Appendix M Study Extension Webinar Slides

Study Extension Webinar

[Insert Date]

Presenter: Linnea

Greetings from the Feeding My Baby Study Team!

Westat

Altarum

Public Health Foundation Enterprises WIC Program

Nutrition Policy Institute of the University of California

USDA Food and Nutrition Service

Presenter: Linnea

Greetings from the Feeding My Baby Study team. Our team includes…..

We are pleased you are joining us today for updates on the study and we very much appreciate your continued cooperation and support for this important and unique study.

Webinar Agenda

Study objectives
Study timelines
Study activities
Study report highlights
Study activities during the extension
Role of State Agencies and sites during study extension period
Questions from State Agencies and sites

Presenter: Linnea

Our agenda today is going to cover 7 topics starting with a brief review of the study objectives, timelines and activities. We’ll share highlights from study reports that have been produced to date. Then, we’ll talk about the future study activities to take place during the study extension period up to the time the children in the study turn age 6 and describe how we’ll be asking state agencies and WIC sites to assist.

We’ll end with time to answer your questions, and, over the next few weeks, we’ll also be having phone calls with each state agency and its sites in the study to talk about the assistance needed and address your questions.

Study Objectives

Update results of WIC infant feeding practices study conducted in 1994-95
Compare new findings with previous WIC study and other studies of infant and toddler feeding practices
Assess conditions of overfeeding and overconsumption
Identify nutrition education influences on infant and child feeding practices
Assess the impact of WIC on nutrition, health and developmental outcomes
Determine changes in feeding practices and behaviors as infants transition to toddlers and preschoolers and early childhood (beyond WIC eligibility)
Identify factors that lead to continued, discontinued, or renewed participation in WIC through age 5 years
Uncover potential issues such as food insecurity during the gap between WIC and school-based programs

Presenter: Linnea

The Feeding My Baby Study is designed to answer many questions regarding nutrition and feeding practices for infants and young children. Because it is a nationally representative, longitudinal study of children up to age 5, now with an extension to age 6 which we will talk about today, we have the opportunity to gain a tremendous amount of information about these topics. Major study objectives include…..

How will the findings be used?

Provide insight on the factors and influences that impact feeding practices—useful for planning nutrition education
Describe food and nutrient intake from infancy through age 6 years—useful for assessing WIC food packages
Identify factors associated with movement in and out of WIC—useful for addressing program retention and outreach
Inform the nation about the important role WIC plays in early childhood nutrition even beyond the period of eligibility

Gage the level of food insecurity during the gap between WIC and school-based programs

Presenter: Linnea

The findings from this study will be useful for WIC program policy and planning, and it will provide insights regarding infant and child feeding practices that will be valuable for health and nutrition practices outside of WIC. Examples of how the findings may be useful include…..

Study Timeline

Presenter: Linnea

This snapshot of the timeline shows 5 points in time starting in 2013 when prenatal women and parents of young infants were recruited for the study through 2022 when the study will end with the publication of the final report.

Previously we talked with you about an extension of the study through age 5; today we’re sharing information regarding a second extension to age six or 72 months.

Study States and Sites

Presenter: Linnea

This map shows the states and sites that are participating in the study. The 27 states are shown in green and the red dots indicate where the 80 study sites are located. There have been changes in some of the site locations since 2013, however in most cases, replacement sites are in the same vicinity.

Webinar Poll: How many of webinar attendees have participated in the study activities since it began in 2013?

You are all important partners in this study and we thank you for your cooperation.

Study Activities

2013: Recruitment of prenatal women and infants into study; WIC staff interviews and survey
2013-2016: Interviews of prenatal women and infants from birth through 24 months; infant measurements at 6, 12 and 24 months
2015-2017: Interviews for children at 30 and 36 months; measurements at 36 months
2016-2019: Interviews for children at 42 through 60 months; measurements at 48 and 60 months
2019-2020: Interviews for children at 72 months; measurements at 72 months
2022: Final report

Presenter: Linnea

Study activities during each of the time periods include…..

