NPM 5A - Percent of infants placed to sleep on their backs
NPM 5B - Percent of infants placed to sleep on a separate approved sleep surface
NPM 5C - Percent of infants placed to sleep without soft objects or loose bedding
Introduction: Safe Sleep
For the Perinatal/Infant Health domain, Hawaii selected NPM 5 based on the results of the 2020 Title V needs assessment. The 2025 Title V state objective for NPM 5A is to increase the percentage of infants placed to sleep on their backs to 86.0%.
Data: NPM 5A: The latest data from the 2020 PRAMS survey (80.1%) indicates that Hawaii did not meet the 2021 state objective or the Healthy People 2030 objective of 88.9% but was similar to the national estimate of 79.8%. The proportion of infants placed to sleep on their backs has not changed significantly since 2015 (81.5%).
NPM 5B: The latest data for NPM 5B indicates that 24.7% of Hawaii infants were placed to sleep on a separate approved sleep surface, not meeting the state objective of 29%, which is significantly below the national percentage (36.9%). The decline from 2019 (28.7%) was non-significant. There were no significant differences among subgroups, based on 2020 data (which may be due to the small numbers).
NPM 5C: The latest data for NPM 5C indicates that 45.9% of infants were placed to sleep without soft objects or loose bedding, which did not meet the state objective (49.0%) and is significantly lower than the national percentage of 52.5%. The decrease in the estimate from 2019 (48.1%) was not statistically significant. Higher risk groups could not be reported due to small numbers.
PRAMS data: There was no PRAMS data collection in Hawaii from 2017 to 2018. The Title V 2019 NPM 5 indicators are derived from the 2016 PRAMS survey, and the 2020 indicators are from 2019 PRAMS survey. Note: The 2019 dataset includes only six months of weighted data. The 2020 PRAMS data reported for Title V FY 2021 includes a full year of data.
Objectives: Following a review of the baseline data and the HP 2030 objective, the state objectives for all three measures were updated through 2025.
Child Death Review: Although the total number of child deaths in 2020 was smaller (113) during the COVID-19 pandemic, compared to the Hawaii average of 140-160 child deaths in 2016-2019, infant sleeping conditions continued to emerge as possible factors in several Child Death Review (CDR) cases.
Title V lead/funding: The supervisor for the Family Strengthening and Violence Prevention (FSVP) Unit under the MCH Branch (MCHB) serves as the Title V program lead for safe sleep. The FSVP supervisor oversees family violence prevention and parenting support programs. There is no dedicated funding source for Safe Sleep staffing or program activities; however, state funds are leveraged to support efforts. Title V-funded staff provide branch-level leadership and overall support for safe sleep.
Strategies: In 2021, the strategies for safe sleep were:
- Increase the awareness of the importance of Safe Sleep and provide safe sleep education through public service announcements and digital media
- Expand outreach to non-English-speaking families and caregivers through the translation of educational materials and safe sleep messages to promote families accessing the Parent Line
Evidence: A recent review of the AMCHP and MCH Evidence Center research indicates that targeting caregivers with education is supported by moderate evidence of effectiveness. National campaigns focused on vulnerable subgroups as having the most significant impact on advancing health equity. In 2020, a Hawaii strategy was added specifically to address disparities in safe sleep behaviors targeting key ethnic groups by developing multilingual educational outreach to limited English-speaking communities. The strategy was also supported by input from local service providers working with underserved, multicultural families. ESM 5.2 was created to measure progress on this new strategy.
A report on the safe sleep strategies and activities are discussed below.
COVID-19 Impacts: The advent of COVID-19 pandemic shutdown orders and social distancing created enormous disruptions to daily life with school and business closures with travel restrictions that led to profound economic hardships and increased stress on families. The lockdown restrictions continued through FY 2021, changing prenatal, delivery, and postpartum services (including family involvement), resulting in less direct support and information for new parents and putting newborns at potential increased risk.
For many families, Hawaii’s lack of affordable housing heightened existing rates of overcrowded households and housing insecurity. Residential overcrowding emerged as a major problem during the pandemic, exacerbating COVID disease transmission and highlighting key health and social disparities. With many families sheltering at home, crowded living conditions encouraged more co-sleeping with infants already a common practice in Hawaii.
Throughout 2021, safe sleep outreach/education efforts were put on hold as more critical messaging around COVID prevention and essential economic entitlements/supports were prioritized. These, and other factors, likely adversely impacted safe sleep conditions for families with newborns and infants. Although 2020 PRAMS data shows a slight decline in the Title V safe sleep measures, the percentages are not statistically significant.
