Abstract
Background The 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 six years. Discount variety stores (DVS) can be useful points of food access for low-income communities. Objective To identify facilitators and barriers to WIC implementation in multiple DVS locations. Identifying the 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. Study Design, Settings, Participants We conducted in-depth interviews with 30 staff at corporate (n = 6), managerial (n = 22), and store clerk (n = 8) levels at ten DVSs in low-income communities in North Carolina. These stores implemented WIC over a 10-month pilot study to access WIC feasibility; nine stores were located in food deserts. Measurable Outcome/Analysis Interviews were coded, and an inductive approach was used to identify qualitative themes. Results All 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. Conclusion Most employees have a positive view of WIC but barriers related to product selection and training must be addressed to improve future WIC implementation. Notably, WIC's new electronic benefit transfer system (eWIC), which does not require as much detailed and manual employee training, should address several barriers to implementation. Future studies should evaluate implementation of eWIC in DVSs.
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