Recruitment of Study Participants

Recruited 4,367 participants

- Prenatal women
- Mothers of infants up to 2.5 months old

Presenter: Crystal

With help from all of you, we recruited 4,367 participants for the study. This met our recruitment goal.

Interviews with Parents/Caregivers

Interview	Upcoming	In Process	Complete	Not Complete	Cooperation Rate**
Prenatal	0	0	2645	298	90%
1-Month	0	0	3428	316	92%
3-Month	0	0	2904	447	87%
5-Month*	0	0	2656	429	86%
7-Month	0	0	3186	629	84%
9-Month*	0	0	2487	553	82%
11-Month*	0	0	2365	646	79%
13-Month	0	0	2852	877	76%
15-Month*	0	0	2109	833	72%
18-Month*	0	0	2031	866	70%
24-Month	0	0	2497	1070	70%
30-Month	0	0	2643	815	76%
36-Month	0	0	2627	717	79%
42-Month	0	0	2636	601	81%
48-Month	1	8	2573	596	82%
54-Month	1638	175	1070	239	82%
60-Month	1167	68	58	1	98%
All	2806	251	40767	9933	80%

Presenter: Crystal

Since 2013, we have conducted a total of 40,767 interviews with the prenatal women and with the parents/caregivers of the infants and children. We have finished all of the interviews for children through age 42- months and we are currently conducting interviews for children age 48 through 60 months.

Measurements of Infants/Children

WIC data requests to State Agencies for measurements at 6, 12, 24, 36 and 48 months
Feeding My Baby measurement cards—started using these for children at 36 months
Also accepted copies of recent health care provider reports with height and weight

Presenter: Crystal

We are obtaining weight and height measurements through several sources. Most of the measurements to date have come via WIC administrative data requests to state agencies. The states have provided measurements from the WIC records for those in the study that continue to participate in WIC including measurements for ages 6, 12, 24, 36 months and 48 months.

We have also been obtaining measurements for children at age 3 years and older via a Feeding My Baby measurement card completed by WIC sites or children’s healthcare providers or from printouts from recent doctor visits. About 1/3 of these measurements came from cards completed by WIC, 1/3 from cards completed by the healthcare providers and 1/3 from copies of recent doctor visit printouts.

Thanks to all of the State agencies for providing the data from the WIC visits and for staff in the sites for doing the measurements and completing the measurement card when requested. The measurements are so important for the study.

Second Year Report Topics

 Work, child care, and feeding practices
 Complementary feeding practices
 Food intake
 Energy and nutrient intake
 Weight and growth

Mothers enrolled in WIC
are returning to work

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-WIC mothers report returning to work steadily over the first two years of the child’s life

PRESS A SECOND TIME FOR THE ARROW TO APPEAR

-At 3 months postpartum 30 percent are working, with just over half working working full-time.
-There’s a gradual rise in employment, and by 24 months, 48 percent of mothers report working, with 56 percent of those working doing so full-time.
-Of note here is also that a small but present group of mothers report both working and going to school, a heavy burden for a woman with an infant or young child.

The percentage of WIC ITFPS-2 caregivers working matches closely the percentage of FDA IFPS-II mothers who are WIC recipients and employed at 3 months (36 percent), 6 months (40 percent) and 12 months (45 percent).

-WIC mothers report returning to work steadily over the first two years of the child’s life

PRESS A SECOND TIME FOR THE ARROW TO APPEAR

-At 3 months postpartum 30 percent are working, with just over half working working full-time.
-There’s a gradual rise in employment, and by 24 months, 48 percent of mothers report working, with 56 percent of those working doing so full-time.
-Of note here is also that a small but present group of mothers report both working and going to school, a heavy burden for a woman with an infant or young child.

The percentage of WIC ITFPS-2 caregivers working matches closely the percentage of FDA IFPS-II mothers who are WIC recipients and employed at 3 months (36 percent), 6 months (40 percent) and 12 months (45 percent).