Strategy 1: Increase the awareness of the importance of Safe Sleep and provide safe sleep education through public service announcements and digital media
This strategy focuses on media messaging activities to reach families in response to much of the social isolation created during COVID.
Safe Sleep Hawaii (SSH)
: SSH is the statewide coalition that promotes safe sleep efforts, focusing on the development of appropriate and consistent parent education materials and general awareness messaging. SSH helps assure information of safe sleep practices follow the current version of the American Academy of Pediatrics (AAP) Evidence-Based Recommendations for a Safe Infant Sleeping Environment at Birthing Hospitals, Child Care Centers, and Child Care Providers.
SSH has a diverse membership with representation from government, nonprofits, for-profits, and grassroots organizations and sectors, as well as families who are committed to preventing infant mortality through safe sleep practices. Quarterly meetings were held virtually during the ongoing pandemic and participation remained relatively stable. SSH reviewed trainings and public messaging to ensure that information was consistent with AAP guidelines.
Annual Safe Sleep Summit. An annual Safe Sleep Hawaii Summit is normally held in-person to promote networking and partnering and to provide current information updates to support public and private stakeholders' efforts. The 2020 and 2021 Summits were cancelled due to COVID.
Media Campaign: Given the greater social isolation experienced by families and the limited availability of direct services during COVID, Title V decided to use mass media efforts to promote safe sleep messaging. In 2021, a Safe Sleep media campaign was planned to educate parents and caregivers as part of October’s Safe Sleep and SIDS Awareness Month. Working with the Title V-funded public information officer, television and digital spots promoting safe sleep were developed using the ABC messaging (Alone, on their Backs, in a Crib), which are the evidence-based recommendations from AAP. The spots mirrored the content of a widely used Hawaii Safe Sleep Guide for Parents. The Guide was jointly developed in collaboration with several state agencies. SSH reviewed the content before its release. The call to action for the campaign steered the public to Safe Sleep information available via the Parent Line, which is the primary Title V hotline.
The Parent Line: The Parent Line, which is contracted by MCHB, provides support to parents and caregivers with information on community resources, child behavior, child development, and parent education. The Parent Line is free and confidential and can be accessed by phone, chat, and/or website. The Parent Line was featured in the Safe Sleep media campaign, displaying the web URL and phone number for the public to obtain more information on safe sleep. In preparation for the campaign launch, MCHB worked with The Parent Line to create a dedicated webpage for safe sleep with electronic copies of the Safe Sleep Guide available and a schedule of accessible virtual safe sleep workshops.
Strategy 2: Expand outreach to non-English-speaking families and caregivers through translation of educational materials and safe sleep messages.
Hawaii is a state with a large immigrant and multiethnic population, including many English as a second language (ESL) households. These populations bring diverse traditional and cultural practices for infant sleep, including co-sleeping practices. To expand outreach to these groups, MCHB partnered with the Department of Human Services (DHS) and the Office of Language Access (OLA) to translate the Hawaii Safe Sleep Guide for Parents into 11 of the most common secondary languages spoken in local households. The Guide is also used by all licensed childcare providers and other early child programs statewide.
The translation joint venture began in 2020. The workgroup reviewed several sources of data, including Census data, requests for language interpretation services by DHS entitlements programs, and PRAMS data to identify cultural groups/languages with an increased risk for sleep-related infant mortality. Eleven languages were selected for translation: Chuukese, Ilocano, Japanese, Korean, Marshallese, Samoan, Spanish, Simplified Chinese, Tagalog, Traditional Chinese, and Vietnamese.
The Safe Sleep Guide translated text and design layouts were thoroughly reviewed and crosschecked by focus groups of native speakers to ensure that all translations were accurate, and that information and graphics were appropriately displayed in a readable and understandable manner.
Distribution of the Safe Sleep Guides was contracted to The Parent Line to ensure equitable access statewide. Printed versions of the Guide were mailed out upon request and electronic copies can be found on The Parent Line website. The media campaign spots were designed to promote broader dissemination of the newly translated Safe Sleep Guides via the website or by request (phone or chat).
ESM 5.2 was developed to track progress on efforts to reach diverse populations with Safe Sleep information in multiple languages. The completion of the translations and dissemination plan coupled with the launch of the media campaign in FY 2022 largely completes the work for ESM 5.2. A new ESM will be developed next year with the addition of a new strategy.
