WIC National Outreach Campaign – In-depth Interviews (IDIs) among Healthcare Professionals

OMB CONTROL NO.: 0584-0611

EXPIRATION DATE: 11/30/2025

OMB BURDEN STATEMENT: This information is being collected to assist the Food and Nutrition Service in developing a National Outreach Campaign to increase awareness of the health and nutrition benefits associated with specific programs. This is a voluntary collection and FNS will use the information to meet the needs and understand the mindsets of current program participants, as well as those individuals who are eligible but do not participate. This collection does not request any 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 0584-0611. The time required to complete this information collection is estimated to average 1 hour 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 22306 ATTN: PRA (0584-0611). Do not return the completed form to this address.

Attachment D-1 Healthcare Providers Individual Interview Guide

Individual Interview Guide Draft – 09/20/2023

Healthcare Provider IDIs

Target Time ≈ 45 minutes of discussion

1. Introduction (5 minutes]

1. Interviewer introduction

2. Remind respondents to be in a quiet place

3. If you need to step away, do so briefly and come back as soon as possible

4. Anonymity

5. Introduction – Share your first name, where you live, and how long you have been a healthcare provider

2. Introduction (5 minutes)

1. To start, I’d like to spend a little time talking about your typical interactions with patients in your role as a healthcare provider.

   1. What type of setting do you work in and who your facility primarily serves (what types of patients and people and in what community). [IF NECESSARY, PROBE ON GENERAL PATIENT DEMOGRAPHICS]

   2. What is a typical interaction like? What is the standard process when a patient comes to you/your office/clinic for a visit? [PROBE: check-in, whom they see first, second, before leaving]

   3. At what point are you interacting with them?

3. WIC Awareness and Brand Perceptions (20 minutes)

1. I’d like to transition a bit and talk to you about how you or others in your office approach talking with patients about nutritional risk/meeting nutrition needs or food insecurity.

   1. How do you approach these types of conversations?

   2. What information, if any, are you gathering or screening prior to meeting with patients, and what types of conversations are you having about these topics? [IF NO NUTRITION/FOOD-RELATED RESPONSE, PROMPT: could include screening for regular dietary intake or food security]

   3. [IF NECESSARY:] What, if any, associations, nonprofits, or government programs come to mind that provide assistance to people who face food insecurity or nutritional risk?

[INTERVIEWER TO LISTEN FOR GOVERNMENT PROGRAMS (SNAP, WIC, ETC.)]

2. Today’s discussion will be focused on WIC or the Special Supplemental Nutrition Program for Women, Infants and Children.

3. First of all, tell me a little bit about WIC.

1. What do you know about WIC?

2. How aware and familiar are you with the program?

3. How do you know about WIC?

4. What, if anything, have your interactions been with WIC?

4. Now let me read you a short description of WIC. [INTERVIEWER SHARE ON SCREEN]

WIC, which is also referred to as the Special Supplemental Nutrition Program for Women, Infants, and Children, is a federally-funded program of the United States Department of Agriculture. To qualify for WIC, individuals must be one or more of the following:

• Pregnant.

• Breastfeeding a baby under 1 year of age.

• New parent who had a baby or was pregnant in the past 6 months.

• An infant younger than 1 year.

• A child younger than 5 years.

WIC is open to many incomes including working and non-working families.

WIC’s primary benefits and services are the foods available through WIC, breastfeeding support, nutrition education/counseling, and referrals to other healthcare and community or social services.

1. How much of this short description were you aware of or familiar with?

5. In your role as a healthcare provider and at your facility, how and how much, if at all, does WIC play a role with your patients? [Interviewer to probe on relevance, frequency, importance, etc.]

1. Do you have an idea of how many of your patients participate in WIC?

2. How much, if at all, are you talking to patients about WIC?

   1. Are patients bringing it up to you at all?

3. What about your colleagues or other members of your staff?

6. [For instances when WIC is shared] What prompts you or a member of your team to share information about WIC (i.e., potentially enrolling in WIC) with a patient?

1. How do you share information about the program?

   1. What tools, materials, or resources do you use?

   2. How do you get them? [Interviewer to probe from a WIC agency in your community? The website? Make them yourself?]

2. What do you typically say about WIC? How do you introduce or describe the program?

3. What works well in terms of persuading your patients to apply to WIC? [NOTE: If HCP uncomfortable with ‘persuading’ ask about ‘sharing information’.]

4. How much, if at all, are patients inquiring to you about WIC?

5. When you do talk to patients about WIC, generally what are their reactions?

6. If another healthcare provider asked you for advice, what would you recommend in terms of best practices for referring WIC to patients?

7. [For instances when WIC is not shared] Why not – what are the primary reasons why information about WIC is not shared with a patient (assuming the patient would qualify)?

1. What are barriers or challenges to sharing information about WIC to patients?

2. What variables come into play when you decide not to refer WIC? [Interviewer to probe on the HCP, the patient, and the WIC program, i.e., the information HCP has or knows, uncertainty how the patient will react, uncertainty if patient qualifies, etc.]

3. What could WIC do to make it easier for you as a healthcare provider to provide patients with information about the program?

8. [If have familiarity of WIC:] Next, I’d love to get your thoughts, impressions, or perceptions of the program.

   1. What does the program do well?

   2. What concerns do you have about the program?

4. WIC HCP Information & Messaging (10 minutes)

1. How, if at all, have you received any training or education or promotional materials about food insecurity in general? [PROBE ON WIC AND SNAP]

2. In terms of learning more or getting information about WIC, where would you go, whom would you talk to, or what resources would you access?