Mothers who work full-time
are less likely to be
breastfeeding than are mothers who are not employed at each time point

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-Breastfeeding an infant while working can be challenging, but at 3 months postpartum 34% of women working full-time chose this path. That number drops with time as do all the breastfeeding rates, until at 13 months 10% of women working full-time are still breastfeeding.
-If you look at the same-colored circles, that’s the comparison I want to focus on for a moment. Circled numbers indicate statistically significant differences.
-Rates of breastfeeding for women working full-time are consistently significantly lower than rates for women who are not employed.
-It’s not shown here, but mothers employed full-time also have a significantly shorter median BF duration than mothers employed PT or not employed.

-Breastfeeding an infant while working can be challenging, but at 3 months postpartum 34% of women working full-time chose this path. That number drops with time as do all the breastfeeding rates, until at 13 months 10% of women working full-time are still breastfeeding.
-If you look at the same-colored circles, that’s the comparison I want to focus on for a moment. Circled numbers indicate statistically significant differences.
-Rates of breastfeeding for women working full-time are consistently significantly lower than rates for women who are not employed.
-It’s not shown here, but mothers employed full-time also have a significantly shorter median BF duration than mothers employed PT or not employed.

Many breastfeeding
mothers report workplace accommodations for breastfeeding

-A natural question is whether workplaces are supporting mothers’ efforts to continue to breastfeed.
-The Affordable Care Act specifies that most employers must provide breastfeeding women with:

- -Reasonable breaks to pump
- -A private space to pump that isn’t a bathroom
- -A reasonable place to store pumped milk
-57 percent of WIC ITFPS-2 women who are working and breastfeeding report getting all three of these accommodations, and 85 percent get at least one, but that leaves 15 percent report receiving no accommodations at all.
-The most commonly reported accommodation is reasonable breaks, with 76% reporting getting that accommodation, and roughly 70 percent reporting a private, non-bathroom space or a place to store pumped milk.

-A natural question is whether workplaces are supporting mothers’ efforts to continue to breastfeed.
-The Affordable Care Act specifies that most employers must provide breastfeeding women with:

- -Reasonable breaks to pump
- -A private space to pump that isn’t a bathroom
- -A reasonable place to store pumped milk
-57 percent of WIC ITFPS-2 women who are working and breastfeeding report getting all three of these accommodations, and 85 percent get at least one, but that leaves 15 percent report receiving no accommodations at all.
-The most commonly reported accommodation is reasonable breaks, with 76% reporting getting that accommodation, and roughly 70 percent reporting a private, non-bathroom space or a place to store pumped milk.

Caregivers say
that the WIC food package
allows them to purchase
foods they typically feed their child

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7 months

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15 months

We asked caregivers if the WIC food package allowed them to purchase foods they would typically be feeding their child.

Both at 7 months, for the infant food package, and 15 months, for the child food package, caregivers overwhelmingly said yes, the food package allows them to do this.

Top foods and
beverages consumed at
breakfast at 13 and 24 months

Month 13		Month 24
Top five foods or beverages	Percent of study children consuming	Top five foods or beverages	Percent of study children consuming
Breakfast		Breakfast
Milk and milk products	50.4%	Milk and milk products	61.2%
Any fruit (excluding juice)	28.6	Non-infant cereal (not presweetened)	31.8
Non-infant cereal (not presweetened)	25.1	Eggs	29.1
Infant cereals	23.5	100 percent fruit juice	27.5
Eggs	20.5	Any fruit (excluding juice)	23.8
Unweighted n	2,613	Unweighted n	2,375
Weighted n	410,041	Weighted n	428,368

-We can see evidence of this by looking at the most common foods consumed.

-During the 24-hour recall, the mothers label each eating occasion – breakfast, lunch, dinner, snack.
-So, we looked at what foods and beverages were most commonly consumed on a given day for each eating occasion.

-This slides shows the top 5 foods and beverages consumed by participants at breakfast at 13 and 24 months.
-For this purpose we did some collapsing into food groups – for example any fruit excluding juice rather than individual fruits. This is because there is enough variability in individual sub-types of fruits, vegetables, juices, etc., that patterns don’t emerge very well.
-As you can see the top 5 at both month 13 and month 24 included the types of foods available through WIC. For breakfast you can see that at both times milk, cereals, eggs, and fruit are common. By 24 months, as infant cereals are no longer common, 100 fruit juice comes into the top 5.

