WIC NE State & Local - Phase I

appendix O:
Phase I SIte Inteview Guide

OMB Control Number: 0584-XXXX
Expiration date: XX/XX/XXXX

WIC NUTRITION EDUCATION STUDY

Interview Guide for Phase I Site Interviews

State:

Local agency no. _________________ Site no.

Respondent name and title:

Phone:

E-mail address:

Date/time of interview:

Interviewer name: __________________________________________________

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 30 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.

Interview Procedures

The interviews will build on the Phase I survey responses to provide a more comprehensive picture of how nutrition education services are provided in the sites selected for the interviews. Interviewers will have the relevant responses to the Local Agency and Site Surveys available at the time of the interviews.

The target respondents who will be recruited for the interviews are site staff members who provide nutrition education 10 or more hours per week on average. Some of the respondents may have the additional role of site supervisor, breastfeeding coordinator or lead over nutrition education at the site. The interview guide includes five modules:

• Module A: One-on-one nutrition education

• Module B: Group education sessions

• Module C: Technology-based nutrition education

• Module D: Nutrition education reinforcers

• Module E: Coordination of nutrition education activities with others

At the beginning of the interview, the interviewers will ask the first two questions to classify the respondent by primary job role and type of nutrition education they use. The order of interview module administration will be determined by the respondent’s classification. Because each respondent completes only a subset of questions, the average burden per respondent is 30 minutes.

Introduction

Thank you for taking the time for this interview. The U.S. Department of Agriculture’s Food and Nutrition Service (FNS) has contracted with RTI International and its partners from Altarum Institute and the University of California, Berkeley to conduct a nationally representative study of WIC nutrition education processes in local sites. As part of the study, Altarum is conducting interviews with sites that responded to a recent survey about nutrition education, and your [name of site] was selected. Altarum is a nonprofit health and nutrition policy research and consulting organization, and our work focuses on helping improve the health and nutrition status of children, families, and adults. My name is [Interviewer Name] and I work for Altarum.

I will be asking you questions about how you provide nutrition education. The information you provide will be combined with information from the other sites we are interviewing, and nothing that you tell me will be identified in our report as coming from you, your local agency, or site. I expect that the interview will take about 30 minutes. Before I begin, do you have any questions?

Classification Questions for Module Administration

The first questions are about your role in nutrition education at the WIC site.

[Interviewer Instructions: Based on the responses to the first two questions, determine the order of module administration in the table below the questions. Ask as many questions as possible from the selected modules within the 30-minute interview window.]

1. What is your primary job or role at the WIC site? (Probe as needed to identify which of the roles below is most appropriate.)

• WIC director/coordinator  Role = X

• Site/clinic supervisor  Role = X

• Registered dietitian  Role = X

• Degreed nutritionist, not RD  Role = X

• Trained nutrition paraprofessional  Role = Y

• Nurse  Role = X

• Nutrition educator coordinator  Role = X

• Administrative/clerical/support staff  Role = Y

• Lactation consultant/WIC-designated breastfeeding expert  Role = Y

• Breastfeeding coordinator  Role = Y

• Other (describe): ______________________________  Role = Y

2. Which of the following types of nutrition education do you provide as part of your job? (Read list and select all that apply.)

• One-on-one counseling  Education Type = 1

• Group education sessions  Education Type = 2

• Assist participants with technology-based nutrition education (either offsite via Internet or onsite via computer, kiosk, tablet)  Education Type = 3

Role	Education Type	Order of Module Administration
X	1	E D A
X	1, 2	B A E D
X	1, 2, 3	C E D B A
Y	1	A D E
Y	1, 2	B A D E
Y	1, 2, 3	C B A D E

Module A: One-on-One Nutrition Education

I have several questions about individual, also called one-on-one counseling, nutrition education sessions you provide.

A1. Please think about your most recent one-on-one nutrition education session.

1. Describe the participant/parent that you worked with and the reason for the session, for example, certification, high-risk counseling, secondary education.

2. What topics did you discuss?

3. How did you decide what topics to discuss?

4. What information did you share?

5. What questions or concerns did the participant have? How did you address these questions or concerns?

6. What, if any, goals were set?

7. About how long was the session?

8. Was all of the time spent on nutrition education? If no, what amount was for nutrition education?

9. Was this session different from a typical session? If so, how?

10. How was the next nutrition education or follow-up visit determined?

A2. Are there differences in your one-on-one counseling sessions during certification visits and other visits?

1. If no, go to Question A3.

2. If yes, please describe what is different.

A3. Do you help participants set behavioral goals?

1. If no, skip to Question A5.

2. If yes, please describe how you work with participants to set goals.

Probe:

• How are the goals determined?

• How do you work with participants who say they don’t want to set goals?

A4. What is your process for following up on behavioral goals?

Probe:

• Do you access information about previously established goals before conducting individual nutrition sessions?

• How do you work with participants to assess their progress on goals?

A5. Do you adapt or change your approach to one-on-one nutrition education for different types of participants (for example, different education levels/literacy levels or different cultures)?

1. If no, go to Question A6.

2. If yes, please describe how you adapt or change it.

A6. Do you measure a participant’s readiness to change when providing one-on-one nutrition education?

1. If no, go to Question A7.

2. If yes, please describe how you measure it and how, if applicable, it changes your approach to providing nutrition education.

A7. Please describe the training that you have received from WIC to help you develop your nutrition counseling skills.

1. Have you made changes in your discussions with participants based on the training you received from WIC? If yes, please describe the changes.

2. What, if any, are the challenges to incorporating the new skills into your daily counseling sessions with participants?

3. What, if any, help did you receive after training to incorporate the new skills?

A8. What do you think are the key techniques for making a one-on-one nutrition education session effective?

