Individual and Household Responsive

Appendix T.2.

WIC participant experience survey recruitment email from WIC State agency

Public Burden Statement

This information is being collected to assist the Food and Nutrition Service to better understand the implementation and impact of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) modernization efforts on WIC State and local agencies, WIC vendors and WIC participants. This is a voluntary collection and FNS will use the information to monitor and strengthen WIC program modernization efforts. 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-[xxxx]. The time required to complete this information collection is estimated to average .0167 hours/1 minute 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, Evidence, Analysis, and Regulatory Affairs Office, 1320 Braddock Place, 5th Floor, Alexandria, VA 22306, ATTN: PRA (0584-xxxx). Do not return the completed form to this address.

To: [WIC Participant]

From: [WIC State agency director]

Subject: WIC wants to hear from you! Seeking your participation in the WIC Participant Experience Survey

Dear [Name of WIC participant],

WIC has been working hard over the past several years to improve the program and make it easier for people to participate. We want to hear what you think about the recent updates to WIC!

The United States Department of Agriculture’s (USDA) Food and Nutrition Service (FNS) is sponsoring a new study to learn about the experiences of WIC participants. FNS has contracted with a research company called Mathematica to do a short online survey with WIC participants. Participation in this survey is completely voluntary and will not affect the WIC services you receive.

The survey will ask about your experience with recent changes to the WIC program. You will receive a $10 [TYPE] gift card for filling out the survey.

Over the next [TIMELINE], you will receive an email from [WIC State Agency or Mathematica] with more information about the study and how to complete the survey.

As the Director of [STATE] WIC, I believe your opinions and thoughts about WIC are important to for us to include in the study.

Thank you so much for your participation in this important study.

Thank you,

[WIC State agency Director Name, TITLE]