-We can see evidence of this by looking at the most common foods consumed.

-During the 24-hour recall, the mothers label each eating occasion – breakfast, lunch, dinner, snack.
-So, we looked at what foods and beverages were most commonly consumed on a given day for each eating occasion.

-This slides shows the top 5 foods and beverages consumed by participants at breakfast at 13 and 24 months.
-For this purpose we did some collapsing into food groups – for example any fruit excluding juice rather than individual fruits. This is because there is enough variability in individual sub-types of fruits, vegetables, juices, etc., that patterns don’t emerge very well.
-As you can see the top 5 at both month 13 and month 24 included the types of foods available through WIC. For breakfast you can see that at both times milk, cereals, eggs, and fruit are common. By 24 months, as infant cereals are no longer common, 100 fruit juice comes into the top 5.

Top foods and beverages
consumed at lunch at 13
and 24 months

Month 13		Month 24
Top five foods or beverages	Percent of study children consuming	Top five foods or beverages	Percent of study children consuming
Lunch		Lunch
Any vegetables	30.5%	Non-baby food meat	34.7%
Milk and milk products	28.3	100 percent fruit juice	34.6
Any fruit (excluding juice)	28.0	Any vegetables	28.1
100 percent fruit juice	27.1	Milk and milk products	25.3
Non-baby food meat	23.9	Any fruit (excluding juice)	24.7
Unweighted n	2,459	Unweighted n	2,280
Weighted n	383,586	Weighted n	410,871

-For lunch at 13 and 24 months, vegetables, milk and milk products, non-baby food meats, fruit, and 100 percent juice are the top 5 items.
-Note that between 13 and 24 months meat jumps from fifth place to first place, 100 percent juice and milk swap places such that a higher percentage of children are consuming juice than milk with lunch.
-Still, you can see by the green checks that these are mostly foods included in the WIC child food package

And top foods and
beverages consumed at
dinner at 13 and 24 months

Month 13		Month 24
Top five foods or beverages	Percent of study children consuming	Top five foods or beverages	Percent of study children consuming
Dinner		Dinner
Any vegetables	42.9%	Non-baby food meat	45.5%
Non-baby food meat	32.0	Any vegetables	43.6
Milk and milk products	29.5	Milk and milk products	30.1
100 percent fruit juice	19.1	100 percent fruit juice	24.4
Any fruit (excluding juice)	13.7	Rice and pasta	16.1
Unweighted n	2,491	Unweighted n	2.309
Weighted n	389,063	Weighted n	415,502

-For dinner we see a pattern similar to lunch, with vegetables, meats, milk and milk produces, and 100 percent juice in the top five. At 13 months fruit is the fifth most common item with dinner, but by 24 months it is replaced by rice and pasta.
-Again these include many foods in the WIC food package.

Top five foods and
beverages consumed as
snacks at 13 and 24 months

Month 13		Month 24
Top five foods or beverages	Percent of study children consuming	Top five foods or beverages	Percent of study children consuming
Snacks		Snacks
Any fruit (excluding juice)	42.1%	Any fruit (excluding juice)	50.0%
Milk and milk products	38.5	Milk and milk products	39.0
Crackers, pretzels, rice cakes	34.1	Crackers, pretzels, rice cakes	29.1
100 percent fruit juice	19.5	100 percent fruit juice	20.7
Baby food desserts	15.6	Salty snacks	19.9
Unweighted n	2,160	Unweighted n	1,999
Weighted n	329,421	Weighted n	351,307

Snacks contain both healthy WIC foods and less healthy choices.

-Snacks contain some healthy foods, including fruit, milk and milk products at the top.
-We see crackers, pretzels, and rice cakes third at both time periods, and 100 percent fruit juice fourth.
-The final most common snack is baby food desserts at 13 months, and salty snacks at 24 months, neither of which is a healthy choice.

Snacks contain both healthy WIC foods and less healthy choices.

