TEXFAN

Texas Food and Nutrition Questionnaire

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Background
This two-phase project centers on 1) the design and development of a Food and Nutrition Questionnaire to obtain information related to WIC foods and participating mothers, infants, and children at WIC clinics throughout Texas, and 2) utilizing the questionnaire responses to assess how the new WIC food packages impact food preferences, purchases and consumption among WIC participants. The questionnaires will be administered at all of the state’s 73 WIC local agencies both before (pre-rollout questionnaire) and after (post-rollout questionnaire) the rollout of the new WIC foods package. The data will then be used to evaluate the impact of the food benefit changes on the food-related behaviors of WIC participants.

Who is participating in the TEXFAN study?
Approximately 4,500 English and 2,300 Spanish questionnaires were sent out to WIC participants in late 2008 early 2009 prior to the new food package rollout on October 1, 2009. Every local agency participated in distributing questionnaires, and almost 90% of the questionnaires were completed and returned.

TEXFAN_participation_map

What were the research focal points for the pre-rollout questionnaire?
The pre-package change questionnaire was completed by WIC participants prior to February 2009, in advance of the new food package rollout on October 1, 2009.  The questionnaire focused on WIC client demographics with relation to preferences, purchasing, feeding and consumption practices, with particular focus on the following areas:TEXFAN_coverpage

  • Fruits and Vegetables
  • Whole Grain Foods
  • Lower Fat Milk
  • Adult Eating Practices
  • Infant Eating Practices
  • Child Eating Practices
  • Cultural Preferences

What revisions were made to the new WIC food package?
WIC foods package revisions were designed to align the WIC food benefit with the Dietary Guidelines for Americans and the American Academy of Pediatrics’ current dietary guidance for feeding infants. The overall goals of the changes were to encourage consumption of fruits and vegetables, emphasize the need for whole grains and to lower saturated fat intake, in addition to promoting the establishment of long-term breastfeeding and adapting the food packages to appeal to diverse populations. Package revisions include:

  • Inclusion of fresh and frozen fruits and vegetables
  • Inclusion of whole grain items such as whole wheat bread, oatmeal, brown rice, and tortillas –(both corn & whole wheat)
  • Increased amounts of food available to exclusively breastfeeding women and their infants
  • Exclusion of whole milk for recipients over 2 years of age
  • Expansion of commercial baby foods available for infants
  • Availability of soy milk and tofu as options to accommodate cultural food preferences

What are we assessing with the post roll-out questionnaire?
The post rollout questionnaire will seek to identify changes or improvements in consumption patterns of WIC clients as a result of the WIC foods package revisions. This questionnaire will again be sent to all local WIC agencies in Texas; participants who completed the pre-rollout questionnaire may or may not receive the post-rollout questionnaire.

Summary
The Texas WIC program developed and implemented a statewide nutrition education campaign to inform participants about the changes in the food benefit program. The TEXFAN project offers the opportunity to examine WIC participants’ consumption of and attitudes about the newly-introduced foods that are available to mothers, infants, and children. The results of the pre-rollout questionnaires will be available during early 2010. A special website has been set up at orin1.tamu.edu to provide local agencies access to the questionnaire responses from their own participants and the state as a whole. The results will be helpful in targeting future nutrition education for WIC clients as well as potential revisions to specific items within the food groups. Post-rollout results will offer the unique opportunity to track the effects of the food benefit changes upon WIC participants’ consumption patterns.

Acknowledgements:
TexasDepartment of State Health Services WIC Program

Researchers:

  • Dr. Peter S. Murano – Principal Investigator
  •  Dr. E. Lisako J. McKyer – Co-Principal Investigator
  •  Dr. Carol Spaulding – Director Program Evaluation
  •  Asha Girimaji, M.S. – Project Coordinator
  •  Dr. Christine Tisone – Assistant Project Coordinator

Student Support:

  • Cassie Diep
  • Reynolette Ettienne-Gittens
  • Dinah Harriger
  • Elizabeth Kaster
  • Yan Li
  • Katrina Serrano
  • Kelly Vaughan

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