ESM 5.2 The number of languages Hawaii safe sleep educational materials are currently available for the community
|
|
2019 |
2020 |
2021 |
2022 |
2023 |
2024 |
2025 |
|
Annual Objective |
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11.0 |
11.0 |
11.0 |
11.0 |
11.0 |
11.0 |
|
Annual Indicator |
|
0 |
11 |
|
|
|
|
Current Year Highlights FY 2022 (10/1/2021 – 6/30/2022)
Hawaii continued to convene the SSH coalition through virtual meetings as COVID restrictions continued into 2022
Media Campaign: The planned Safe Sleep media campaign was launched in October 2021 as part of the Safe Sleep and SIDS Awareness Month. A press release announced the campaign, with interview spots scheduled on the major morning television news programs. The television and digital spots ran through December, reaching approximately 590,819 people/households; with over 6 million impressions (total amount of times our ad is seen or heard). The combined digital and social media spots totaled 863,824 total virtual contacts.
Cribs for Kids Program: The DOH is contracting to expand the Cribs for Kids Program, which provides statewide safe sleep education as well as a pack and play crib to ensure a safe sleeping environment for families in need. This program energizes partnerships around the state. This year, there will be an emphasis on the dissemination of translated safe sleep materials, as well as engagement of homeless or at-risk for homelessness populations statewide.
Responding to COVID-19: Given the broadly changing conditions brought by COVID, the MCHB and SSH developed new safe sleep activities for future implementation.
Statewide Assessment: A contractor was secured to complete a statewide environmental scan and assessment of safe sleep related activities and partnerships in Hawaii. The scan will also identify any significant disparities and gaps in services and information with recommendations to help guide future safe sleep planning and implementation efforts.
Safe Sleep Hawaii Summit: The annual virtual Safe Sleep Summit was held in May 2022 and featured keynote speaker, Dr. Suzanne M. Bronheim, Adjunct Associate Professor in the Department of Pediatrics at Georgetown University Center for Child and Human Development (GUCCHD). Dr. Bronheim discussed trends in effective approaches to safe sleep education. Barb Himes, IBCLC, Director of Education and Bereavement Services at First Candle, facilitated discussion on personal provider biases that can adversely impact the delivery of messages to families. Nursing Continuing Education credits were offered.
Review of the Action Plan
A revised logic model was developed for NPM 5 to review alignment among the SS strategies, activities, measures, and desired outcomes. Focusing on two strategic areas (messaging and translating educational materials for limited-English speaking populations), efforts to increase the percentage of infants placed safely to sleep and in safe environments improved. Reductions in disparities are also anticipated for all measures and outcomes. The activities associated with each of the three strategies directly correlate with short-term outcomes and will also impact longer-term outcomes (NPM 5 and NOMs 9.1, 9.2, 9.5). Short-term outcomes include:
- Parents and families increased awareness, capacity, and self-efficacy, specific to safe infant sleep
- Increased accessibility of safe sleep messaging and information to diverse ethno-cultural groups
- Development of a statewide media campaign, with public service announcements on television and other digital media
- Expanded use of The Parent Line, to disseminate Safe Sleep Guides across the state
Challenges Encountered
COVID-19: Safe sleep activities were revised for 2021, as SSH partners and Title V, in response to operational changes and changing community needs due to COVID. SSH continued to conduct remote partner meetings as COVID continues to affect the state.
The Cribs for Kids program that provides statewide safe sleep education and distribution of a Pack and Play crib to support a safe sleeping environment for infants switched from in-person parent/caregiver training to virtual in order to adhere to COVID safety guidelines. A program evaluation will determine whether/how this change has impacted the effectiveness of the program.
Addressing Co-Sleeping: As Hawaii PRAMS data confirmed, co-sleeping is a common cultural practice in Hawaii. Initiatives such as Pack and Play crib distribution and education through the Cribs for Kids Program have proven effective nationally with at-risk populations. However, addressing local/cultural beliefs and a general acceptance of co-sleeping continues to be challenging. The practice may be attributed to the state’s ethnic/cultural diversity and household overcrowding, housing insecurity, and multi-family living arrangements due to the high cost of housing. Data indicates that certain ethnic groups, young mothers, and low-income families are particularly at risk for co-sleeping practices. Working in conjunction with cultural leaders and other community organizations will be key to the success of targeted outreach to these priority disparate populations. SSH will expand efforts to include more diverse coalition participation as the multilingual messaging is disseminated.
