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Irwindale, CA, United States

Kim L.P.,Pepperdine University | Koleilat M.,California State University, Fullerton | Whaley S.E.,PHFE WIC Program
Journal of Pregnancy

Women of reproductive age are particularly at risk of obesity because of excessive gestational weight gain (GWG) and postpartum weight retention, resulting in poor health outcomes for both mothers and infants. The purpose of this qualitative study was to examine perceptions and barriers to GWG among low-income women in the WIC program to inform the development of an intervention study. Eleven focus groups were conducted and stratified by ethnicity, and each group included women of varying age, parity, and prepregnancy BMI ranges. Participants reported receiving pressure from spouse and family members to "eat for two" among multiple barriers to appropriate weight gain during pregnancy. Participants were concerned about gaining too much weight but had minimal knowledge of weight gain goals during pregnancy. Receiving regular weight monitoring was reported, but participants had inconsistent discussions about weight gain with healthcare providers. Most were not aware of the IOM guidelines nor the fact that gestational weight gain goals differed by prepregnancy weight status. Results of these focus groups analyses informed the design of a pregnancy weight tracker and accompanying educational handout for use in an intervention study. These findings suggest an important opportunity for GWG education in all settings where pregnant women are seen. © 2016 Loan Pham Kim et al. Source

Crespi C.M.,University of California at Los Angeles | Alfonso V.H.,University of California at Los Angeles | Whaley S.E.,PHFE WIC Program | Wang M.C.,University of California at Los Angeles
Pediatric Research

Introduction: The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) serves 50% of infants and 25% of preschool-aged children in the United States and collects height and weight measurements from eligible children every 6 mo, making WIC data a valuable resource for studying childhood growth and obesity. We assessed the accuracy of measurements collected by WIC staff by comparing them to gold standard measurements collected by trained research staff. Results: Intraclass correlation coefficients (ICCs) measuring agreement between WIC and research protocol measurements for height, weight, and BMI were 0.96, 0.99, and 0.93, respectively. Although WIC measurements overestimated height by 0.6 cm and weight by 0.05 kg on average, BMI was underestimated by only 0.15 kg/m 2 on average. WIC BMI percentiles classified children as overweight/obese vs. underweight/normal with 86% sensitivity and 92% specificity. Discussion: We conclude that height, weight, and BMI measurements of children aged 2-5 y collected by trained WIC staff are sufficiently accurate for monitoring and research purposes.Methods:At seven WIC clinics in southern California, 287 children aged 2-5 y measured for height and weight by WIC staff using WIC standard protocol were remeasured by research staff using a research protocol (duplicate measurements with shoes and outerwear removed were taken by trained personnel). © 2012 International Pediatric Research Foundation, Inc. Source

Ritchie L.D.,University of California at Berkeley | Whaley S.E.,PHFE WIC Program | Spector P.,University of California at Berkeley | Gomez J.,PHFE WIC Program | Crawford P.B.,University of California at Berkeley
Journal of Nutrition Education and Behavior

Objective: To explore the impact of coordinated statewide nutrition education on Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) family behavior regarding fruits and vegetables, whole grains, and lower-fat milk. Design: Survey of different cross-sectional samples of WIC families before and after education. Setting: Intervention delivered at all WIC sites in California from April-September 2009. Participants: Random samples of pregnant or postpartum women and/or caregivers of children enrolled in WIC: 3,015 before and 3,004 after coordinated nutrition education. Intervention: Education directed at families to eat more, and a greater variety of, fruits and vegetables; eat more whole grains; and drink lower-fat milk instead of whole milk. Main Outcome Measures: Data collected by phone interview of women and caregivers on recognition of education messages, intention to consume, and change in family consumption of target food items. Analysis: Means and frequencies computed. Chi-square and t tests used to compare responses before and after education and for Spanish and English subgroups. Results: Following nutrition education, women and caregivers reported increased recognition of education messages, positive movement in stage of change for target food items, increased family consumption of fruits and whole grains, and replacement of whole milk with lower-fat milk. Impacts were similar for Spanish and English speakers. Conclusions and Implications: Coordinated nutrition education in WIC can significantly influence consumption toward more healthful food choices. © 2010 Society for Nutrition Education. Source

Whaley S.E.,PHFE WIC Program | Jiang L.,PHFE WIC Program | Gomez J.,PHFE WIC Program | Jenks E.,PHFE WIC Program

OBJECTIVE: This article describes the impact of a bilingual literacy intervention conducted with nearly 118 000 children in Special Supplemental Nutrition Program for Women, Infants and Children (WIC) sites in Los Angeles County, California. METHODS: All WIC participants at 6 WIC sites in Los Angeles County participated in the literacy intervention. Three cohorts of participants were selected to participate in the evaluation of the intervention. A control group of 200 families received no intervention, 103 families received 2 years of intervention, and 102 families received 4 years of intervention. Participants were predominantly Hispanic (92%), 3- to 4-year-old children and their parents. All families had low income levels, and more than one-half were Spanish-speaking. School readiness assessments were conducted with the children; parent literacy resources and activities at home were observed. Structural equation modeling was used to allow for simultaneous testing of relationships between variables. RESULTS: The Spanish-speaking subset showed a strong intervention effect. Among Spanish speakers, the 4-year intervention group (P < .001) and the 2-year intervention group (P < .05) had significantly higher school readiness scores, compared with the control group. The structural equation model revealed that exposure to the intervention significantly enhanced literacy resources and activities at home, which in turn led to greater school readiness. CONCLUSION: WIC-based literacy intervention significantly increased low-income, Spanish-speaking children's school readiness. Copyright © 2011 by the American Academy of Pediatrics. Source

Whaley S.E.,PHFE WIC Program | Koleilat M.,PHFE WIC Program | Whaley M.,PHFE WIC Program | Gomez J.,PHFE WIC Program | And 2 more authors.
American Journal of Public Health

Objectives: We present infant feeding data before and after the 2009 Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food package change that supported and incentivized breastfeeding. We describe the key role of California WIC staff in supporting these policy changes. Methods: We analyzed WIC data on more than 180 000 infants in Southern California. We employed the analysis of variance and Tukey (honestly significant difference) tests to compare issuance rates of postpartum and infant food packages before and after the changes. We used analysis of covariance to adjust for poverty status changes as a potential confounder. Results: Issuance rates of the "fully breastfeeding" package at infant WIC enrollment increased by 86% with the package changes. Rates also increased significantly for 2- and 6-month-old infants. Issuance rates of packages that included formula decreased significantly. All outcomes remained highly significant in the adjusted model. Conclusions: Policy changes, training of front-line WIC staff, and participant education influenced issuance rates of WIC food packages. In California, the issuance rates of packages that include formula have significantly decreased and the rate for those that include no formula has significantly increased. Source

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