W_Phase II FAQ

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PHASE II FREQUENTLY ASKED QUESTIONS (FAQ)

WIC Nutrition Education Study (NEST) Phase II

Note: Burden statement not included since it is provided on the email to which the FAQ document is attached.

The U.S. Department of Agriculture (USDA), Food and Nutrition Service (FNS) has contracted with RTI International to conduct the WIC Nutrition Education Study (NEST). In Phase I, RTI and its research partner Altarum Institute conducted surveys and interviews with local agencies and sites to provide a comprehensive, nationally representative description of WIC nutrition education. The next phase of the study is to conduct a study with six WIC sites from across the United States. The findings from Phase II will be used to develop a methodology for conducting a future national evaluation study on the impact of WIC nutrition education on participants’ nutrition and physical activity outcomes. Below are some helpful FAQs regarding Phase II of the study.

1. Who is conducting this study?

This study is being conducted for USDA, FNS by RTI International with funding from USDA. RTI’s study team partners are the Altarum Institute, the Atkins Center for Weight and Health at the University of California at Berkeley, and the Public Health Foundation Enterprises WIC Program.

2. What is this study about?

The purpose of Phase II is to develop a methodology for conducting a future national evaluation study on the impact of WIC nutrition education on participants’ nutrition and physical activity outcomes. Six sites from across the United States will be asked to participate in the study, which includes two components: (1) an impact evaluation with surveys of WIC recipients or their caregivers to assess the impact of WIC nutrition education on participants’ nutrition and physical activity outcomes and (2) a process evaluation to collect information on how nutrition education is offered and to examine different models of nutrition education received by WIC participants in the six sites. The study will take place from MM/YY to MM/YY.

3. How will data be collected for this study? How long will it take?

For the impact evaluation, we will conduct surveys with WIC recipients or their caregivers. Working closely with each WIC site, two RTI field representatives stationed in the waiting room will recruit study participants and collect baseline data using a self-administered questionnaire over a period of 6 to 8 weeks. We plan to enroll about 135 participants at each site.

Participating sites will not be asked to help with study enrollment or survey administration, other than posting flyers in their site. If the site agrees, RTI will provide sites with fact sheets they can begin passing out about 3 months before data collection is scheduled to start (for a 4-week period starting around MM/YY) and also during the data collection period (a 6- to 8-week period starting around MM/YY). We will work closely with each site to ensure that the recruitment and survey administration activities do not interfere with the delivery of services. If possible, interested participants will be asked to arrive 20 minutes early so that they can complete enrollment and the first part of the baseline survey before their appointment.

We will mail participants two more surveys to complete over the 12-month study period. Recruitment and enrollment will take about 10 minutes, and the baseline and other two surveys will take about 20 minutes each to complete, with administration in Spanish taking a little longer. Participants will receive $50 in gift cards if they complete all three surveys; $20 for the first survey and $15 each for the second and third surveys.

For the process evaluation, data will be collected through

• Requests for Local Agency Nutrition Education Plans. The Local Agency Nutrition Education Plan will be requested at the beginning of the study, which will provide valuable information about the local agency’s and site’s nutrition education activities.

• Request for administrative data. At the end of the study (in MM/YY), we will work with each site to obtain administrative data for a subset of WIC recipients participating in the study (about 30 people). These data include whether the WIC recipient is high risk; the date of WIC visits; and, if available, whether nutrition education was provided. It is estimated that it will take about 2.8 hours (2 people, 1.4 hours per person) for each site to prepare and submit these data. If this does not seem feasible, we will discuss alternative approaches for obtaining this information.

• Onsite observation visits to collect educational materials frequently used at the sites and to observe staff conducting nutrition education (one-one-one and group sessions) to document the length, mode, approach, and other key features of nutrition education. This visit will take place at the beginning of the study (in MONTH YEAR) and last about 16 hours over 2 to 3 days. One study team member will conduct the observations, and site staff will not be required to do anything.