-Snacks contain some healthy foods, including fruit, milk and milk products at the top.
-We see crackers, pretzels, and rice cakes third at both time periods, and 100 percent fruit juice fourth.
-The final most common snack is baby food desserts at 13 months, and salty snacks at 24 months, neither of which is a healthy choice.

Children enrolled
in WIC are increasing
consumption of fruits,
vegetables, cow’s milk, and meats and other proteins…

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Age (in months)

Percentage of Study Children Consuming on a Given Day

-This slide shows consumption rates over time of fruits, vegetables, cow’s milk, and meats and other protein sources.
-You can see that fruits and vegetables, the two darkest lines, rise with the introduction of complementary foods and are steady after about 9 months, with fruits consumed by slightly more children than are vegetables.
-Cow’s milk spikes at 13 months, in line with WIC recommendations that children start consuming cow’s milk at 1 year.
-Meat and proteins grow steadily from the time of introduction of complementary foods, and by 12 months they are the most commonly consumed food group.

…but are also increasing
consumption of desserts,
sugar-sweetened beverages,
and salty snacks

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Age (in months)

Percentage of Study Children Consuming on a Given Day

-At the same time that WIC children are eating healthy foods, they are also gradually increasing intake of dessert and candy, sugar-sweetened beverages, and salty snacks on a given day.
-By 24 months, half of children are consuming a dessert or candy on a given day.
-Sugar-sweetened beverages are increasing as well, with about a quarter of children consuming one on a given day at 24 months. These are mostly fruit flavored drinks.
-Salty snacks are rising too, including foods like chips, popcorn, and cheese puffs.

Macronutrient and
micronutrient intakes mostly
meet or exceed recommended
levels through the first year of life

At each month, median macronutrient levels meet or exceed the recommended levels for that age.
At each month, most median micronutrient levels also exceed the recommended levels for that age. The exceptions are:

- Median vitamin D intake is below adequate intake levels throughout infancy.
- 20% of children have intakes of iron below the estimated average requirement at month 7, 16.7% at month 9, and 14.7% at month 11.
- 17.4% of children have intakes of zinc below the estimated average requirement at month 7, 11.4% at month 9, and 6.9% at month 11.

Macronutrient
and micronutrient intakes
mostly meet or exceed recommended levels through the second year of life

From months 13-24, median macronutrient levels exceed the recommended levels for each age.
From months 13-24, prevalence of inadequate intakes (below the estimated average requirement) for most micronutrients is less than 5%.
Inadequate intakes of iron and zinc decrease as children age, and less than 5% have inadequate intakes in the second year.

Vitamins E and D are the exceptions

Vitamins E and D have high prevalences of inadequate intakes in the second year.

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-The exceptions to the good news are vitamins D and E.

-Median vitamin D intakes are below adequate intake levels through infancy, and have prevalences of inadequate intakes above 75 percent in the second year.

-Median vitamin E intakes are above the adequate intake levels during the infant year, but rise in the second year to a prevalence of between 55 and 77 percent inadequate intakes.

At 7 months, median caloric
intake is lowest among infants
issued the partially (mostly) breastfed food package at 6 months

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kcal

Median energy intake of female infants receiving the partially (mostly) breastfed food package is 15 percent lower than the median intake of female infants receiving the fully breastfed food package (98 kcal, or the equivalent of about 4.5 ounces of breastmilk), and 12 percent lower than female infants receiving the fully formula fed package (77 kcal, or the equivalent of about 4 ounces of infant formula).

WIC ITFPS-2 follows the same procedures as the FITS 2008 study and other research (Butte et al., 2010; Heinig et al., 1993), using the child’s age and breastfeeding exclusivity status to estimate intake quantities of breastmilk when it is reported as fed directly from the breast. For fully breastfed infants between 6 and 11.9 months, a total breastmilk intake of 600ml/day is assumed. For partially breastfed infants between 6 and 11.9 months, breastmilk intake is imputed by summing the amounts of infant formula and other milks reported and subtracting that total amount from 600ml/day. For partially breastfed infants whose reported intake is more than 600ml of formula and/or other milks, a total breastmilk intake of 60ml per day is assumed.