1. Why those resources?

2. Where do you look/would you look for credible information about WIC? [probe on where and who, i.e., sites, associations, journals, etc.]

3. What about any websites? What sites have you visited? What sites might it make sense for you to access for this type of information?

4. Where/how is it easiest for you to access or find relevant information?

5. [If not sharing information about WIC:] What information would you like to see from these resources to make you more likely to refer WIC to your patients?

3. If WIC wanted to provide healthcare providers like you with information about the program, what are the best ways to reach you?

1. What types of materials work best for you when you share information with patients? [probe on types of materials online, offline, how to deliver them, etc.]

2. What information do you think a WIC website should provide for healthcare providers, and what would make this type of resource most useful to you?

3. How much, if at all, would you be interested in taking classes for CE credit on food insecurity and WIC?

4. How much, if at all, would you be interested in being contacted by a local WIC agency for information and updates on WIC? If interested, how often would you want them to visit?

5. How does your office typically share such information with patients? What type of information do they respond to best? How do you know?

6. [If not previously mentioned:] At your facility, who/what roles are most responsible for locating and sharing this type of information?

4. In order to provide healthcare providers with information about WIC, various messaging and materials are currently in development. To that end, I have a few different messaging concepts to share with you, which are not yet final, and it would be helpful to hear your reactions and feedback in terms of what’s working or not working about these different ideas from your perspective as a healthcare provider. This information is being designed to encourage healthcare professionals like you to urge patients to consider applying for WIC.

First, let me share my screen to show you an overview statement:

WIC, also known as the Special Supplemental Nutrition Program for Women, Infants, and Children, is a federally funded nutrition program of the United States Department of Agriculture (USDA). Key things to know about WIC:

5. Next, there are four different areas for the “key things to know about WIC,” and I would love to get your feedback on each of these different concepts:

[INTERVIEWER TO SHOW HEALTH BENEFITS AND ONE OTHER IDEA AS TIME ALLOWS, ONE CONCEPT AT A TIME AND ALLOW DISCUSSION OF THE IDEA; ORDER OF CONTENT WILL BE ROTATED ACROSS GROUPS]

Many people don’t realize they are eligible for WIC.

• WIC supports pregnant women, mothers and their infants, and children up to age 5.

• Women are eligible for WIC as soon as they find out they are pregnant.

• WIC is open to many incomes, including working and non-working families.

• Many people with higher incomes still qualify for WIC. A couple with two children and can make $55,000. A couple with three children and one on the way can make $74,000.

• WIC is also available to fathers, grandparents, foster parents, and caregivers of children under 5.

• Only about half of eligible people participate in WIC.

WIC offers free healthy foods and much more.

• All WIC members receive healthy foods, personalized nutrition advice (including those with specific dietary needs), one-on-one breastfeeding support, and referrals to health and social services at no cost.

• WIC participants have one-on-one meetings with WIC staff who are experts in nutrition. These experts provide advice and resources based on each participant’s personal needs.

• The free healthy foods that WIC offers helps families save money…money they can put to other health-related and parenting expenses.

WIC offers important health benefits to your patients.

• Participation in WIC has been associated with improved:

• Diet quality

• Consumption of fruits, vegetables, whole-grain foods, lower-fat milk

• Cognitive and academic performance

• Growth rates

• Infant feeding practices

• Likelihood of receiving prenatal care

• Likelihood of children having a regular provider of medical care

• WIC participation decreases:

  • Moderate-to-severe infections in children as of 6–11 years of age

  • Premature births

  • Incidence of moderately low and very low birth weight infants

  • Fetal deaths and infant mortality

WIC continues to modernize and become more convenient.

• WIC now uses EBT cards for food benefits. No more paper vouchers.

• Many WIC services and appointments can now be done remotely, saving time and money on transportation.

• More and more WIC participants can use online ordering for grocery pick-up or use the self-checkout aisle in the grocery store.

Closing Statement:

Consider recommending WIC to your patients today! WIC provides you with another way to help your patients and their families improve their health. Have your patients visit their state WIC website to check their eligibility and to apply.

1. What is your reaction? What do you think about the information included in this version?

2. What, if any, information is new to you?

3. How relevant do you think this information would be for your patients?

4. Would any of this be helpful in making you feel more comfortable sharing information about WIC with your patients?

5. What do you think would make your patients more receptive to information about WIC?

6. What, if any, questions remain? What else would you need/want to know about WIC to make you and your colleagues more likely to share information about the program?

[AFTER CONCEPTS HAVE BEEN DISCUSSED INDIVIDUALLY, INTERVIEWER WILL SHARE SCREEN WITH BOTH MESSAGES FOR COMPARISON]

1. Which of these versions does a better job providing information you need about WIC? Your patients need about WIC? Why?

2. What information was most surprising to you? How so?

3. What did you find most compelling? What makes you say that?

4. Which of these points do you think is most impactful to patients?

5. As we look at these options overall, which is most likely to increase your likelihood of recommending WIC to your patients?

6. Would any of the information we have discussed today change how or how much you share information about WIC with patients? What makes you say that?

5. Wrap-up/False Close (5 minutes)

Thank you for all of the information you have provided.

1. While I check with my colleagues to make sure they do not have any additional questions, could you summarize what would be most helpful to you to share information about WIC with your patients?

2. To wrap-up, we wanted to share a few links with WIC information, if you are interested in it. We will paste them in the chat.

   1. WIC Factsheet: https://www.fns.usda.gov/fns-101-wic

   2. WIC state agency

Thank you again for your time.