Measuring Effectiveness: The Safe Sleep media campaign, Safe Sleep Guide for Parents and Caregivers (both in English and translated languages), and the Parent Line were used for public health messaging. Increased access to key information for a wider range and more diverse population had some measure of effectiveness. However, it is unknown to what extent the messaging has changed family attitudes and behavior around safe sleep practices. It is also unclear to what extent service providers have been utilizing the translated information with their client populations. The safe sleep environmental scan will collect and document additional data to better determine effectiveness of these efforts.
Overall Impact
COVID changed outreach efforts on safe sleep practices, relying more on electronic/digital methods that have increased virtual access to key information statewide. The Safe Sleep Guide for Parents and Caregivers was primarily distributed through printed posters and is now available in electronic form via the Parent Line website. The website also provides virtual safe sleep parent and caregiver workshops at no cost to families. Written information may also be requested via regular mail.
Title V MCHB worked on increasing statewide awareness of safe sleep education by promoting the Parent Line through public service announcements aired on TV and digital media, press releases, and television/morning show interviews. This brought more awareness of the issue by the general public and also highlighted the resources available.
The statewide crib distribution programs offered by community-based organizations was paired effectively with safe sleep education to help families. This is particularly geared to low-income families most affected by COVID restrictions and overcrowded living conditions. These community and social media-driven initiatives strengthened widespread dissemination of evidence-based AAP safe sleep guidelines for infants.
SPM 2 - Number of participants in the WIC program in Hawaii
Introduction: Food Insecurity Priority
For the Perinatal/Infant Health domain, Hawaii added a new state priority to address food insecurity, based on the results of ongoing needs assessment and the adverse economic impacts on Hawaii’s families due to COVID. The focus for this priority will be promotion and increased utilization of the Supplemental Nutrition Program for Women, Infants, and Children (WIC).
Data: The data for this measure comes from U.S. Department of Agriculture WIC participation reports. The enrollments for WIC continue to increase through 2021 and COVID, with 25,907 women, infants, and children served by the program.
Objective: By 2025, increase the total number of WIC participants in Hawaii to 30,000 pregnant women, infants, and children.
Title V Lead/Funding: The Hawaii WIC Services Branch is the lead program for this food insecurity priority, as the largest public food security program in the state and nation specifically serving pregnant and parenting women with health education and support. Although WIC Services are not funded by Title V, WIC does benefit from Title V-funded administrative supports, including media, contracting, data analytics, and IT services.
Key Partners: To improve the outreach for WIC services, a community advisory committee was formed, supported by a small private grant from the Partnership for America’s Children (PAC). The key partner in this project is the Hawaii Children’s Action Network (HCAN), a nonprofit whose mission is to ensure that all children are healthy, safe, and ready to learn. Other organizational partners include the Appleseed Foundation and the University of Hawaii Center on the Family, which will assist with data analysis.
Evidence: There is strong longitudinal evidence to show the effectiveness of the WIC program in addressing food insecurity. For more than four decades, researchers have investigated WIC’s effects on key measures of maternal and child health, such as birth weight; infant mortality; diet quality and nutrient intake; initiation and duration of breastfeeding; cognitive development and learning; immunization; use of health services; and childhood anemia. The findings strongly support WIC’s demonstrated ability to help improve maternal, infant, and child health outcomes (Center on Budget and Policy Priorities, 2021).
Strategies: Hawaii’s three food insecurity strategies are described in detail in the PAC grant:
- Partner with agency and community programs to establish a working group that is committed to improving WIC utilization
- Identify key barriers to WIC benefit utilization and enrollments
- Develop recommendations for initiatives to pursue to improve WIC utilization
Updates on the five strategies follow; however, since the grant was awarded late in FY 2021, this narrative largely reflects collaborative efforts to develop and submit the successful grant application.
COVID Impact Updates: In FY 2021, health and social service disruptions due to COVID continued through much of the year; however, federal relief efforts helped to offset some of the community and financial pressures associated with Hawaii’s slowly recovering economy. Unfortunately, many of these COVID-related federal supports ended in December 2021. Several Hawaii surveys and reports from local service providers confirmed that Hawaii families continue to suffer from food insecurity. In recognition of these findings, Governor Ige extended the state COVID disaster emergency period through October 2022, specifically to extend supplemental SNAP food benefits for Hawaii families.
