C2a_Local Agency Director Survey Screenshots

WIC Nutrition Assessment and Tailoring Study

C2a_Local Agency Director Survey Screenshots

OMB: 0584-0663

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Appendix C2a. Local Agency Director Survey Screenshots

This information is being collected to assist the Food and Nutrition Service in obtaining a comprehensive
and detailed description of the WIC nutrition risk assessment process and the ways in which participant
benefits are tailored to address the assessment results. This is a voluntary collection and FNS will use
the information to improve the delivery and tailoring of WIC services and increase satisfaction of both
staff and participants. This collection does request personally identifiable information under the Privacy
Act of 1974. According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor,
and a person is not required to respond to, a collection of information unless it displays a valid OMB
control 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 33 minutes (0.55 hours) 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. Send
comments regarding this burden estimate or any other aspect of this collection of information, including
suggestions for reducing this burden, to: U.S. Department of Agriculture, Food and Nutrition Service,
Office of Policy Support, 1320 Braddock Place, 5th Floor, Alexandria, VA 22314 ATTN: PRA (0584xxxx). Do not return the completed form to this address.

USDA

WIC NUTRITION ASSESSMENT AND TAILORING STUDY
Local Agency Survey

NUTRITION RISK ASSESSMENT PROCESSES AND PROTOCOLS
Think about the nutrition risk assessment trainings offered to all WIC staff who
conduct nutrition risk assessments at your Local Agency's clinics. Which of the
following topics are included in the trainings provided to these staff? (Check
all that apply.)

D

Prenatal nutrition

D

Postnatal nutrition (including nutrition for breastfeeding mothers)

D
D

Infant nutrition
Child nutrition

D

The nutrition assessment process

D

Assessment of breastfeeding behaviors

D

Anthropometric data collection techniques (e.g., how to properly obtain heights,
lengths, and weights)

D

Hematological data collection techniques (e.g., how to collect blood specimens for
measuring hemoglobin levels)

D

Physical s·igns and symptoms of nutrition�related conditions (e.g., nutrition�focused
physical exams)

D

Dietary assessment (e.g. 24 hour recalls, food frequency questionnaires)

D

Documentation of nutrition assessment findings

D

Motivational interviewing/Counseling and participant�centered service skills

D

Multicultural awareness

D

Critical thinking

D

Counseling and participant�centered services skills

D

Weight issues (e.g. obesity, prenatal weight gain)

D

Therapeut!ic formula

D

Use of interpreter services

D

Other (Specify):

D

Other (Specify):

D

Other (Specify):

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Survey Instructions

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AuthorWestat
File Modified2020-10-15
File Created2019-12-31

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