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New York State: Preparing for the WIC Food Package Stacey Flanagan, MS Medical & Health Research Association of NYC, Inc. Overview • Successful statewide (NY) pilot project from 2006 that provided vouchers for WIC participants to purchase vegetables and fruits. • Corner Store based training for WIC Vendor Management Low-Fat Milk Initiative. • Sample findings from study of, emphasizing lessons learned and tips for others working to bring healthier food into small-scale stores. • Comments on opportunities for getting produce into small-scale stores created by WIC package changes. New York State WIC : Vegetable and Fruit Pilot Program 2006 In September 2005, The New York State Division of Nutrition identified state funds to provide WIC families with children the opportunity to purchase vegetables and fruits at all 4,400 NYS WIC-authorized grocery stores. The purpose of this project was to: •support the State’s childhood obesity prevention efforts; •promote the consumption of vegetables and fruits among program participants; and •evaluate the process in preparation for the permanent addition of these products to the WIC food benefits. From January 1, 2006 through March 31, 2006, more than 158,000 children (two to five years old) were issued three WIC checks (with a value of $5.00 each) specifying the purchase of vegetables and fruits (fresh, frozen, canned). Participants shopped with these checks through June 30, 2006. Acceptable Foods • Most Vegetables and Fruits were allowed for purchase by WIC participants. • The list of “not allowed” items was small for ease of administration at the store. Fresh White Potatoes (all varieties) Items from the Salad Bar Nuts, including Peanuts Canned White Potatoes Frozen White Potatoes Items in Plastic containers French Fries, Hash Browns, or Glass Jars Tater Tots, or other shaped potatoes Vegetables with sauces Vegetables mixed with pasta or rice The project was well received by participants, WIC local agencies and the vendor community. “I am glad to be able to sell new types of foods to WIC Participants.” WIC Vendor, New York City “I really love buying fruits with my WIC checks. Please continue this special program.” WIC Mom, Syracuse, NY Food Availability The greatest variety available was for canned products, with 80 percent of Downstate vendors and 70 percent of Upstate stores stocking moderate or several varieties of canned vegetables and/or fruits. About 66 percent of Upstate stores had moderate to several varieties of both fresh and frozen products. In the Downstate region, 62 percent of stores had moderate to several varieties of fresh products, and 59 percent had moderate to several varieties of frozen products. Visiting Corner Stores to Prepare for Transitions to Low-fat Milk Program Goals for 2007: Ensure that WIC Vendors: – Understand the importance of low-fat/non-fat milk to the health of the community. – Consistently maintain low-fat/non-fat milk on their shelves – Continue to redeem low-fat/non-fat milk WIC checks appropriately. WIC Vendors need to know: Not stocking 1% or skim milk means vendors lose both WIC and non-WIC business. When a store doesn’t have low-fat (1%) or skim milk, the WIC participant has to shop at another store that does. Because most participants also shop for non-WIC foods while they’re in the store, vendors without 1% or skim milk will lose WIC business AS WELL AS any non-WIC business. Today, more WIC vendors in NYC have 1% or skim milk on their shelves. 100 90 80 70 60 50 40 30 20 10 0 89 84 75 73 27 No Yes 25 16 Baseline Intervention Follow-up1 11 Follow-up2 As vendors increase their stocks of 1% milk, 2% milk stocks decrease. 100 90 89 84 80 70 78 73 78 75 69 71 60 50 Baseline Intervention Follow-up1 Follow-up2 2 percent 1 percent What the WIC vendors have been saying about Low-fat Milk: • Many vendors were confused, believing that 2% is lowfat. Some vendors actually thought 2% was the healthier choice. • Some vendors continued to claim that 1% milk does not sell. • Some vendors reported resistance from some WIC participants who refuse to accept the 1% milk. • Many vendors expressed surprise at the large amount of saturated fat in whole milk, and said they themselves would switch to 1%. Things to Consider with New Food Package The benefit design needs to be easy for WIC participants to understand and simple for vendors to administer. Input from the vendor community on the benefit design is critical to its success. Education at a local level is very important. Through store-based one-on-one trainings, health promoters were able to provide needed knowledge, support and incentives for WIC vendors to stock new foods. Program information and educational materials designed for WIC local agencies participants, and WIC vendors must be effective and easy to understand, in several languages. While we observed some availability of fruits, vegetables, and low-fat milk throughout these initiatives, it remains important to clearly define an acceptable minimum amount of low-fat / non-fat milk to be carried by WIC vendors.