• Semistructured interviews with the Site Supervisor or other designated person to collect information on key features of the site’s nutrition education program and to update information provided in the Phase I surveys and interviews. One 45-minute in-person interview will be conducted at the beginning of the study in conjunction with the site visit. Additionally, two 15-minute telephone interviews will be conducted, one about 6 months into the study (in MONTH YEAR) and a second at the end of the 12-month study to obtain any changes in the site’s nutrition education program (in MONTH YEAR).

• Survey of nutrition educators to collect information about how staff implement nutrition education, their opinions on effective strategies for supporting participants to make behavioral changes, and perceived barriers to applying skills learned in training on the job. The Web-based survey will be conducted at the beginning of the study (in MONTH YEAR) and will take about 20 minutes to complete. Paper surveys will be provided for staff who do not have Internet access.

• Focus groups with WIC recipients to better understand their perception of WIC nutrition education. We will conduct two focus groups with a subset of study participants from each site at the end of the study (in MONTH YEAR). The focus groups will be conducted at a location other than the WIC site, and site staff will not need to attend. Participants will receive a $50 gift card.

4. How were sites selected for this study?

In Phase I of this study, about 1,600 sites completed an online survey on nutrition education policies, methods, staffing, and other features of nutrition education. Based on the survey results, 80 sites were asked to participate in in-depth interviews to collect more detailed information on the delivery of nutrition education. From these 80, we identified potential candidates for the Phase II study to assess a variety of WIC nutrition education approaches across the country, and your site was selected.

5. Why am I being asked to participate? Do I have to participate?

The Healthy, Hunger-Free Kids Act of 2010 (P.L. 111-296, Sec. 305) requires WIC State and local agencies to cooperate in studies or evaluations conducted by or on behalf of USDA. Your participation will help FNS and WIC agencies demonstrate the importance of WIC nutrition education and identify ways to enhance it.

6. What will participating sites be asked to do?

Sites who participate in the study will be asked to identify a point of contact (POC). We will work with the POC to coordinate the enrollment of WIC recipients or their caregivers into the study for the impact evaluation and to schedule and coordinate the other data collection activities for the process evaluation. To summarize, LA/site staff will be asked to do the following:

• Provide a copy of the most recent Local Agency Nutrition Education plan at the start of the study.

• Three months before data collection and during the 6- to 8-week study period, post signs about the study and distribute a study fact sheet. Staff will not be asked to assist with enrollment or study administration in any other way.

• For the onsite observation visits (beginning of study), meet briefly with the POC at the start of the site visit to clarify the schedule for the visit; confirm the group class schedule (if applicable); and, at the end of the visit, obtain the number of participants served during the visit.

• For the semistructured interviews, the POC or site supervisor will complete one 45-minute in-person interview (beginning of study) and provide a tour of the site and review steps in service delivery. Additionally, this same person will participate in two 15-minute telephone interviews at the midpoint and end of the study.

• For the survey of nutrition educators, all staff will be asked to complete a 20-minute survey by Web (if Internet access is available) or to complete a paper survey and return by mail.

• At the end of the 12-month study period, provide limited administrative data for a subset of study participants.

7. What about data privacy and security?

We will work with each participating LA and site to obtain the appropriate Institutional Review Board (IRB) approvals, and the study protocol will also be reviewed and approved by RTI’s IRB. All of the data collected as part of this study will be kept private. Individual data from WIC recipients and caregivers and individual responses to the interviews and survey of nutrition educators will not be shared with site staff or anyone outside the research team. In any reports we prepare, participants’ and site staff members’ names will not be associated with their responses and the report will not identify the names of the six sites participating in the study.

8. What are the benefits to my agency and site for participating?

Your participation helps the entire WIC community in our effort to improve nutrition education and its impact on WIC recipients’ health outcomes such as nutrition and physical activity. We hope that you will agree to participate in this important study.

9. What happens next?

Members of the research team will be contacting representatives from your State and local agencies and site to provide additional information on the study and answer any questions you may have.

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