Median energy intake of female infants receiving the partially (mostly) breastfed food package is 15 percent lower than the median intake of female infants receiving the fully breastfed food package (98 kcal, or the equivalent of about 4.5 ounces of breastmilk), and 12 percent lower than female infants receiving the fully formula fed package (77 kcal, or the equivalent of about 4 ounces of infant formula).

WIC ITFPS-2 follows the same procedures as the FITS 2008 study and other research (Butte et al., 2010; Heinig et al., 1993), using the child’s age and breastfeeding exclusivity status to estimate intake quantities of breastmilk when it is reported as fed directly from the breast. For fully breastfed infants between 6 and 11.9 months, a total breastmilk intake of 600ml/day is assumed. For partially breastfed infants between 6 and 11.9 months, breastmilk intake is imputed by summing the amounts of infant formula and other milks reported and subtracting that total amount from 600ml/day. For partially breastfed infants whose reported intake is more than 600ml of formula and/or other milks, a total breastmilk intake of 60ml per day is assumed.

But by 11 months, those differences are smaller in magnitude

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kcal

Infants who receive
the partially (mostly) breastfed package at 6 months are at risk
for not meeting some nutrient needs

Median macronutrient intake levels are similar across the three food package groups.
Median micronutrient intake levels, however, are lower for the partially (mostly) breastfed package group.
Controlling for energy intake suggests that the problem may be rooted in low energy intake for the partially (mostly) breastfed package group.
Nutrient levels return to higher levels by 11 months.

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mg/d

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µg/d

-Looking at nutrient intake across the groups at 7 months, median macronutrient intake is similar across the food package groups, but micronutrient levels are not.
-At 7 months the partially breastfed package group falls below recommended levels on most micronutrients (if asked, vitamin K is the one exception).
-These charts show some examples of the discrepancy between groups at 7 months, highlighting the nutrients of concern and the ones that had high prevalence of inadequacy for the whole study population.
-We repeated the analysis controlling for energy intake (calculating nutrient intake per 100 kcal), and that clarified that the issue is not nutrient poor diets among the partially breastfed package infants, but just less intake overall. These infants are still at risk for not meeting their nutritional needs at 7 months, however.
-All of these intakes return to higher levels by 11 months.

While most children are
healthy weight-for-length, the percentage who are high
weight-for-length increases with age

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Weight for Length Groups

Next Report (Age 3)

Work, child care, medical care, federal food benefit receipt
Healthy food purchasing, feeding beliefs, rules, and practices
Food intake
Energy and nutrient intake
Weight and growth

Study Activities during Extension

Obtain State/local IRB approvals
Notify parents/caregivers and ask them to continue with study
Stay in contact with parents/caregivers
Conduct one additional interview at 72 months
Obtain weight and height measurements at 72 months

Presenter: Crystal

Now we want to turn our attention to the future….the study activities during the extension to age 6. The key activities include…..

Study Participation during Extension

	Number	Percent Interviews Completed
42 Months	2,636	65%
48 Months	2,573	64%
54 Months	2,087	52%
60 Months	1,980	49%
72 Months	1,901	47%

Presenter: Crystal

Here are our estimates of the number of children who will continue in the study and the percent of their parents who will participate in the interview at 72 months.

We started with a little over 4,000 infants (4,067) and expect to have about 1901 of them in the study at the end of 6 years with a final 72-month interview. This would be about 47% of their parents completing the last interview at 72 months. Note that children remain in the study even if they are no longer participating in WIC.

Keeping Parents/Caregivers Engaged

Extension flyer, birthday cards, thank you notes, phone calls, text messages
Proposed incentives

- $60 (plus $10 for use of cell phone) for 72 month interview
- $60 (plus $10 for transportation) for obtaining measurements at 72 months

Presenter: Crystal MAY WANT TO MENTION THE SECOND AM/PM INTERVIEW FOR SUBSET

One of our biggest challenges is to keep parents/caregivers engaged in the study—participating in the interviews and providing the measurements. We use several methods to keep in touch with them including….

We have found that the higher incentives offered as children get older are important for keeping them engaged in the study.

