Abstract

ObjectivesThe Special Nutrition Assistance Program for Women, Infants, and Children (WIC) increases access to nutritious foods for low-income pregnant, postpartum, and breastfeeding women and their children under five. Participation in WIC has declined for the past 6 years. Discount variety stores (DVS) can be useful points of food access for low-income communities. We conducted in-depth interviews with staff at corporate, managerial, and store clerk levels at ten DVSs in North Carolina. These stores implemented WIC over a 10-month pilot study to assess WIC feasibility. Our study goal was to identify facilitators and barriers to WIC implementation in DVS. Learning more about facilitators and barriers associated with WIC implementation may lead to more successful program adoption, allowing more families to benefit from WIC and increase DVS revenues. MethodsThe design was an inductive approach to identify themes in qualitative in-depth interviews of employees of DVS at corporate, managerial, and store clerk levels. The interviews were uploaded into NVivo software. Thirty DVS employees were interviewed: six worked at the corporate level, 22 were in-store managers, and eight were store staff; 22 participants were women; eight were men. Ten DVS in low-income communities participated; nine of these stores were located in areas that were classified as a food desert. ResultsAll except one participant provided positive feedback about being involved in the WIC program. Many DVSs store employees had previous experience participating in the WIC program which gave them a good understanding of the WIC shopping experience. Previous WIC experience and proximity to store location for DVS customers were facilitators of WIC implementation. The primary barriers included limited choice in store products for customers, complicated or unclear labeling for WIC-eligible products, and difficulty training store employees to process WIC payments. ConclusionsBased on the WIC implementation, DVS found that selling WIC-eligible products, especially infant formula, was associated with selling more non-WIC items. The North Carolina WIC program moved from a paper-based system to an electronic benefit transfer system (eWIC); therefore, several of the barriers to successful WIC implementation should be addressed through the new electronic system that does not require as much detailed and manual employee training. Increased infant formula sales to both WIC and non-WIC customers drove increased sales in other products. Funding SourcesRobert Wood Johnson Foundation.

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