Appendix A4 WIC NATS Recruitment Summary

Appendix A4. WIC NATS Recruitment Summary

After a diverse sample of 10 SAs is selected, FNS will notify the 10 selected SAs about the details of the study via email (Appendix D1). The study team will follow up with the recruited SA directors with an introductory email (Appendix D2) and a Memorandum of Understanding (MOU) that outlines the roles of SAs, LAs, and clinic sites at different stages of the study and the responsibilities of the study team (Appendix D3). The study team will arrange telephone calls with each recruited SA, during which they will discuss the study and request that SAs share any SA-specific policy and guidance documents used for nutrition assessment and tailoring protocols (Appendix C1). In the same phone call, the study team will also request that SAs share MIS data and documentation relevant to the nutrition assessment and nutrition services processes, such as documented nutrition risks, food package tailoring, nutrition education offered, and referrals (Appendix C1).

SA directors will be asked to send a pre-drafted email (Appendix E1) to all LA directors in their respective SA to inform them about the study and promote participation in the Local Agency Director Survey (Appendix C2). The Local Agency Director Survey will be administered online, and the study team will email LA directors with a unique link to access the survey (Appendix E2). To improve the response rate, the study team will send out a reminder email (Appendix E3) to LA directors that have not completed the survey.

Information provided through the Local Agency Director Survey will guide purposeful selection of a diverse set of 30 LAs, from which one WIC clinic site each will be identified and recruited for a site visit—for a total of 30 WIC clinic sites. The study team will notify SA directors via email (Appendix F1) which of their LAs were selected for site visits and will ask SA directors to notify these LAs of their selection via a pre-drafted email (Appendix F2). The study team will follow up with the recruited LA directors with an introductory email (Appendix F3). The study team will discuss the site visit plans with selected LAs in a phone call during which they will also ask LA directors to share any relevant LA-specific documents or tools used in the nutrition assessment and benefit-tailoring processes (Appendix C3). Clinics will be purposively selected for site visits using information collected on the Clinic Site Information Form (Appendix C4). During their call with LA directors, the study team will also request that LAs work with their respective SA to populate the Clinic Site Information Form. LAs are welcome to share the clinic site information with the study team in whatever format is most convenient—including filling out an Excel template (Appendix C4), sharing information directly over the phone, or transferring existing data files from which the study team can extract the necessary information. The study team will follow up with LAs that have not submitted their clinic information and/or shared the requested LA-specific nutrition assessment documents or tools via an email reminder (Appendix F4).

Once the study team selects the 30 clinics for the site visit sample, they will notify each LA by email (Appendix G1) of the clinic site in that LA that was selected. LA Directors will also be asked to notify the selected clinic about the study via a pre-drafted email (Appendix G2). The study team will then send an introductory email (Appendix G3) to the site director of each of the 30 selected clinic sites and will schedule a phone call (Appendix G4) to discuss the logistics of the study, answer any questions, and schedule the site visit.

Two trained field researchers will complete each of the 30 WIC clinic site visits. Upon arrival at each clinic, the field researchers will complete the Clinic Observation Form (Appendix C5). Prior to the WIC Clinic Site Director Interview (Appendix C6), the field researchers will ask the site director to review and sign an informed consent document (Appendix G5). Likewise, WIC clinic staff will be asked to review and sign an informed consent document (Appendix G6) prior to allowing the field researchers to observe their nutrition assessment appointments (Appendix C7) and participating in the WIC Clinic Staff Interview (Appendix C8).

WIC participants that are present at the clinic for a certification or re-certification appointment will be handed an informational brochure about the study (Appendix G7), and those that express interest in participating in the study will be screened by the field researchers (Appendix G8). WIC participants that are found to be eligible for WIC NATS will be asked to review and sign an informed consent document (Appendix G9) in order to agree to have their WIC clinic appointment observed and participate in the WIC Participant Interview (Appendix C9). WIC participants are given the option of either completing their interview the same day while at the clinic or over the phone at an agreed upon scheduled time. If the WIC participant elects to conduct the interview over the phone, then they will receive a reminder text message ahead of the scheduled call (Appendix G10) and will receive a follow-up reminder call (Appendix G11) if the study team cannot reach them at scheduled time. To facilitate informed participation among Spanish-speaking WIC participants, the following materials are also translated into Spanish: study Brochure for WIC participants (Appendix G7a); WIC participant screener (Appendix G8a); informed consent for observation and WIC participant interview (Appendix G9a); WIC Participant Interview Guide (Appendix C9a); and the reminder text (Appendix G10a) and reminder call (Appendix G11a) for the WIC Participant Interview.

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