Strategy 1: Partner with agency and community programs to establish a working group that is committed to improving WIC utilization
Expanding the use of WIC and other governmental food support programs continues to be crucial to helping women, children, and families during the economic difficulties created by COVID restrictions and escalating economic costs. WIC total enrollments are now nearly 12% higher than 2019, an encouraging increase from the pre-COVID declines in WIC enrollments since 2016. This pre-COVID decline reflected a similar trend nationally in WIC programs. The reason for the steady decline may have been due to the state’s growing economy prior to COVID, and also the steady decline in births. In 2018, the Hawaii WIC enrollment decline resulted in the closure of several WIC offices and staff reductions statewide.
During COVID, community-based family support services mobilized to expand food assistance programs throughout the state. The Hawaii Children’s Action Network (HCAN) became actively involved with coordinating and disseminating information on family assistance services, including food assistance programs. Recognizing the value and underutilization of the WIC program, HCAN partnered with WIC to apply for a grant from the Partnership for America’s Children (PAC) to improve and enhance outreach and promotion of the WIC program. The grant was awarded in May 2021. Grant implementation activities were delayed primarily due to the Delta COVID surge and other critical COVID-related community needs.
The first grant strategy focused on the establishment of a community working group to partner with the WIC program to improve numbers of enrollments and expand services. The grant activities included:
- Engage a diverse, multisector WIC working group that includes experts; families that rely on WIC for food support; representatives of racial/ ethnic and geographic populations that experience high rates of family food insecurity; WIC providers; nonprofits that serve low-income children and families; DOH WIC administrators; and policymakers who are capable of promoting and facilitating change.
- The working group will define membership, select leaders, establish operating guidelines, set a schedule of meetings, and identify goals and objectives.
Strategy 2: Identify key barriers to WIC benefit utilization and enrollments
This strategy focused on the primary data and research work of the WIC Working Group, to identify barriers and challenges experienced by the WIC program and its clients. Activities included:
- The WIC Working Group will collect, analyze, and review WIC data, community perspectives and will research best practices and innovative models in other states that have the potential to succeed in Hawaii.
- The group will examine WIC utilization data disaggregated by ethnicity and geography, trends in WIC usage in recent years, census data, and other sources of information about family and child food insecurity.
Strategy 3: Develop recommendations for initiatives to pursue to improve WIC utilization
The last strategy focused on the development of evidence-based/informed planning, based on the research and findings of the working group. Activities included:
- The WIC Working Group will research policies and systems in other states across the country to assess how to better address program issues.
- The group will determine potential policy and systems improvements on the state administrative level, including partnerships with other service agencies and/or policy/legislation.
Current Year Highlights for FY 2022 (10/1/2021 – 6/30/2022)
This section highlights the start-up work for the PAC grant in FY 2022.
Strategy 1: Partner with agency and community programs to establish a working group that is committed to improving WIC utilization
A cross-sector working group was recruited for the WIC project. Members include WIC staff from the state WIC office, WIC community clinics (including those located in Federally Qualified Health Centers), university researchers, the Native Hawaiian healthcare system, advocates, and current WIC recipient mothers.
WIC Parent Voices: WIC families were deemed an important partner in the working group. HCAN sent notices to recruit WIC parents to join the working group through community networks and via the Parent Leadership Training Institute alumni group. HCAN interviewed those mothers who showed interest and selected three to join the group. Parents were compensated for their participation in the working group at a rate of $30/hour.
Meetings: The WIC Working Group met monthly since October 2021. HCAN coordinated the logistics, facilitated the meetings, and partnered with WIC to develop agendas and debriefed on outcomes/progress. The Working Group’s primary goal was to deliberate and decide on feasible steps over the next two or three years to improve utilization of the WIC program in Hawaii. The Group will then create a blueprint/ workplan for WIC implementation.
The Group used the national Food Research and Action Center’s (FRAC) May 2019 report, “Making WIC Work Better,” as a guide for its work. The publication provides an extensive menu of strategies to improve the reach of WIC and benefit use, including an understanding of common barriers to participation, based on extensive national research. Based on the FRAC report, the Work Group narrowed down its areas of focus to:
- Partnerships with other agencies and community groups
- Retention of 1–4-year-olds in the program
- WIC contingencies in times of disaster
Strategy 2: Identify key barriers to WIC benefit utilization and enrollments
This strategy focuses on Hawaii data collection/analysis and research work, to identify commonly observed barriers and challenges experienced by the Hawaii WIC program and clients.
