Y.1_Part Flyer

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OMB Control Number: 0584-XXXX

Expiration date: XX/XX/XXXX

PPENDIX Y.1:
PARTICIPANT FLYER DURING ENROLLMENT—ENGLISH

Flyer for Posting in WIC Clinics during Data Collection

Do you get WIC benefits for you or a child?

If yes, you may be able to take part in a national research study on WIC Nutrition Education. Eligible individuals will get up to $50 in gift cards.

To be eligible to participate, you must be 18 or older and be pregnant, postpartum, or the mother or caregiver of a child less than 4 years old.

For more information, please see
XXXXXX XXXXXX

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 2 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.

Suggested Script for WIC Site Staff to Use When Distributing the Study Fact Sheet 3 Months before Data Collection

We will work with each site to determine the best approach for distributing the study fact sheet so as not to burden or inconvenience WIC staff. Possible approaches include having the WIC receptionist give clients the fact sheet before or after their WIC appointments or having WIC nutrition education staff give clients the fact sheet at the end of their WIC appointments. A suggested script is provided below.

[WHEN PASSING OUT FACT SHEET] “This provides information on a research study on WIC nutrition education. If you are eligible, you can get up to $50 in gift cards for filling out three surveys over the next 12 months. If you are interested in the study, please try to come to your next WIC appointment 20 minutes early during the study period, which will be [Month Date–Month Date]. If you have questions about the study, please see the fact sheet for a toll-free number and email address.”

Suggested Script for WIC Site Staff to Use When Distributing the Study Fact Sheet during Data Collection

We will work with each site to determine the best approach for distributing the study fact sheet so as not to burden or inconvenience WIC staff (e.g., having the WIC receptionist give clients the fact sheet when checking in for their appointments). A suggested script is provided below.

[WHEN PASSING OUT FACT SHEET] “This provides information on a research study about WIC nutrition education. If you are eligible, you can get up to $50 in gift cards for filling out three surveys over the next 12 months. Today you will get a $20 gift card for filling out the first survey and $15 gift cards for filling out the second and third surveys. If you are interested in the study, please see one of the study team members in the waiting area [or other location] before your WIC appointment. It will take you about 20 minutes to enroll in the study and complete a survey.”

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