During the study extension to age 6, the amount the parent/caregiver will receive for participating in interviews and providing measurements will be $60 at 72 months and we provide an additional $10 if the parent uses their own cell phone.

For parents who obtain the measurements and send them in to us, we are proposing to give them $60 for the measurements at 72 months plus $10 to cover transportation costs.

We have also proposed to give the parents/caregivers small incentives for updating their contact information with us.

Assistance from States and Sites

Obtaining measurements at 72 months (age 6 years)
All parents/caregivers will be asked to take child to WIC site or healthcare provider for measurements
Measurement cards will be provided to all parents/caregivers to obtain measurements and return to Westat

Presenter: Linnea

During the study extension, we’ll need help from you to obtain the weight and height measurements for the children at 72 months. The amount of assistance we’ll need is fairly small, but it will have a large impact on the study results. We believe measurements taken at WIC sites are one of the most accurate sources available.

We will ask all parents/caregivers of the children in the study at those times to…..

Measurement Card

Presenter: Linnea This is what the measurement card looks like. Many of you or the staff in your WIC sites have seen this card since we’ve been sending to parents of the children in the study who are no longer participating in WIC. We are asking them to take the child to a WIC site or healthcare provider for the measurements and to return the card to us. We will be using this card for the 6 year old children and can make minor revisions based on experience using it to date.

Measurements at WIC Sites

All children in the study who choose to come to WIC for measurements
All parents/caregivers will be offered incentive to have measurement card completed and returned

- Identify convenient WIC site for parent/caregiver

Presenter: Linnea

All parents/caregivers of children in the study will receive the measurement card near the time of the child’s sixth birthday. The number of children we anticipate having in the study at age 6 is 2,534.

All parents will be offered the incentive to return the completed measurement cards.

The parents will be asked to take the child to a WIC site or their healthcare provider for the measurements and to return the completed measurement card. For the parents who choose to go to WIC for the measurements, we will suggest the WIC site where they were enrolled in the study if they still live in the area where it is located. If the family or the site has relocated, we will assist them with identifying a site that is convenient for them. State Agencies and sites have been helping with identifying alternative sites when needed.

What if……?

Original study site has closed?
Family has relocated within study site area?
Family has relocated outside of study site area?

Presenter: Linnea

While we hope that all of the original study sites are willing to continue to assist with measuring the children, we know that some of those sites have closed and more may close over the course of the next 2 years. We also know that families in the study have relocated—sometimes within the vicinity of the WIC site where they enrolled in the study and sometimes outside of the area.

This will be a topic for discussion when we have calls with the State Agencies and sites in the study starting next month. We are hopeful we can work with you to identify alternatives for the children to be measured when the original study site is no longer operational or the family is no longer living in the vicinity of the site.

Measurement Data Alternatives

Parent/caregiver sends in copy of record from healthcare provider if within 3 months of child’s 6th birthday.

Presenter: Linnea

If the measurement card is not returned…..

Other Assistance from WIC

Help with locating parents/caregivers of children in the study if….

- They can’t be located through other means
- They are believed to have participated in WIC through age 5 (other family members may still be participating)

Presenter: Linnea

If we cannot get in touch with parents/guardians using the contact information we will contact the site or, if preferred, the state agency where they were enrolled in the study but only if…..

We will ask for updated contact information if you have information that is more current that what we have. We have been making these requests of WIC sites or state agencies since the study began and appreciate the cooperation we’ve received.

Thank you for your support!

Presenter: All

Opportunity for all on team to make comments of thanks.

What are your questions?

Presenter: Linnea

Now we’d like to hear your questions about the study or the activities during the extension to age 6.

Would anyone like to share experience with measuring the children and completing the measurement card for children in the study who are no longer on WIC?

As mentioned earlier, we’ll be setting up calls with each state and the sites in their state to have a chance to talk about the specifics and logistics for the assistance we’ll need through the end of the study.

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Appendix M Study Extension Webinar Slides

App_M.Extension to age 6 webinar 8.24.18.pptx

WIC Infant and Toddler Feeding Practices Study-2 (WIC ITFPS-2)

Appendix M Study Extension Webinar Slides

OMB: 0584-0580