Assessment: HCAN conducted an assessment of the Hawaii WIC program, including examining census data and other sources of information about child food insecurity, researching policies and systems in other states across the country that successfully maximize WIC utilization, and analyzing trends in WIC usage in recent years. The FRAC report was identified as a useful resource through the assessment. The final report will be comprised of two analyses:
- An overview of existing data on child food insecurity and participation rates of eligible Hawaii residents
- Recommendations to improve WIC utilization in Hawaii
Data Analysis: FHSD contracted with HCAN and University Center on the Family (COF) to analyze and acquire data to better understand the current WIC service population characteristics, their utilization of benefits, and enrollment patterns. WIC has limited internal resources for data analysis; thus, COF will initially be analyzing the WIC dataset. COF is partnering with the WIC Working Group to help develop the data analysis plan. Additional data collection through survey/focus groups will also be considered.
WIC Store Map: The working group is also developing an updated list of WIC-participating Hawaii stores and WIC program locations map that will be uploaded to the website when completed.
Strategy 3: Develop recommendations for initiatives to pursue to improve WIC utilization
Although the WIC Working Group is still awaiting data and assessment results, a list of strategic recommendations was identified after a review of the national FRAC WIC report.
Some of the report recommendations that the WIC Working Group agreed would be worth pursuing include:
- Using social media, web-based advertisements, and a well-designed and strategic online website that leads to WIC content specific to each island
- Creating a special outreach program for Pacific Islanders and other underserved communities to increase engagement
- Creating a formal WIC Advisory Council with representatives and stakeholders from each island
- Partnering with SNAP and Medicaid to share client data and to extend program reach and increase participation
Data Sharing w/SNAP: In May 2022, WIC executed a data-sharing agreement with SNAP to improve the enrollment process for clients who are eligible for both programs. Implementation of the agreement begins in August 2022 with the exchange of client datasets. Although WIC does not currently share its program data with Medicaid, staff from both agencies share the other’s program information with their clients.
Formula Shortage: In FY 2022, WIC addressed the chronic shortage of infant formula due to the Abbott recall and plant shutdown. WIC Branch notified WIC participants of the recall, and shared critical information on recall efforts. As the formula shortage worsened, WIC took action to allow WIC participants to purchase alternative formula brands at least through August 2022. WIC also shared infant formula updates with the general public, providing information on resources and guidance to local service agencies and programs via media interviews, press releases, listservs, social media, and web postings.
Challenges Encountered
The WIC Working Group actively identified barriers to accessing services and opportunities to improve WIC enrollment, intake, and retention, drawing upon the Working Group’s diverse perspectives and experiences with the WIC program.
Some of the barriers identified include:
- WIC’s ability to reach young families is limited by reliance on outmoded forms of communication (i.e., printed materials and face-to-face contacts)
- WIC's outreach materials, smartphone app, and website are almost entirely printed/read in English
- Large geographic areas on all islands currently lacking WIC clinics, including parts of rural Oahu.
Operationally, WIC is impacted by the competitive labor market and is struggling to fill its vacant positions.
The Working Group also identified some potential opportunities for WIC improvement:
- Provide a modern approach to communication with WIC clients, using methods such as texting, email, or messaging directly to WIC staff, as well as receipt of timely reminders when their WIC benefits are about to expire
- Emphasize more cultural competence in WIC clinic workers and provide materials available in languages that are common in WIC applicants and participants
- Partner with agencies that work with the Pacific Islander community such as We Are Oceania (WAO), City and County of Honolulu’s Resilience Resource Center, and the Big Island’s Micronesians United (MU-BI)
- Conduct routine assessment and evaluation of the appropriateness and effectiveness of the WIC Program and services to meet the food security needs of WIC participants
Overall Impact
Prior to the convening of the WIC Working Group, the WIC program had limited opportunity/capacity to dedicate significant resources towards improving the WIC program. This unique private-public partnership has brought sorely needed resources, effort and supports to one of the largest and most significant maternal and child health programs in the state.
The WIC Working Group provided valuable feedback from parties with different perspectives of the WIC program and with direct family experience in the current state social/economic context. The diverse composition of the Working Group – academics, advocates, WIC clinic staff, WIC state office staff, and WIC clients – combines these diverse viewpoints to better inform WIC deliberations and planning.
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