Journal of Nutrition Education and Behavior最新文献

Objective: To investigate the perceived motivators and barriers to Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation in urban and rural Nebraska, to address the disparities in program reach.

Design: Cross-sectional online survey.

Setting: Low-income WIC-eligible households across urban and rural Nebraska.

Participants: N = 1,116 households (n = 801 urban; n = 315 rural) with ≥ 1 child.

Variables measured: Perceived motivators and barriers to WIC participation.

Analysis: Logistic regression with Benjamini-Hochberg correction assessed associations between rural-urban status and perceived motivators/barriers, adjusting for race/ethnicity, income, and education; significance was based on Benjamini-Hochberg adjusted P values < 0.05.

Results: Rural residents were more likely to perceive access to nutritious food (P < 0.01), breastfeeding support (P < 0.01), and health care referrals (P < 0.05) as motivators for WIC participation than urban residents. Conversely, urban residents were 1.7 times more likely to perceive difficulty traveling to WIC clinics (P < 0.01) as a barrier than rural counterparts.

Conclusions and implications: Targeted strategies addressing Nebraska's diverse needs are necessary for improving WIC participation. Longitudinal and multistate data are needed to examine participation factors over time, supporting causal inferences and informing evidence-based policy.

Objective: Investigate the relationship between milk fat consumption from 24 to 36 months and (1) body mass index (BMI) z-score change from 24 to 36 months, and (2) nutrient intake at 36 months among toddlers who were Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)-eligible at study initiation.

Design: Longitudinal analysis using WIC Infant Toddler Feeding Practices Study-2 data collected from 2013 to 2020.

Setting: Eighty WIC enrollment sites across 27 US states.

Participants: Included 2,373 toddlers (27.6% Black, 57.1% White, 15.4% other race; 39.1% Hispanic ethnicity) from households with low income.

Interventions: None.

Main outcome measures: Changes in BMI z-score from 24 to 36 months and dietary intake (added sugars, saturated fat, total energy) at 36 months.

Analysis: Linear regression models analyzing relationships between average milk fat consumption from 24 to 36 months and outcome measures.

Results: Meeting milk fat consumption recommendations between 24 and 36 months (≤ 1%) associated with lower intake of saturated fat (all models) and energy intake (fully adjusted model), but not a change in BMI z-score or added sugars intake.

Conclusions and implications: Further research is needed to understand associations between milk fat consumption, BMI, and dietary patterns in toddlers from households with low income to inform dietary recommendations and nutritional assistance guidelines.

Objective: To investigate associations between multiple nutrition assistance program participation and household food insecurity (HFI).

Methods: Cross-sectional survey among Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participants in Los Angeles County in 2020 (n = 5,184). We fitted covariate-adjusted Poisson regression models to investigate associations between multiple program participation and HFI.

Results: In addition to WIC, 66% of households participated in ≥ 1 other program. Compared with WIC-only households, households who participated in WIC + Supplemental Nutrition Assistance Program (SNAP, prepandemic enrollment prevalence ratio [PR] = 1.28 [95% confidence interval (CI) = 1.09-1.50]; during pandemic enrollment PR = 1.75 [95% CI, 1.47-2.08]) or in WIC + pandemic electronic benefit transfer + SNAP (prepandemic PR = 1.30 [95% CI, 1.11-1.52]; during pandemic PR = 1.51 [95% CI, 1.26-1.80]) had higher relative prevalence of HFI.

Conclusions and implications: HFI was high during the coronavirus disease 2019 pandemic, particularly among families participating in SNAP in addition to WIC, potentially from self-selection of households with HFI into multiple programs. Increases in benefits may be necessary to alleviate HFI.