Probe:

• What nutrition education strategies work best?

• What strategies have you tried that did not work?

Module B: Group Education Sessions

I have some questions about the group education sessions you conduct at your site.

B1. Think about your last group session. Can you describe it to me?

1. How many participants were in the session?

2. Which WIC participant categories were included in the group?

3. How long did the session last?

4. What language was used to conduct the session?

5. What topics did you discuss?

6. How did you decide to discuss these topics?

7. What materials did you use in the session (for example, handouts, visuals, videos, flip charts)?

8. How did the participants respond to the topics?

9. What comments or questions did the participants have about the topic?

10. What went well or did not go well about the session?

11. What did the participants really seem to like or not like about the session?

12. Was this session different from your usual experience with group sessions? If so, how?

B2. After a participant attends a group education session, what is the typical procedure for scheduling their next nutrition education contact?

Probe:

• When is the participant offered nutrition education again?

• How is this determined?

B3. What do you think are the key techniques for making a group session effective?

Probe:

• What nutrition education strategies work best?

• What strategies have you tried that did not work?

B4. Please describe what, if any, training you have received on providing group education.

Probe:

• When was the training offered?

• How long was the training?

• Where was it provided?

• Was the training required?

1. What has been most useful to you in developing your group education skills?

2. What, if any, help did you receive after training to incorporate the new skills?

3. What, if any, training would you like to have that would help you improve your group education skills?

B5. Does your site provide group education for participants who don’t speak English?

1. If no, go to Question B5.

2. If yes, how does your site do this?

Probe:

• If groups are provided in languages other than English, are the staff who lead the group fluent in the language or is an interpreter used?

• If both English- and Spanish-speaking participants are included in one group, how do you provide the education?

B6. Does your site offer group sessions or activities for children?

1. If no, Module B is finished.

2. If yes, please describe these.

Probe:

• What activities or materials are used?

• What topics are covered?

• How frequently does your site conduct these?

3. If yes, what feedback have you had from children and parents who take part in these sessions or activities?

Module C: Technology-Based Nutrition Education

I have some questions about the use of technology-based nutrition education with your participants.

C1. My understanding is that your site offers participants the opportunity to receive nutrition education via the Internet outside of the WIC office. Is that correct? Are you familiar with Internet nutrition education?

1. If no, skip to Question C4.

2. If yes, ask Questions C2 through C4.

3. If don’t know, Module C is finished.

C2. Please tell me how Internet nutrition education is implemented at your site.

Probe:

• Who is eligible to receive Internet education?

• Who develops the Internet education? Is there a web link that I can follow to see it?

• How do you explain Internet education to participants?

• Do you know when a participant has completed Internet education? If so, how?

C3. What, if any, feedback have you received from participants about their experience using Internet education?

C4. What aspects of internet education do you feel make it effective with participants?

1. What aspects of internet education do you feel make it ineffective with participants?

C5. My understanding is that your site offers technology-based nutrition education onsite using a computer, kiosk, tablet, or similar device. Are you familiar with the nutrition education provided this way?

1. If no, Module C is finished.

2. If yes, ask Questions C5 and C6.

3. If don’t know, Module C is finished.

C6. Please tell me how onsite technology-based nutrition education, using a computer, kiosk, tablet, or similar device, is implemented at your site.

Probe:

• Who is eligible to receive onsite technology-based education?

• Who develops the education materials/modules that participants use on these devices? Is there a web link or description of these modules that I can get from you?

• How do you explain onsite technology-based education to participants?

• How do you know when a participant has completed onsite technology-based education?

C7. What, if any, feedback have you received from participants about their experience using onsite technology-based education?

Module D: Nutrition Education Reinforcers

I have some questions about materials and items your site uses to reinforce nutrition education provided in individual or group sessions.

D1. I see on the completed survey for your site that you have [insert names of reinforcer items selected on the survey].

1. What impact, if any, do you think these have on reinforcing nutrition education or helping participants with healthy behaviors?

2. Which items do you think are most effective? Why?

D2. I see on the completed survey for your site that you use text messages, email, or social media (for example, Facebook and Twitter) to reinforce nutrition education.

1. Please describe how your site is using these.

2. What feedback have you heard from participants about this?

Module E: Coordination of Nutrition Education Activities with Others

I see on the completed survey for your site that your local agency and site coordinate nutrition education with other programs and services including (Reference the names of programs and services selected on the Local Agency Survey.)

E1. Are you familiar with how your local agency or site coordinates with these other programs?

1. If no, Module E is finished.

2. If yes, ask Questions E2 through E4.

3. If don’t know, Module E is finished.

E2. Please describe how you coordinate nutrition education activities with these programs or services.

E3. Which coordination strategies have been most successful?

1. What has made these successful?

E4. Please describe any challenges you have encountered with coordinating nutrition education with other programs or services.

1. [If any were described] How have those challenges been addressed?

That ends my interview questions. Now I have just a few questions about you. We will use this information to help describe the individuals who participated in these interviews.

Demographic Questions

1. How many years have you worked for the WIC Program? (Include your time at this site and other WIC experience.)

• Less than 1 year

• 1–3 years

• 4–6 years

• 7–10 years

• 11–20 years

• More than 20 years

2. During your time working for WIC, how many years have you provided nutrition education as part of your job?

• Less than 1 year

• 1–3 years

• 4–6 years

• 7–10 years

• 11–20 years

• More than 20 years

3. What is your age?

• 24 or younger

• 25–34

• 35–44

• 45–54

• 55 or older

That concludes the questions. Do you have any comments that you would like to add? Thank you very much for your time and input for the WIC Nutrition Education Study.

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