02

Neither agree nor disagree 03

Disagree 04

Strongly disagree 05

e. When my baby is six-months-old, I will be breastfeeding my baby without using any formula or other milk. Would you say that you:

Strongly agree 01

Agree 02

Neither agree nor disagree 03

Disagree 04

Strongly disagree 05

Influences on decision to breastfeed or formula feed

Prenatal, 1

Prenatal Question:

KA22. Have you talked with any of the following people about whether you plan to breastfeed, formula feed, or both breastfeed and formula feed your baby? [Source:WIC IFPS-1, modified]

a. Your husband or boyfriend?

Yes 01

No 02

Don’t know 98

Not applicable 99

(If yes) How important was this talk with your husband/boyfriend in helping you decide how to feed your baby? Would you say that it was very important, somewhat important, or not important?

Very important 01

Somewhat important 02

Not important 03

b. Your mother?

Yes 01

No 02

Don’t know 98

Not applicable 99

(If yes) How important was this talk with your mother in helping you decide how to feed your baby? Would you say that it was very important, somewhat important, or not important?

Very important 01

Somewhat important 02

Not important 03

c. Other relatives?

Yes 01

No 02

Don’t know 98

Not applicable 99

(If yes) How important was this talk with your relatives in helping you decide how to feed your baby? Would you say that it was very important, somewhat important, or not important?

Very important 01

Somewhat important 02

Not important 03

d. Friends?

Yes 01

No 02

Don’t know 98

Not applicable 99

(If yes) How important was this talk with your friends in helping you decide how to feed your baby? Would you say that it was very important, somewhat important, or not important?

Very important 01

Somewhat important 02

Not important 03

e. People who work at your WIC office or clinic?

Yes 01

No 02

Don’t know 98

Not applicable 99

(If yes) How important was this talk with people who work at your WIC office or clinic in helping you decide how to feed your baby? Would you say that it was very important, somewhat important, or not important?

Very important 01

Somewhat important 02

Not important 03

f. Your doctor?

Yes 01

No 02

Don’t know 98

Not applicable 99

(If yes) How important was this talk with your doctor in helping you decide how to feed your baby? Would you say that it was very important, somewhat important, or not important?

Very important 01

Somewhat important 02

Not important 03

PARTICIPANT CONTACT INFORMATION UPDATE

Thank you for taking the time to speak with me today. Because we’ll be calling you again for your next interview (PN: in a couple of weeks / all other times: when your child is {AGE – next interview}), I’d like to be sure we have all the right ways to contact you.

CM1. Is your full name still {NAME}?

Yes 01

No 02

(If no, go to a)

a. Can you please tell me what your full legal name is now?

_____________________________________________

Ask only if still on WIC:

CM2. {If have WIC ID on file: We have your WIC ID as {FILL}, is that correct?/If don’t have WIC ID on file: Do you know what your current WIC ID is?}

WIC ID is the same (fill below) 01

New WIC ID (specify below) 02

Don’t know WIC ID 98

Refused WIC ID 99

WIC ID___________________________________

CM3. I reached you today at {FILL #}. Will that still be the best number to call you at for your next interview?

Yes (if yes, go to b) 01

No (if no, go to a) 02

a. What is the best number to call you at for your next interview?

Number (specify ---/---/----)

NO PHONE (go to CM4) 97

Is that number home, work, cell, or something else?

Home 01

Work 02

Cell 03

Other (specify__________________) 04

b. Is there another number we could try in case we have trouble reaching you?

Number (specify ---/---/----)

Is that number home, work, cell, or something else?

Home 01

Work 02

Cell 03

Other (specify__________________) 04

We’d like to keep in touch with you even if we can’t get you by phone or your phone number changes, so I’m going to ask you about a few additional ways we might be able to contact you.

CM4. If have email on file: We have your email address as {FILL}, is that correct?/If no email: Do you have an email address we could use to contact you if necessary?

Email is the same (fill below) 01

New Email (specify below) 02

Don’t know Email 98

Refused Email 99

Email___________________________________

CM5. If mailing address on file: We have your current mailing address as {FILL}. Is that correct? If no mailing address on file: Can I get a mailing address we could use to contact you if necessary?

Address is the same (fill below) 01

New address (specify below) 02

Don’t know/don’t have address 98

Refused address 99

a. Can you please tell me what your current mailing address is?

Street/Apt#________________________________________

City______________________________________________

State_____________________________________________

ZIP______________________________________________

b. (If CM3a is 97 – no phone): Earlier you indicated that you do not have a phone. Since we need to speak with you by phone we will mail you a study phone. You will receive the phone before your next interview. The package will contain instructions on how to use the phone. Should we mail the phone to the mailing address you just provided?

Address is the same (fill below) 01

New address (specify below) 02

Don’t know/don’t have address 98

Refused address 99

Can you please provide the address where the phone should be mailed?

Street/Apt#________________________________________

City______________________________________________

State_____________________________________________

ZIP______________________________________________

CM6. [Social Media – will develop question when procedure is finalized]

CM7. (If contacts on file: Earlier you provided the names and contact information for two people who would always know how to find you. Can I read that information back to you and check that it’s still up to date?/If no contacts on file: Just in case we can’t get in touch with you using the information you just gave me, I’d like to ask you for the names and contact information for two people who would always know how to find you.

Person #1 (If contacts on file, read fill info and correct as needed)

Name

Who is this person to you?

Phone

Address

Email

Person #2 (If contacts on file, read fill info and correct as needed)

Name

Who is this person to you?

Phone

Address

Email

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB number.  The valid OMB control number for this information collection is 0584-XXXX.  The time required to complete this information collection is estimated to average 27 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.