Ann M. Collins

Food-package assignments and breastfeeding initiation before and after a change in the Special Supplemental Nutrition Program for Women, Infants, and Children

BACKGROUND In 2009, the USDA implemented an interim rule that changed the prescribed foods in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Options for mother and infant dyads include a full breastfeeding package with no infant formula, a partial breastfeeding package with some infant formula, and a full formula package with a smaller postpartum food package for the mother. The changes were designed to encourage WIC mothers to choose breastfeeding for their infants. OBJECTIVE The purpose of this study was to measure changes in the following 3 outcomes: WIC food-package assignments, WIC infant formula amounts, and breastfeeding initiation. DESIGN We compared outcomes before and after implementation of the interim rule in a national random sample of 17 local WIC agencies (LWAs). The data source was administrative records for 206,092 dyads with an infant aged 0-5 mo in the sampled LWAs. RESULTS There were changes in WIC food-package assignments and infant formula amounts but no change in breastfeeding initiation. For dyads in whom the infant was in his or her birth month, the percentage of mothers who received the partial breastfeeding package fell from 24.7% (preimplementation) to 13.8% (postimplementation), the percentage of mothers who received the full breastfeeding package rose from 9.8% (preimplementation) to 17.1% (postimplementation), and the percentage of mothers who received the full formula package rose from 20.5% (preimplementation) to 28.5% (postimplementation). CONCLUSIONS After the change, fewer WIC mothers of new infants received the partial breastfeeding package. More WIC mothers received the full breastfeeding package, but more mothers also received the full formula package.

Delivering Summer Electronic Benefit Transfers for Children through the Supplemental Nutrition Assistance Program or the Special Supplemental Nutrition Program for Women, Infants, and Children: Benefit Use and Impacts on Food Security and Foods Consumed

BACKGROUND The Summer Electronic Benefit Transfers for Children (SEBTC) demonstration piloted summer food assistance through electronic benefit transfers (EBTs), providing benefits either through the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) or the Supplemental Nutrition Assistance Program (SNAP) EBT. OBJECTIVE To inform food assistance policy and describe how demonstrations using WIC and SNAP models differed in benefit take-up and impacts on food security and childrens food consumption. DESIGN Sites chose to deliver SEBTC using the SNAP or WIC EBT system. Within each site, in 2012, households were randomly assigned to a benefit group or a no-benefit control group. PARTICIPANTS Grantees (eight states and two Indian Tribal Organizations) selected school districts serving many low-income children. Schoolchildren were eligible in cases where they had been certified for free or reduced-price meals during the school year. Before the demonstration, households in the demonstration sample had lower incomes and lower food security, on average, than households with eligible children nationally. INTERVENTION Grantees provided selected households with benefits worth

A Summer Nutrition Benefit Pilot Program and Low-income Children’s Food Security

60 per child per summer month using SNAP or WIC EBT systems. SNAP-model benefits covered most foods. WIC-model benefits could only be used for a specific package of foods. OUTCOME MEASURES Key outcomes were childrens food security (assessed using the US Department of Agriculture food security scale) and food consumption (assessed using food frequency questions). STATISTICAL ANALYSES Differences in mean outcomes between the benefit and control groups measured impact, after adjusting for household characteristics. RESULTS In WIC sites, benefit-group households redeemed a lower percentage of SEBTC benefits than in SNAP sites. Nonetheless, the benefit groups in both sets of sites had similar large reductions in very low food security among children, relative to no-benefit controls. Children receiving benefits consumed more healthful foods, and these impacts were larger in WIC sites. CONCLUSIONS Results suggest the WIC SEBTC model deserves strong consideration.

Summer Electronic Benefit Transfer for Children (SEBTC) Demonstration: Summary Report 2011-2014 (Summary)

Moderate amounts of summer food assistance (

Summary of Summer Electronic Benefits Transfer for Children: Evaluation Findings for the Full Implementation Year 2012

60 per school-aged child per month) reduce VLFS-C by one-third. BACKGROUND: Federal summer meals programs serve less than one-sixth of children that receive free or reduced-price meals during the school year. To address this gap in food assistance for school-aged children, the Summer Electronic Benefits Transfer for Children (SEBTC) Demonstrations provided summer food assistance in the form of electronic benefits transfer cards to households with school-aged children certified for free or reduced-price meals during the school year. METHODS: Over 2011–2013, the SEBTC demonstrations were evaluated by using a random assignment design. Households were randomly assigned a monthly

Summer Electronic Benefits Transfer for Children (SEBTC) Demonstration: 2012 (Technical Appendices)

60-per-child benefit, a monthly

Summer Electronic Benefits Transfer for Children (SEBTC) Demonstration: 2012

30-per-child benefit, or no benefit, depending on the study year. Key outcomes included children’s food security and consumption of foods and food groups related to a healthful diet (diet quality). At baseline (in the spring) and again in the summer, the evaluation surveyed ∼52 000 households over the course of the 3 years of the impact study. RESULTS: SEBTC reduced the prevalence of very low food security among children by one-third. It also had positive impacts on 6 of the 8 child nutrition outcomes measured (amounts of fruits and vegetables; whole grains; dairy foods; and added sugars). CONCLUSIONS: SEBTC is a promising model to improve food security and the dietary quality of low-income school-aged children in the summer months.