Qualitative exploration of barriers to participation in the WIC program for English-speaking and Spanish-speaking mothers

• In Event: Supporting Families during Formation: Examining predictors of engagement and outcomes of home visiting and supplemental nutrition programs

Abstract

Introduction. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is the largest federal nutritional program serving pregnant and postpartum women and children under age five. In 2019, WIC provided monthly benefits for 6.3 million participants, which represented 57% of all eligible individuals. Importantly, while participation among Hispanic/Latin individuals is above average, their participation rate has decreased over the past decade from 70% in 2010 to 57% in 2019. This demonstrates retention challenges in the WIC program when it comes to enrollment of ethnic minority mothers and their children. While prior literature has identified potential barriers to WIC participation, and recent studies have collected data in different languages (Gago et al., 2022), they have not compared barriers and challenges identified by Spanish-speaking with those identified by English-speaking mothers. Moreover, they have only collected data for one race (McElrone et al., 2021), and have only conducted interviews or focus groups in one language; either English (Chauvenet, et al. 2019; McElrone, et al., 2021) or Spanish (Vehawn et al., 2014) but not both. The present study addresses this gap in the literature.

Methods. We conducted 14 focus groups (N = 14; mothers = 43; 21 Hispanic mothers; aged 19-43) with mothers currently participating in the WIC program in the Midwest. Resilience theory (Masten, 2018) guided our work and we used thematic analysis in NVivo 12 Pro to organize the data. Our findings illustrated salient themes which manifested as barriers English and Spanish speaking mothers experience while using WIC services, as well as challenges these mothers must navigate while participating in WIC.

Results. Three core barriers were identified in the focus groups: (1) Timing and logistic constraint barriers for WIC appointment attendance (2) Administrative barriers for entrance and maintenance in the WIC program, and (3) Language barrier. For English-speaking mothers, the top two barriers were timing (16/22) and administrative (14/22) barriers; while for Spanish-speaking mothers were language (16/21) and timing (12/21). Although mothers also experienced various challenges during their participation in WIC, these challenges did not pose major threats for dropping out of the program. Two core challenges were identified: (a) discriminatory experiences from store clerks and customers, and (b) limited availability of store product options due to mislabeling or shortage.

Discussion and Conclusion. Our study highlights the unique barriers and challenges Hispanic and non-Hispanic mothers confront while participating in the WIC program. Specifically, we argue that Barriers are obstacles pertaining to WIC’s internal modus operandi and Challenges are external “gray obstacles” to WIC wherein the mother’s unique family and personal situation shaped the intensity of the challenges while participating in the WIC program.

Furthermore, given the decreased enrollment of Hispanic mothers in the past decade in the WIC program, understanding institutional barriers is key to better serve Hispanic mothers in new arrival communities. Future research can explore why mothers who qualify for WIC decide not to enroll in the program as well as why mothers who are participating in WIC decide to early drop out of the program.

Authors

• Irma Arteaga, University of Missouri - Columbia
  Presenting Author

• Fiorella L. Carlos Chavez, Arizona State University

• Michelle Segovia, University of Missouri

• Youngbin Lee, University of Missouri - Columbia